BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1526|
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THIRD READING
Bill No: AB 1526
Author: Committee on Aging and Long-Term Care
AmendedIntroduced:9/4/15 in Senate
Vote: 21
SENATE HEALTH COMMITTEE: 8-0, 7/1/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth
NO VOTE RECORDED: Wolk
SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/27/15
AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen
ASSEMBLY FLOOR: 79-0, 6/1/15 - See last page for vote
SUBJECT: Behavioral Risk Factor Surveillance System survey:
caregiver module
SOURCE: Alzheimers Association
DIGEST: This bill 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.
Senate Floor Amendments of 9/4/15 limit the survey to one
Behavioral Risk Factor Surveillance System survey track, and
lower the required number of years in which the survey must be
administered to one.
ANALYSIS:
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Page 2
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 one track of
the annual BRFSS survey by January 1, 2017.
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
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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, In-Home Supportive Services and other public
programs scarce government dollars. This bill calls for a
statewide survey of caregiver burden to help us understand and
support this 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.
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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.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee, annual costs
of $150,000 per year to expand the existing survey to include
the optional caregiving module (General Fund). DPH indicates
that it costs $7,500 per additional question to expand the
existing survey, including the costs to conduct phone interviews
and compile responses.
SUPPORT: (Verified9/4/15)
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Alzheimer's Association (source)
Association of California Caregiver Resource Centers
California Commission on Aging
Justice in Aging
Mental Health America of California
OPPOSITION: (Verified9/4/15)
California Department of Public Health
ARGUMENTS IN 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.
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.
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ARGUMENTS IN OPPOSITION: The California Department of Public
Health states that this bill is unnecessary because other
Modules have been added to BRFSS without a legislative mandate.
DPH also states that funding for additional question is required
from departmental programs, agencies, or stakeholder groups, and
that this bill does not address the costs associated with the
survey, nor does it identify funding.
ASSEMBLY FLOOR: 79-0, 6/1/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray,
Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones,
Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Gipson
Prepared by:Shannon Muir / HEALTH /
9/8/15 15:00:10
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