BILL ANALYSIS Ó SB 613 Page 1 SENATE THIRD READING SB 613 (Allen) As Amended July 6, 2015 Majority vote SENATE VOTE: 40-0 ------------------------------------------------------------------ |Committee |Votes|Ayes |Noes | | | | | | | | | | | | | | | | |----------------+-----+----------------------+--------------------| |Health |18-0 |Bonta, Maienschein, | | | | |Bonilla, Burke, Chiu, | | | | |Gomez, Gonzalez, | | | | |Roger Hernández, | | | | |Lackey, McCarty, | | | | |Nazarian, Patterson, | | | | |Ridley-Thomas, | | | | |Rodriguez, Steinorth, | | | | |Thurmond, Waldron, | | | | |Wood | | | | | | | |----------------+-----+----------------------+--------------------| |Aging |7-0 |Brown, Hadley, | | | | |Gipson, Gray, Levine, | | | | |Lopez, Mathis | | | | | | | |----------------+-----+----------------------+--------------------| SB 613 Page 2 |Appropriations |17-0 |Gomez, Bigelow, | | | | |Bloom, Bonta, | | | | |Calderon, Chang, | | | | |Nazarian, Eggman, | | | | |Gallagher, Eduardo | | | | |Garcia, Holden, | | | | |Jones, Quirk, Rendon, | | | | |Wagner, Weber, Wood | | | | | | | | | | | | ------------------------------------------------------------------ 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 (Guidelines) in California to address changes in the health care system and requires DPH to submit a report on the workgroup updates and recommendations to the Legislature on or before March 1, 2017. FISCAL EFFECT: According to the Assembly Appropriations Committee, a negligible fiscal impact, including a total estimated cost to update the Guidelines of $120,000. COMMENTS: 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. 1)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 SB 613 Page 3 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. Estimates vary, but experts suggest that as many as five million Americans age 65 and older may have Alzheimer's disease. 2)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 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 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 SB 613 Page 4 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. 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 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 SB 613 Page 5 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. There is no known opposition on file. Analysis Prepared by: Paula Villescaz / HEALTH / (916) 319-2097 FN: 0001672