Call to Order and Roll Call
The 5th meeting of the Interim Joint Committee on Labor and Industry was held on Thursday, November 21, 2013, at 10:00 AM, in Room 131 of the Capitol Annex. Representative Rick G. Nelson, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Representative Rick G. Nelson, Co-Chair; Senators Julian M. Carroll, Perry B. Clark, Carroll Gibson, Denise Harper Angel, Ernie Harris, Jimmy Higdon, Dennis Parrett, and Mike Wilson; Representatives Lynn Bechler, Regina Bunch, Denver Butler, Will Coursey, Jeffery Donohue, C.B. Embry Jr., Richard Henderson, Toby Herald, Dennis Horlander, Joni L. Jenkins, Thomas Kerr, Adam Koenig, Mary Lou Marzian, Charles Miller, Terry Mills, Tanya Pullin, Tom Riner, Jim Stewart III, and Brent Yonts.
Guests: Chris Bartley, Captain, Lexington Fire Department, Legislative Agent, Kentucky Professional Firefighters Association; Joe Baer, President, Kentucky Professional Firefighters Association; Dr. Virginia Weaver, Physician, Associate Professor of Occupational Medicine, Johns Hopkins University Bloomberg School of Public Health; Dwight Lovan, Commissioner, Department of Workers’ Claims; Lucretia Johnson, Director, Department of Workers’ Claims; Pam Knight, Supervisor, Department of Workers’ Claims; Larry Roberts, Secretary, Kentucky Labor Cabinet; Thomas Zawacki, Secretary, Education and Workforce Development Cabinet; Charles McGrew, PhD., Executive Director, Kentucky Center for Education and Workforce Statistics; J.D. Chaney, General Counsel, Kentucky League of Cities.
LRC Staff: Carla Montgomery, Matt Ross, Adanna Hydes, and Betsy Nickens.
The minutes of the Interim Joint Committee on Labor and Industry for October were approved by voice vote.
BR 140 - AN ACT relating to Firefighters.
Mr. Chris Bartley, Dr. Virginia Weaver, and Mr. Joe Baer spoke in favor of BR 140, AN ACT relating to firefighters. Mr. Baer reminded the committee of previous legislation in 2012 regarding the presumption of cancer in firefighters. Evidence has shown that certain cancers are more prevalent in firefighters due to the hazards of the occupation. Dr. Virginia Weaver spoke on behalf of the International Association of Firefighters and the Kentucky Professional Firefighters Association. Dr. Weaver stated her testimony was her own and did not necessarily reflect the views of Johns Hopkins University. Firefighters, in their occupation, are exposed to dangerous chemicals despite efforts over the past two decades to dramatically decrease hazardous occupational exposure in the U.S. workforce. Numerous studies have documented cancer causing chemicals within the smoke that firefighters are exposed to. For example, there are highly probable carcinogens in wood, coal, and diesel fuel smoke. The International Agency for Research on Cancer (IARC), categorizes chemicals according to the potential for causing cancer in humans. Among those categorized by IARC as known carcinogens, firefighters are exposed to asbestos, benzene, formaldehyde, soot, and diesel exhaust. Dr. Weaver stated that a Harvard study of 200 structural fires and resulting air contaminants showed the cancer-causing chemical benzene was detected in 92 percent of the fires. Further adding to the risk of exposure, firefighters are equipped with protective equipment which does not completely block carcinogens. Advancements in occupational safety have greatly decreased exposure risk in other occupations; however, it is nearly impossible to protect firefighters in the highly uncontrolled situations their occupation puts them in.
Dr. Weaver explained that 32 separate studies of 20 different cancers were summarized in a single meta-analysis, compiling the significance of the risk for firefighters. A significant increased risk was determined for 10 types of cancer and a smaller increase for the other 10 types. The National Institutive for Occupational Safety and Health conducted a study of firefighters from three major U.S. cities in comparison with the general U.S. population and found an increased overall risk for all types of cancer and increased individual risk in cancers of the digestive and respiratory tracts for firefighters.
Dr. Weaver explained the challenges posed in assessing the significance of risk. First, misclassification can occur. When death certificates are used to classify the occupation of the deceased, a firefighter may be misclassified if he/she was employed in another occupation at time of death. Second, the strength and overall health of a firefighter may pose what is called the “healthy worker effect,” firefighters may not appear to be at high risk for developing cancer. Third, firefighters make up a very small occupational group for studies. In conclusion to her testimony, Dr. Weaver said that 36 states have enacted legislation regarding presumption of cancer in firefighters.
Mr. Bartley explained BR 140. The types of cancer covered in BR 140 are brain, bladder, colon, prostate, kidney, liver, testicular, non-Hodgkin’s, and lymphatic or hematopoietic system. Coverage would include career firefighters who have been working for five years or more and would only remain eligible five years after leaving their career. The use of tobacco products during a five year period after diagnosis would negate coverage. In terms of cost analysis, there are approximately 3,500 career firefighters in Kentucky. According to analysis completed in 2012, costs would be negligible since the premium paid for firefighters is .3 percent of the total premium paid for the state. Mr. Bartley presented statistics from several states that have enacted legislation, noting that the small workforce has meant a very small number of claims and very low costs.
In response to questions from Representative Henderson, Mr. Bartley stated there are 17,000 volunteer firefighters in Kentucky. BR 140 would not provide coverage to them due to costs, but it would provide coverage to 3,500 paid career firefighters.
Dr. Weaver responded to a question from Representative Belcher regarding the stipulation of five year periods in the bill. Dr. Weaver said that five years is the traditional policy for research studies and provides for a latency period for most cancers. Representative Yonts said that if a firefighter leaves work for a short period of time for military duty and returned to work there, the bill provides no provisions. Mr. Bartley will look into state comparisons.
J.D. Chaney explained how the Kentucky League of Cities (KLC) would participate in refiguring BR 140. KLC will conduct an independent actuarial evaluation of the cost of the legislation and what impact it could have on workers’ compensation premiums. The results will be presented to the board of directors to consider the effects of the bill.
Medical Fee Schedule
Commissioner Lovan discussed KRS 342.035(1), which requires the Department of Workers’ Claims to periodically assess the physicians’ medical fee schedule by July 1 occurring every two years beginning in 1994. Three fee schedules are in operation, the physicians’ fee schedule, hospital fee schedule, and pharmacy fee schedule. Commissioner Lovan stated that in the 2012 service year, 63 percent of every dollar in workers’ compensation was attributed to medical costs, which are distributed among the categories of physicians, hospital outpatient, hospital inpatient, ambulatory surgical centers, drugs, durable medical equipment, supplies, implants, and other. Further, the category of physicians is broken down to include several separate categories. In Commissioner Lovan's presentation, the data for Kentucky was compared to the region and countrywide.
The physician fee schedule must go through an extensive process for evaluation, including a stakeholder’s meeting and a public hearing, and many revisions. In 2013, the objective revisions to the physicians’ fee schedule include adding dental services, expanding durable medical equipment codes as well as vision and hearing codes, and enhancing ambulance fee access. Commissioner Lovan’s presentation included a spreadsheet examining the changes in the fee schedule comparing 2010 to 2013. A list of the top 100 CPT codes from the National Council on Compensation Insurance is available to committee members. Commissioner Lovan anticipates amendments to the administrative regulation to be filed in early 2014.
Apprenticeship Programs
Secretary Roberts spoke about changes to be made to KRS 343.010 on apprenticeship and training during the 2014 General Assembly. During the 2013 Regular Session, HB 152 was proposed to address changes to conform to federal regulations, but was not enacted. Secretary Roberts also addressed the committee on the progress of the TRACK program, a partnership between the Labor Cabinet and Office of Career and Technical Education. Seven technology centers in the state have partnered with industry and business to produce eleven apprenticeship programs, which identify qualifying high school students for co-op opportunities, leading to education credit, and ultimately to certified skilled positions within the workforce. Twelve students were participating at the time of the meeting, the program expects to double in the spring of 2014, and possibly reach 20 areas statewide in the fall of 2014, reaching some 250 students in 25-30 apprenticeship programs.
In response to Senator Wilson, Secretary Roberts said a listing of the seven participating technology centers and the counties included in the expansion efforts would be made available to the committee. Senator Higdon expressed concern for some negative industry response regarding allowing workers under the age of 18 onto the worksite. Secretary Roberts said that it is permissible and efforts are being made to inform partners of the regulations and rules regarding underage workers in the workplace.
In response to Representative Yonts and Senator Carroll, Secretary Roberts agreed that outreach to students in high school is key to directing employable people into skill-based programs, which would lead to filling open jobs within the technical and skill-based workforce.
Kentucky Center for Education and Workforce Statistics
Secretary Zawacki explained that the Kentucky Center for Education and Workforce Statistics (KCEWS) was created by Executive Order in 2012 and enacted in 2013 in order to determine if the initiatives put forth by the Education and Workforce Development Cabinet are effective and what impact it has on the commonwealth. Dr. McGrew said in the past year, the center has expanded upon kindergarten through twelfth grade statistical data to include data regarding Kentucky’s workforce at large. Information is linked together in a confidential program called the Kentucky Longitudinal Data System. KCEWS is charged with evaluating education and workforce programs statewide, developing state level metrics, and monitoring privacy, confidentiality, and data quality. Dr. McGrew emphasized the importance of providing information to policy makers, the legislature.
KCEWS provided members with area-specific data, highlighting high school graduates who continued to college. Rather than reports of simple high school ACT scores, the center produces data that reflects the percentage of high school students that actually go to college and whether they succeed there. In the near future, data will expand to cover areas such as Head Start, unemployment claims, proprietary colleges, children and family services, apprenticeships, out-of-state military employment, and career and technical education. KCEWS is funded in the state budget and by a federal grant.
Dr. McGrew presented a series of examples in his presentation of statistical reports made available by the center including the percentage of public high school graduates ready for college level English, math, and reading broken down by county, as well as a detailed high school feedback report for each district examining college going and college success. Detailed informational reports regarding employment, education, and earnings are available. Dr. McGrew stated that nearly 90 percent of Kentucky’s employed population is included in the KCEWS data system.
In response to Representative Horlander, Dr. McGrew said an update to information provided in the committee members’ folders would be provided in January as new information is linked to previous graduation years.
Representative Yonts asked how information from KCEWS is being shared with schools statewide. Dr. McGrew said that press coverage as well as connections with school board associations, superintendents associations, the Kentucky Department of Education has helped to get the word out. He emphasized training and understanding how to use the information will be important to making the reports useful to the public. Secretary Zawacki referred to a comment made by Representative Yonts earlier in the meeting, stating how important the statistical information may be to parents and teachers who will be guiding students into the workforce. Representative Yonts asked if Kentucky’s wages are lower than other states. Dr. McGrew replied that according to census data and labor statistics that Kentucky wages are lower across the board.
Dr. McGrew said that all public reports are available at www.kcews.ky.gov.
There being no further business the meeting adjourned.