BILL ANALYSIS Ó SCR 59 Page 1 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 SCR 59 Page 2 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 SCR 59 Page 3 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. SCR 59 Page 4 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. SCR 59 Page 5 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: SCR 59 Page 6 Support None on file. Opposition None on file. Analysis Prepared by:Patty Rodgers / HEALTH / (916) 319-2097