BILL ANALYSIS Ó SB 613 Page 1 Date of Hearing: June 30, 2015 ASSEMBLY COMMITTEE ON HEALTH Rob Bonta, Chair SB 613 (Allen) - As Amended April 20, 2015 SENATE VOTE: 40-0 SUBJECT: State Department of Public Health: dementia guidelines: workgroup. SUMMARY: Requires the Department of Public Health (DPH) to convene and appoint the members of a workgroup to update the 2008 Guidelines for Alzheimer's Disease Management in California to address changes in the health care system. Requires DPH to submit a report on the workgroup updates and recommendations to the Legislature on or before March 1, 2017. EXISTING LAW: 1)Establishes DPH, which oversees various public health programs, including programs related to genetic diseases such as Alzheimer's Disease. SB 613 Page 2 2)Requires the California Health and Human Services Agency to establish an Alzheimer's Disease and Related Disorders Advisory Committee consisting of 14 members, and requires the Committee to: a) Provide ongoing advice and assistance to the Administration and the Legislature as to the program needs and priorities of the target population; and, b) Provide planning support to the Administration and the Legislature by updating recommendations of the 1987 California Alzheimer's Disease Task Force Report and regularly reviewing and updating recommendations as needed. 3)Requires DPH to provide public and professional education on Alzheimer's disease to educate consumers, caregivers, and health care providers, and to increase public awareness. FISCAL EFFECT: According to the Senate Appropriations Committee, minor costs to provide support to the workgroup. COMMENTS: 1)PURPOSE OF THIS BILL. According to the author, Alzheimer's disease is a public health crisis in California, but unlike other public health concerns there is no known cause, cure or prevention to reduce the impact on individuals, families, communities, and our state's public programs such as Medi-Cal and In-Home Supportive Services. The author states that there has been a 42% increase in Alzheimer's diagnosis in just the last decade. SB 613 Page 3 The author further states that experts agree managing the course of Alzheimer's disease after a diagnosis is the best public health strategy we have available today. This bill proposes a statewide working group under the leadership of the DPH, drawing on the existing resources and expertise of our state's 10 university-affiliated Alzheimer's Disease Centers. Experts will update the physician Guideline for Alzheimer's Disease Management to systematically improve quality of care, better manage complex patient populations, and lower public costs associated with Medi-Cal-funded hospital stays and nursing home placements. The author concludes that when someone in California learns they have Alzheimer's, there should be evidence-based, up to date, guidelines for physicians to follow to ensure the patients receive the care and support they need. 2)BACKGROUND. a) Alzheimer's disease. California's aging population is growing rapidly and also becoming more racially and culturally diverse. The population of individuals over age 65 will increase by 27% for young retirees (aged 65-74) and 10% for mature retirees (aged 75-84) by the year 2017. Additionally, the number of adults with disabilities in California is expected to grow by approximately 20% in the next 20 years. Alzheimer's disease and other dementias are on the rise and projected to affect an estimated 1.1 million Californians by 2030. According to the federal National Institute on Aging (NIA), Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with Alzheimer's, symptoms first appear after age 65. Plaques and tangles in the brain are two of the main features of Alzheimer's disease. The third is the loss of connections between nerve cells (neurons) in the brain. Although treatment can help manage symptoms in some people, SB 613 Page 4 currently there is no cure for this disease. Estimates vary, but experts suggest that as many as five million Americans age 65 and older may have Alzheimer's disease. Alzheimer's disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning-thinking, remembering, and reasoning-and behavioral abilities, to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. b) 2008 Guidelines for Alzheimer's Disease Management. The "Guideline for Alzheimer's Disease Management - California Workgroup on Guidelines for Alzheimer's Disease Management Final Report 2008" was published to update and expand previous guidelines issued in 2002 and 1998. The 1998 effort was paid for through a Health Resources and Services Administration grant. The guidelines were based upon work begun by the Ad Hoc Standards of Care Committee of the Alzheimer's Disease Diagnostic and Treatment Centers (ADDTCs) of California and were supported in part by the State of California, Department of Health Services, and the Alzheimer's Association, California. Southland Chapter. The California Council of the Alzheimer's Association sponsored the Alzheimer's Disease Education Initiative (ADEI) and secured a one-time $2.4 million budget augmentation in fiscal year 2000-01 to launch a public education campaign centered on the Guidelines for Alzheimer's Disease Management. The funds from the ADEI were used to pay for the 2002 update. The 2008 Guidelines state that most older adults, including those with Alzheimer's Disease, receive their medical care from primary care practitioners (PCPs) who may lack the information and other resources they need to treat this SB 613 Page 5 growing and demanding population. The 2008 Guideline was intended to provide assistance to PCPs in offering comprehensive care to patients with Alzheimer's Disease and those who care for them over the course of their illness. The Guideline's recommendations are organized by major care issues (assessment, treatment, patient and family education and support, and legal considerations). Each section of the guidelines deals with one of the four care issues and provides an overview of the issue, followed by the care recommendations and a review of the literature supporting them. The language used throughout the report reflects the strength of the supporting evidence, either "strong" (e.g., randomized clinical trial) or "moderate." In some instances, recommendations that are not evidence-based are nevertheless supported by expert opinion and workgroup consensus, and are labeled as such. c) Select Committee on Long-term Care and Aging Report. The Select Committee on Aging and Long Term Care's published a 2014 report, "A Shattered System: Reforming Long Term Care in California". i) The Patient Protection and Affordable Care Act (ACA): The ACA presents opportunities to improve long term care (LTC), concurrently creating and strengthening linkages between medical care and supportive services. Critical reforms spelled out in the ACA include the establishment of the Center for Medicare and Medicaid Innovation and the Federal Coordinated Health Care Office (informally known as the "Office of the Duals"). These ACA provisions create the space to test ideas that can lead to improvements in coordination across the multiple payment and delivery systems, including mechanisms to break through regulatory barriers and integrate funding sources and mitigate fragmentation in the current system. Efforts to transform payment and delivery system models also offer the promise to expand beyond a narrow Medi-Cal SB 613 Page 6 scope of practice toward connecting older adults in need of LTC to supportive services in their community. ii) The Coordinated Care Initiative (CCI): California's CCI reflects a new approach to delivering services whereby Medi-Cal managed care entities maintain responsibility for delivering both health and LTC services. This new model of care requires the medical community, supportive service providers, and health plans to change how they do business and develop the skills to deliver person-centered, coordinated services. Through the CCI, the state contracts with Medi-Cal managed care plans to administer an array of services across the medical and LTC systems, with an incentive to avoid institutional care whenever possible. The CCI is being implemented in seven counties, starting with San Mateo, which began on April 1, 2014; other counties include Los Angeles, Orange, Riverside, San Bernardino, San Diego, and Santa Clara. 3)SUPPORT. This bill is sponsored by the Alzheimer's Association to update California's physician Guideline for Alzheimer's Disease Management to improve quality of care and support for individuals diagnosed with dementia, manage complex, costly populations in our health care delivery system, and reduce individual, family, and government health care costs. The Alzheimer's' Association states this bill draws on the existing resources and expertise within DPH's 10 university-affiliated Alzheimer's Disease Centers to review and analyze evidence in support of a state-of-the-art guideline for Alzheimer's disease management. The Alzheimer's Association further states that Medi-Cal beneficiaries with a diagnosis of Alzheimer's disease have 19 times higher costs than those without a cognitive impairment. Likewise, patients with dementia use hospitals and nursing facilities at more than triple the rate without Alzheimer's. The Alzheimer's Association concludes that the development of a physician SB 613 Page 7 Guideline for Alzheimer's Disease Management advances public policy for patients, physicians and government payors. The National Association of Social Workers - California Chapter, and the American Federation of State, County and Municipal Employees, AFL-CIO state in support of the bill that currently over 60,000 people with dementia are enrolled in California's Coordinated Care Initiative. Supporters further state that the Medicaid cost of care for seniors with Alzheimer's disease and other dementias is 19 times higher than the average per person spending for all seniors. Supporters conclude that dementia care management has been proven to improve the affected population's health, provide a better experience of care, and lower per capita health care costs. 4)PREVIOUS LEGISLATION. a) AB 1744 (Brown) of 2014 proposed to require, until January 1, 2018, the California Department of Aging to establish a blue-ribbon task force comprised of at least 13 members, as specified, to make legislative recommendations to improve services for unpaid and family caregivers. AB 1744 was vetoed by the Governor, who stated: "The California State Plan on Aging, the California Plan for Alzheimer's Disease, the significant reports and action plans developed by the 33 Area Agencies on Aging, the Alzheimer's Association, the AARP and so many others have produced ample evidence for knowledgeable and caring people to recommend ways to improve support for family caregivers. Establishing another task force in state law simply isn't necessary." b) SB 491 (Alquist), Chapter 339, Statutes of 2008, SB 613 Page 8 established California's State Plan for Alzheimer's Disease under the CA Health and Human Services Agency. The State Plan called for an update to the 2008 physician Guideline and made physician education a top priority for California. 5)DOUBLE REFERRAL. This bill is double referred; upon passage in this Committee, this bill will be referred to the Assembly Committee on Aging and Long-Term Care. REGISTERED SUPPORT / OPPOSITION: Support Alzheimer's Association (sponsor) American Federation of State, County and Municipal Employees, AFL-CIO California Commission on Aging Leading Age California SB 613 Page 9 Opposition None on file. Analysis Prepared by:Paula Villescaz / HEALTH / (916) 319-2097