Legislature(2021 - 2022)ADAMS 519
03/15/2022 09:00 AM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB306 | |
| HB308 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 306 | TELECONFERENCED | |
| + | HB 308 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE BILL NO. 308
"An Act relating to dementia awareness."
10:35:04 AM
Co-Chair Merrick indicated Representative Stutes's staff
was available to introduce HB 308.
FATE PUTMAN, STAFF, REPRESENTATIVE LOUISE STUTES,
introduced the bill. The purpose of the bill was to draw
awareness to dementia and Alzheimer's. He explained the
bill was designed to create a public awareness campaign to
educate Alaskans about the issue of Alzheimer's. He relayed
there were currently no known cures for Alzheimer's or the
dementia diseases; however, education and early detection
could help to manage the disease and avoid medical
intervention including long-term institutionalization or
hospitalization. He detailed that fewer than half of
Americans living with Alzheimer's disease receive a
diagnosis. Additionally, due to Alaska's lack of public
health infrastructure for dementia, a lower rate of
Alaskans with dementia received a formal diagnosis. The
bill was intended to improve the rate of diagnosis for
dementia through the production and dissemination of
educational material to the public.
Mr. Putman relayed that Alzheimer's was one of the ten most
common types of dementia. He reported there were about
12,500 people experiencing dementia in Alaska and about
8,500 of the total were Alzheimer's patients. He stated
Alaska needed to be prepared for the coming years of the
"Alzheimer's tsunami" and delay the onset of dementia to
help reduce the disease impacts on patients, families, and
the healthcare system. The sponsor's office was working
with the Department of Health and Social Services (DHSS) on
the legislation to represent the interest of those
suffering from Alzheimer's and dementia. He highlighted
intent to change the legislation to ensure it complied with
an expanded intent to look at the workforce as well as the
problem. He noted there would be a fiscal note coming from
DHSS. Additionally, there was a new committee substitute
(CS). He noted there were individuals online to answer
questions.
10:37:38 AM
Representative Rasmussen asked about the 12,500 cases of
dementia including 8,500 cases of Alzheimer's in Alaska.
She asked if the number reflected known cases. She thought
the number was probably low.
Mr. Putman replied that the problem with Alzheimer's is
that people with the disease may not realize they have it.
The number reflected the current diagnosed cases in Alaska.
Vice-Chair Ortiz MOVED to ADOPT the proposed committee
substitute for HB 308, Work Draft 32-LS1397\I (Foote,
3/14/22).
Co-Chair Merrick OBJECTED for discussion.
Mr. Putman explained the changes in the CS. The CS added
the words "and healthcare capacity" to the bill title. He
explained the bill would look at the healthcare capacity
for Alzheimer's and dementia patients in the state. There
was a statutory reference to include the words "and
healthcare capacity." Additionally, the word "program" had
been removed and replaced with the word "campaign." In the
body of the statute, the words "develop, implement" would
be replaced with the word "build." After the word
"dementia" the word "public" had been inserted. The
reference to the [federal] BOLD Act was removed because the
funds could be accessed without being referenced in
statute. Sections 1 through 6 were removed and replaced
with new language. Section 7 had been added to require a
biannual report to the legislature about the barriers and
problems with dementia preparation. He relayed an eight-
year sunset had been added, which would enable the
legislature to opt not to renew the program if it was
deemed unnecessary. Additionally, the CS included an
immediate effective date.
Co-Chair Merrick noted that Mr. Putman had been working
with stakeholders, which had resulted in some of the
changes. She WITHDREW her OBJECTION to the adoption of the
CS.
There being NO further OBJECTION, Work Draft 32-LS1397\I
was ADOPTED.
Representative LeBon asked if there was an opportunity for
federal funding in the future.
Mr. Putman replied affirmatively. He highlighted the
federal Building Our Largest Dementia and Alzheimer's
(BOLD) Act and relayed that $15 million had been
appropriated from Congress in 2021 for informational
educational purposes related to Alzheimer's awareness.
There were two levels of funding including a $350,000 grant
and a $500,000 grant depending on the level of activity of
the applying agencies.
10:41:03 AM
Representative LeBon asked if the state's funding level
enabled leveraging of the federal dollars. He asked if the
federal dollars required a level of state support. He asked
if there was a relationship the state could take advantage
of with state dollars.
Mr. Putman replied affirmatively. There was a level of
funding required from the state in order to apply for the
federal funds. Additionally, a program needed to be up and
running in order for the federal government to decide
whether the level of funding would be $350,000 or $500,000.
Co-Chair Merrick asked to hear from invited testimony.
PAMELA KELLEY, EXECUTIVE DIRECTOR, ALZHEIMER'S RESOURCE OF
ALASKA, ANCHORAGE (via teleconference), relayed that
Alzheimer's Resource of Alaska was the largest dementia
services organization operating in Alaska with offices in
Fairbanks, Juneau, Mat-Su, and Anchorage. She was also the
chair of the Alaska Dementia Action Collaborative, a
workgroup comprised of more than 35 stakeholders including
public, private, tribal, and nonprofit entities. She shared
that the organization had assisted tens of thousands of
Alaskans impacted by dementia over the past 38 years. She
elaborated that individuals came to the organization after
they or a family member had begun to experience memory
problems or another symptom of concern. She explained at
that point it was typically too late for prevention
activities. The organization worked with individuals to
help slow the rate of cognitive decline and to help them
plan and adapt for the future.
Ms. Kelley was certain the state should be building greater
awareness about the disease and brain health to reach those
whose risks could be reduced well before the worrying
symptoms appeared. The work was needed in order to reduce
the grim forecasted numbers. She referenced the 12,500
individuals currently diagnosed with dementia in Alaska.
She reported that by 2030 the number was projected to be
23,000. She emphasized that paying attention to a person's
modifiable risk factors in her 30s, 40s, or 50s could have
an impact; however, in reality, most individuals were not
aware of dementia during those years.
Ms. Kelley did not want to give the indication there was no
public awareness work being done in Alaska. She relayed
there was work being done, but at what she called the
retail level including health fairs, community events, VFW
halls, and through speaking engagements. The bill would a
population level campaign over time, allowing dementia
awareness to be taken wholesale. She communicated that
messages about early lifestyle choices and the value of
early detection were needed to reduce risk. The messages
needed to be provided in many languages to reach those with
the greatest risk. She supported the bill because she
wanted to see Alaska develop better data around the extent
of dementia in the state. She noted the state's prevalence
rates were only estimates. She knew the Division of Public
Health had the experience to operate a dementia campaign
with impact and she knew there were federal dollars
available to help achieve the effort. She thanked the
committee.
10:45:33 AM
NONA SAFRA, MEMBER, ALASKA COMMISSION ON AGING, HOMER (via
teleconference), she shared information on her work and
shared she was a caregiver of a person with Alzheimer's.
She read from prepared remarks:
You have all of the data on Alzheimer's as a public
health crisis that's devastating to Alaska. Our
workforce and our state budget will be impacted by the
sheer number of Alaskans who will be diagnosed with
dementia in the next decade. So, Alaska needs to
address this crisis now. The fiscal note covers one
position, which can facilitate federal receipt
authority to meet the crisis.
So, not passing HB 308 is a missed opportunity for
every Alaskan family affected by dementia. This
funding gives Alaska better access to focus on issues
like increased early detection and diagnosis, risk
reduction, prevention, and supporting dementia
caregiving.
The Alzheimer's Impact Movement shows Medicaid cost of
the disease in Alaska is at $76 million in 2020, with
$110 million projected in 2025, which is a 44.6
percent increase and that doesn't take into account
the latest research published this month in Nature
that brain changes due to COVID statistically show a
cognitive decline in the population, which adds to our
need to have [?] awareness.
I speak because my odds for dementia are increased due
to a brain injury as well as I am a caregiver and I
speak for Alaskans who don't know their increased odds
of getting dementia and that they can do things now to
change that. I'm also a member of the Brain Injury
Taskforce so I'm dealing with people with brain
injury. They need HB 308 passed to learn how to avoid
or delay the onset and for all the caregivers who need
support. So, Alaskans are depending on you, our
representatives, to do that. I urge the committee to
support HB 308.
Ms. Safra noted she was currently in Nome for the finish of
the Iditarod. She had been talking with people during her
visit and was amazed by the number of families impacted by
dementia. She thanked the committee for its time.
10:48:21 AM
Co-Chair Merrick asked the Department of Health and Social
Services to review the fiscal note.
KAROL FINK, SECTION CHIEF, DIVISION OF PUBLIC HEALTH,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES (via
teleconference), relayed that the CS had changed
significantly from the original bill and would change the
fiscal note. The amount in the current fiscal note was
based on the most basic foundational aspects of creating
and implementing a new evidence-based education campaign.
She noted that the amount could be scaled. She explained
the baseline amount could be reduced if there was
additional funding or the state was able to secure the
federal grant in the future. She explained the amount shown
on the current fiscal note was the minimum required.
Representative Carpenter saw the same costs in the out
years shown on the note. He asked what scalable meant.
Ms. Fink answered that scalable pertained to the reach and
frequency of how the messages met individuals. She
explained that a smaller budget would mean reaching fewer
people with less frequency.
Representative Carpenter stated his understanding of the
statement. He asked if Ms. Fink meant that if the
legislature funded under $777,000, the program would be
scaled down.
Ms. Fink agreed.
10:50:37 AM
Representative LeBon referenced the sunset date of July 1,
2030. He asked if it was because the sponsor hoped to
utilize federal participation and the sunset date would be
extended if federal funds were received. Alternatively, he
wondered if the sunset would occur if the state did not
receive federal funding.
Mr. Putman answered it was the latter scenario provided by
Representative LeBon. He explained the bill was designed to
have funding for eight years through undesignated general
funds (UGF) if necessary. He noted that the grant could be
a one-time grant. He elaborated that if no new federal
funds came forward, the eight-year sunset date was designed
so the legislature could end the program if there was no
funding or if it determined the program was no longer
needed.
Representative Carpenter asked who would be doing the
education of the court system, law enforcement, fire
fighters, and other.
Mr. Putman answered the initial intent was to have DHSS
provide the education. The CS took some of the specific
language out, but the intent remained to have the
department educate first responders, firefighters, and
others about what they were experiencing in dementia
situations.
Representative Carpenter stated the original intent was for
all training to be done by DHSS. He elaborated that the CS
specified the state would continue to train. He asked for
verification that some of the training would be done by
DHSS and the other training would be done by an
unidentified party.
Mr. Putman clarified that DHSS would be fully responsible
for the training.
10:53:04 AM
Representative Carpenter looked at the sectional analysis
(copy on file) indicating the new statute would require
DHSS to maintain a list of state providers who diagnose,
evaluate, and manage dementia. He asked what the list
enabled DHSS to do. He asked if the information would
enable DHSS to target its training.
Mr. Putman responded that the list was intended in the
original legislation to ensure that people who may have
dementia and doctors identifying a person may have
dementia, to provide the list to patients in order for the
patients to access a doctor. He clarified that the
department would prepare the documents and provide them to
medical professionals and the medical professionals would
hand them out to patients.
Co-Chair Merrick thanked Mr. Putman. She set an amendment
deadline for Wednesday, March 23 at 6:00 p.m.
HB 308 was HEARD and HELD in committee for further
consideration.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 306 - PHA Bd Letter of Support - 2.25.22.pdf |
HFIN 3/15/2022 9:00:00 AM |
HB 306 |
| HB 308 CS WorkDRaft FIN v.I 031422.pdf |
HFIN 3/15/2022 9:00:00 AM |
HB 308 |
| HB 308 - Sectional on LH.pdf |
HFIN 3/15/2022 9:00:00 AM |
HB 308 |
| HB 308 Sponsor Statement.pdf |
HFIN 3/15/2022 9:00:00 AM |
HB 308 |
| HB 306 PDMP Board Chairs Letter to House Finance (3.21.22).pdf |
HFIN 3/15/2022 9:00:00 AM |
HB 306 |