BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2253
                                                                  Page  1

          Date of Hearing:   April 21, 2010 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                 AB 2253 (Coto) - As Introduced:  February 18, 2010 

          Policy Committee:                              Insurance  
          Vote:11-1

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill eliminates a five-year cap on a workers' compensation  
          cancer presumption for public safety professionals (e.g.: fire  
          firefighters, police officers, highway patrol) and quadruples  
          the rate at which professionals accrue the presumption. This  
          bill applies to tens of thousands of public safety professionals  
          statewide. Specifically, this bill:
           
          1)Changes the five-year cap to a 15-year cap imposed following  
            termination of employment, on a workers' compensation cancer  
            presumption. 

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

          3)The cancer presumption extensions offered in this bill means  
            tens of thousands of state and local firefighting and law  
            enforcement employees who may be diagnosed with, or die of,  
            cancer-related causes receive the following benefits:

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

           FISCAL EFFECT  

          1)Major out-year on-going costs to state and local government of  
            billions of dollars. For state employees such as the  
            California Highway Patrol, the California Department of  
            Forestry and Fire Protection, the University of California,  






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            and a variety of peace officers, costs created by this bill  
            are 100% GF. More than 20,000 state-funded law enforcement and  
            firefighting personnel could eventually be made eligible for  
            the cancer presumption contained in this bill. GF costs will  
            likely exceed $200 million GF. 

          2)The cost of benefits that will accrue to individuals under  
            this cancer presumption range from several thousands of  
            dollars to hundreds of thousands  per claim  . These costs  
            reflect less serious conditions as well as major treatment,  
            indemnity benefits, and payments to eligible spouses and  
            dependents upon death of an eligible individual. 

          3)While public safety professionals routinely put their lives at  
            risk in the course of their work, most research does not  
            support a strong association between cancer and workplace  
            exposures. For example, recent statistical and epidemiological  
            analysis by the RAND Institute found no statistically  
            significant risk of cancer for police and fire fighters. In  
            other words, the cancer risk was found to be similar to the  
            general population. 

          4)Cancer is a leading cause of death for all individuals,  
            regardless of profession, 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. 

           COMMENTS  

           1)Rationale  . This bill is sponsored by the California  
            Professional Firefighters (CPF) to extend a workers'  
            compensation cancer presumption for tens of thousands  
            professionals statewide. CPF represents more than 30,000  
            firefighters. 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 five-year cap after  
            retirement and are 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  






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            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 oppose this bill.  
            According to opponents, public entities that employ safety  
            officers already face a nearly impossible burden in attempting  
            to defend presumption claims. Cities and counties statewide  
            are struggling with budget deficits.  In addition, the  
            opposition is alarmed at the fiscal burden this bill creates  
            by lifting the five-year presumption cap. 

           5)Related Legislation  . AB 128 (Coto) in 2009 was similar to this  
            bill but established a lifetime cancer presumption, rather  
            than a presumption limited to fifteen years. AB 128 was held  
            on the Suspense File of this committee. 
           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081