BILL ANALYSIS Ó
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Date of Hearing: June 23, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
SCR
59 (Galgiani) - As Introduced May 5, 2015
SENATE VOTE: 38-0
SUBJECT: Chronic obstructive pulmonary disease awareness.
SUMMARY: Declares the month of November 2015 to be California
Chronic Obstructive Pulmonary Disease (COPD) Awareness Month.
Calls on all Californians to assist in achieving more early
diagnoses and proper management of COPD among California's
diverse populations. Encourages the Department of Health Care
Services, the Department of Public Health, and other state
entities to partner with COPD stakeholders to improve education
regarding COPD in the course of implementing the statewide
strategic plan. Specifically, this resolution makes the
following findings and declarations regarding COPD:
1)COPD, also known as chronic bronchitis and emphysema, is the
third leading cause of death in the U. S., claiming the lives
of over 138,000 Americans in 2010;
2)American women are about twice as likely to be diagnosed with
chronic bronchitis as men. In 2011, 3.3 million men (29.6 per
1,000 population) had a diagnosis of chronic bronchitis
compared to 6.8 million women (56.7 per 1,000 population). In
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2011, more than 72,000 women died compared to over 65,000 men;
3)COPD is a chronic and progressive disease that impacts an
estimated 1.6 million residents of California who suffer
directly from the disease;
4)In 2010, the national annual cost for COPD was estimated to be
$49.9 billion, including $29.5 billion in direct health care
expenditures;
5)In 2006, the Office of Statewide Health Planning and
Development reported that hospitalizations associated with
COPD alone amounted to an estimated $1.34 billion in medical
costs within the state;
6)Early diagnosis and management of COPD can effectively reduce
the overall financial burden of this illness on publicly
funded health care programs, including Medi-Cal;
7)Achieving early diagnosis and proper management of COPD among
California's diverse populations, within the Medi-Cal program
as well as other publicly funded health care programs,
requires overcoming cultural, language, and literacy
challenges;
8)Proper management of COPD can lead to an improved quality of
life and self-sufficiency for patients who receive publicly
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funded benefits; and,
9)The California COPD Coalition has developed a comprehensive
plan to address COPD in the state, entitled the "Strategic
Plan to Address COPD in California."
FISCAL EFFECT: This resolution has not been analyzed by a
fiscal committee.
COMMENTS:
1)PURPOSE OF THIS RESOLUTION. According to the author, this
resolution brings awareness to COPD and how we can work
together to improve the quality of life of the individuals who
are diagnosed.
2)BACKGROUND. COPD refers to chronic lung disorders that result
in blocked air flow in the lungs that make it difficult to
breathe. It is a progressive disease that gets worse over
time. The two main COPD disorders are emphysema and chronic
bronchitis. Most people with COPD have a combination of both
conditions. Emphysema occurs when the walls between the
lung's air sacs become weakened and collapse, degenerating and
destroying the air sac walls. Damage from emphysema is
usually permanent and irreversible. With the second major
disorder, chronic bronchitis, the lining of the airways is
irritated and inflamed, causing thick mucus to form in the
airways. Most common symptoms of chronic bronchitis are cough
(with or without mucus), fatigue, respiratory infections,
shortness of breath (that gets worse even with mild activity),
trouble catching one's breath, and considerable wheezing.
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COPD is a major cause of disability, and it's the third leading
cause of death in the U.S. Currently, millions of people are
diagnosed with COPD and many more have the disease and don't
yet know it. COPD has no cure and doctors don't know how to
reverse the damage to airways and lungs. However, treatments
and lifestyle changes can help a person feel better, stay more
active, and slow the progress of the disease.
The cause of COPD is almost always smoking. The more a person
smokes, the greater chance they will develop COPD. There are
many things that can be done to relieve symptoms and slow its
progression. The disease will quickly get worse if a person
does not stop smoking. Smoking accelerates COPD, and also
minimizes the effects of established therapies. Aside from
quitting smoking, the best thing to keep COPD from getting
worse is walking. Even walking a few minutes a day can make a
difference, and then slowly increase the distance. Therapies
that can help COPD symptoms include pulmonary rehabilitation,
which is learning to breathe in a different way in order to
stay active and there is oxygen therapy that can be done at
home for people who have a low level of oxygen. Those
suffering from COPD should avoid very cold air and air
pollution, get rid of fireplace smoke and other irritants, eat
healthy foods, including fish, poultry, or lean meat, as well
as fruits and vegetables. It is very important to maintain a
healthy weight.
Medicines used to treat COPD include inhalers to help open
airways, inhaled or oral steroids to reduce lung inflammation,
and anti-inflammatory drugs to reduce swelling in the airways.
In severe cases or during flare-ups, it is common to use of
steroids by mouth or intravenously, bronchodilators through a
nebulizer, and assistance in breathing through a mask, BiPAP
(Bilevel Positive Airway Pressure) machine, CPAP (continuous
positive airway pressure) machine, and endotracheal tube. In
addition, antibiotics during symptom flare-ups or for
infections are often needed.
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Surgery may be used to treat COPD, including surgery to remove
parts of the diseased lung, which can help less-diseased parts
work better in some patients with emphysema and lung
transplant for very severe cases. With COPD, many people also
have other health problems, such as, irregular heartbeat,
heart swelling and heart failure due to chronic lung disease,
pneumonia, pneumothorax, severe weight loss and malnutrition,
thinning of the bones (osteoporosis), and serious weakening
and loss of energy.
3)STRATEGIC PLAN TO ADDRESS COPD IN CALIFORNIA. The American
Lung Association in California convened the first California
COPD Summit in Los Angeles during the summer of 2008. The
Strategic Plan to Address COPD in California is a product of
that summit and the attendees who represented a diverse array
of stakeholders from all across California who came together
to address COPD. Since then, COPD has moved from fourth to
third place as the leading cause of death in the U.S. The
working groups generated recommendations that were utilized in
the development of the several sections in this Strategic
Plan. The plan represents a five-year timeframe for action.
4)PREVIOUS LEGISLATION. Previous resolutions to raise awareness
on COPD are:
a) SCR 75 (Galgiani), Resolution Chapter 128 , Statutes of
2014;
b) ACR 131 (Galgiani), Resolution Chapter 128 , Statutes of
2011; and,
c) ACR 26 (Galgiani), Resolution Chapter 102 , Statutes of
2011.
REGISTERED SUPPORT / OPPOSITION:
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Support
None on file.
Opposition
None on file.
Analysis Prepared by:Patty Rodgers / HEALTH / (916)
319-2097