BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1526
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|AUTHOR: |Committee on Aging and Long-Term Care |
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|VERSION: |March 16, 2015 |
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|HEARING DATE: |July 1, 2015 | | |
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|CONSULTANT: |Shannon Muir |
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SUBJECT : Behavioral Risk Factor Surveillance System survey:
caregiver module.
SUMMARY : Requires the Department of Public Health to include the
federal Centers for Disease Control and Prevention's Caregiver
Module in the annual Behavioral Risk Factor Surveillance System
survey for five years, beginning on January 1, 2016, unless
another act extends before that time.
Existing law:
1)Establishes, under state law, the Department of Public Health
(DPH) to produce and disseminate data to inform and evaluate
public health status, strategies and programs.
2)Authorizes, under federal law, the Centers for Disease Control
and Prevention (CDC) to determine behaviors that place the
nation at risk for threats to public health, and conduct state
surveys to assess factors affecting the nation's public
health, such as the Behavioral Risk Factor Surveillance System
(BRFSS) survey.
This bill:
1)States legislative intent that informal caregivers in
California contribute billions of dollars' worth of unpaid
care to people with disabilities and chronic conditions, and
that public health staff seek to know how many caregivers
there are, the types of care they provide, and a the amount of
care they give in an effort to understand caregivers' needs,
which will allow decision makers to support caregivers and
recipients.
2)Requires DPH to include CDC's Caregiver Module in the annual
AB 1526 (Committee on Aging and Long-Term Care) Page 2 of ?
BRFSS survey beginning January 1, 2016, and until January 1,
2021.
FISCAL
EFFECT : According to the Assembly Appropriations Committee,
General Fund costs to DPH of $150,000 General Fund per year for
five years, assuming costs stay the same over the five year
period. At the current time, the cost for inclusion in the 2015
BRFSS survey is $7,500 per question, and the module contains ten
questions. Over one calendar year, there are two survey tracks
that are administered, bringing the annual cost per question to
$15,000.
PRIOR
VOTES :
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|Assembly Floor: |79 - 0 |
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|Assembly Appropriations Committee: |17 - 0 |
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|Assembly Aging and Long Term Care |6 - 0 |
|Committee: | |
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COMMENTS :
1)Author's statement. According to the author, an important point
that bears repeating over and over again is that 1,000 people in
California turn 65 each day for the next 14 years. This reality
will transform our state, resulting in a diverse and vibrant
population where one-in-five people are 65 or older.
Corresponding with change will be an increase in the number of
disabilities, and the corresponding reliance upon others for
support and care. Family caregivers know first-hand the
financial, emotional and physical demands associated with placing
one's life aside in order to care for loved one. Today, more than
one-in-six American workers cares for an elderly or disabled
family member. These extraordinary individuals sacrifice their
own health, their emotional well-being, and in many cases, their
financial security to fill the gaps in our fragile system of
long-term services and supports. Combined, caregivers contribute
$450 billion in economic value to our nation's economy and they
save Medicare, Medi-Cal, IHSS and other public programs scarce
government dollars. This bill calls for a statewide survey of
caregiver burden to help us understand and support this
AB 1526 (Committee on Aging and Long-Term Care) Page 3 of ?
population, as their contributions are vital in their homes,
communities and to society.
2)Caregiving. According to the Family Caregiving Alliance,
informal caregiving is any help provided to an older,
chronically ill, or disabled family member, neighbor, or
friend. Caregiving can include buying groceries, cooking,
cleaning, driving someone to the doctor, or helping someone
get dressed, take a shower, or take medication. A 2013 study
by the Pew Research Center states that 39% of adults in the
U.S. are caregivers, and a report by MetLife states that 10
million caregivers over 50 who care for their parents lose an
estimated $3 trillion in lost wages, pensions, retirement
funds and benefits. The AARP states that researchers have long
known that caregiving can have deleterious mental health
effects and serious health consequences for caregivers, with
17% of caregivers feeling their health has become generally
worse as a result of their caregiving responsibilities.
3)BRFSS. According to DPH, BRFSS is a national ongoing
telephone survey whereby participating states and U.S.
territories utilize a standardized survey research
methodology. BRFSS surveys randomly selected adults to
collect information on a wide variety of health-related
behaviors such as obesity, immunization, AIDS, tobacco use,
access to care, diabetes, physical activity, diet, cancer
screening, and emerging health issues that have significant
impacts on society, such as asthma and the flu vaccine. DPH,
in collaboration with CDC, has conducted BRFSS since 1984.
BRFSS is the main source of data in California for monitoring
at least half of the leading health indicators established by
the Healthy People 2020 Objectives. Many programs within DPH,
local health departments, the American Cancer Society,
universities, and other nonprofit organizations use the data
collected by BRFSS. BRFSS allows for trend analysis and
direct comparison to the nation and other states. Data are not
only used for research, but also for planning of programs,
program evaluation, and resource allocation.
AB 1526 (Committee on Aging and Long-Term Care) Page 4 of ?
4)BRFSS structure. The BRFSS questionnaire is divided into
three parts: the core component; optional modules; and,
state-added questions. The core component includes queries
about current health-related perceptions, conditions, and
behaviors such as health status, health care access, alcohol
consumption, tobacco use, disability, and HIV/AIDS risks, as
well as demographic questions. The optional modules contain
sets of questions on topics such as excess sun exposure,
cancer survivorship, mental illness, and stigma. States can
also add their own questions outside of the optional CDC
modules. According to CPD, there are currently 12 programs
within DPH participating in BRFSS, adding a total of 131
questions to the survey. In 2014, nine programs participated,
adding 141 questions to the survey. DPH programs that have
consistently participated on an annual basis include, but are
not limited to: Nutrition Education Obesity and Prevention
Branch, California Tobacco Control Branch, Chronic Disease
Control Branch Diabetes Program, Immunization Branch,
Childhood Lead Poisoning Prevention Branch, Chronic Disease
Surveillance and Research Branch's Comprehensive Cancer
Control Program, Environmental Health Investigations Branch,
and the Office of Health Equity.
5)Optional caregiver module. The BRFSS Caregiver Module
contains nine questions regarding caregiving, including the
caregiver's relationship to the recipient, the amount of time
care has been provided, the number of hours per week the
caregiver provides assistance, that nature of the care, the
condition from which the recipient suffers, and support
services needed by the caregiver.
6)Support. The Alzheimer's Association, the sponsor of this
bill, states that an efficient and effective infrastructure to
support caregivers requires high-level, evidence-based data
such as the BRFSS. As California's population ages and
demographics shift, the pool of available family caregivers is
diminishing, and will significantly impact public health
programs such as Medi-Cal and other state and federally funded
health, education and human services. The sponsor also states
that greater data on the scope of caregiving within California
will help the state better prepare support systems for
caregivers in the future.
AB 1526 (Committee on Aging and Long-Term Care) Page 5 of ?
A coalition of supporters including the Association of
California Caregiver Resource Centers, Mental Health America,
and Justice in Aging state that California's health and human
service programs benefit from unpaid, informal caregivers who
provide direct services to family members and friends who need
assistance with activities of daily living. They assert that
California's economy relies on informal caregivers to share
the cost of health and human service programs, yet there is no
formal mechanism to effectively evaluate the impact of
caregiving statewide. Inclusion of the Caregiver Module within
the 2016 BRFSS survey will help collect reliable data for
future use by the Legislature and stakeholders on this
important population.
SUPPORT AND OPPOSITION :
Support: Alzheimer's Association (sponsor)
Association of California Caregiver Resource Centers
California Commission on Aging
Justice in Aging
Mental Health America of California
Oppose: None received.
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