Background: In the case of certain firefighters, there is a prima facie presumption that the certain diseases are occupational diseases under certain circumstances for workers' compensation, including cancer. This presumption of occupational disease may be rebutted by a preponderance of evidence. This evidence may include, but is not limited to, use of tobacco products, physical fitness and weight, lifestyle, hereditary factors, and exposure from other employment or nonemployment activities. The presumption is extended to an applicable member following termination of service for a period of three calendar months for each year of requisite service, but may not extend more than 60 months following the last date of employment.

The cancer presumption only applies to any active or former firefighter who has cancer that develops or manifests itself after the firefighter has served at least ten years and who was given a qualifying medical examination upon becoming a firefighter that showed no evidence of cancer. The presumption only apply to these types of cancers:

prostate cancer diagnosed prior to the age of fifty;
primary brain cancer;
malignant melanoma;
leukemia;
non-Hodgkin's lymphoma;
bladder cancer;
ureter cancer;
colorectal cancer;
multiple myeloma;
testicular cancer; and
kidney cancer.

Generally, the presumption does not apply to a firefighter who develops a heart or lung condition and who is a regular user of tobacco products or who has a history of tobacco use. The Department of Labor and Industries (L&I), using existing medical research, is required to, and has defined in rule, the extent of the tobacco use exclusion.

Summary of Bill: L&I must adopt by rule, the healthy in, healthy out best practices for reducing firefighter risk of exposure to carcinogens, which was a project funded through L&I's safety and health investment project. These best practices must include postfire activities to reduce the risk of exposure to carcinogens, such as decontamination, cleaning, and disinfecting. L&I may update the best practices.

Employers with workers involved in firefighting who follow the best practices may be eligible for a premium discount as determined by L&I after an actuarial determination of anticipated future reductions in firefighter risk of exposure to carcinogens.

L&I is appropriated $100,000 for the purposes of providing funding to employers with workers involved in firefighting who have limited resources to purchase additional equipment and other gear that may be needed to follow the best practices.

Staff Summary of Public Testimony: PRO: This is a bill that first came to mind last year as we struggle with the bills related to presumptions. These were important bills but the work is not done. It led to conversations about the risks to firefighters. The first principle when dealing with the challenges associated with safety is that the best solution is always prevention.

In 2013, the Legislature worked on the logger safety initiative. There was a very proactive approach to encourage safety upfront and establish best practices. Those who enroll and engage in work to be safer will have some reward. This bill applies the same practice to fire service. We found the healthy in and healthy out, which was funded by a SHIP grant a few years ago. This program does a great job of laying out best practices for reduction of risk to firefighters.

The bill provides that if you adopt best practices to reduce exposure to contamination and then long term disease, you are going to be safer and then L&I can look at reducing the cost of your premiums in the future based on an actuarial rate. This will keep firefighters safe and drive down costs for both cities and fire districts.

The best practices provides for how to decontaminate and removing the gear to make sure that debris is not inhaled and spread. Some of our departments are financially able and doing a great job. Some may not be using best practices because of the department's culture or because of lack of funding.

The issue of presumptive disease in worker's comp is extremely contentious. Cities have consistently been supportive of proactive measures. The best practices are outstanding. A lot of cities are already doing a lot of that work but somewhat ad hoc. If L&I does some of this work, it can be applied in a much more general widespread way. The provision related to additional resources for smaller cities or departments is that an outstanding step forward.

L&I is in support of the concept that the only good injury or occupational disease is one that is avoided. There are some technical suggestions. The return on investment could be more quickly seen and recognized through the premium reduction if preventing injuries is added. Firefighters are not just called out to fires. We are seeing injuries in lifting patients. Where we can identify the most common injuries and then create incentives for departments to adopt best practices to address those injuries, we would see those premium reductions because injuries would be avoided. There are questions of how to provide incentives for the self-insured employers who do not pay premiums.

OTHER: We support it with some concerns. This bill is important. We have to put some investment in prevention. There are some concerns on how this would impact volunteer firefighters. The concerns are very fixable.