Existing law establishes the California Department of Aging in the California Health and Human Services Agency. Existing law requires the department to designate various private nonprofit or public agencies as area agencies on aging to work for the interests of older Californians within a planning and service area and provide a broad array of social and nutritional services. Existing law requires the department to provide leadership to those agencies in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments and requires those agencies to function as the community link at the local level for the development of those services. Existing law requires each area agency on aging to maintain a professional staff that is supplemented by volunteers, governed by a board of directors or elected officials, and whose activities are reviewed by an advisory council consisting primarily of older individuals from the community.

Existing law requires the department to adopt policies and guidelines to carry out the purposes of the Alzheimers Day Care-Resource Center program, whereby direct services contractors receive funding to provide services to meet the special care needs of, and address the behavioral problems of, individuals with Alzheimers disease or a disease of a related type.

This bill would require require, until July 1, 2023, each area agency on aging to develop an evidence-based or evidence-informed core training program for staff relating to Alzheimers disease and dementia, and any additional training based on local needs. The bill would also require each agency to maintain an Alzheimers and dementia specialist to provide information, assistance, referrals, and options counseling to families. If an agency lacks the capacity to maintain a specialist, the bill would authorize the agency to contract with a qualified local entity to provide these services, as specified. The bill would specify that it would be implemented only to the extent that funds are appropriated by the Legislature for its purposes. purposes, including funding to augment the administrative operations of the department that are necessary to implement these provisions.

Existing law establishes the California Department of Aging in the California Health and Human Services Agency. Existing law requires the department to designate various private nonprofit or public agencies as area agencies on aging to work for the interests of older Californians within a planning and service area and provide a broad array of social and nutritional services. Existing law requires the department to provide leadership to those agencies in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments and requires those agencies to function as the community link at the local level for the development of those services. Existing law requires each area agency on aging to maintain a professional staff that is supplemented by volunteers, governed by a board of directors or elected officials, and whose activities are reviewed by an advisory council consisting primarily of older individuals from the community.

Existing law requires the department to adopt policies and guidelines to carry out the purposes of the Alzheimers Day Care-Resource Center program, whereby direct services contractors receive funding to provide services to meet the special care needs of, and address the behavioral problems of, individuals with Alzheimers disease or a disease of a related type.

This bill would require each area agency on aging to develop an evidence-based or evidence-informed core training program relating to Alzheimers disease and dementia, and any additional training based on local needs. The bill would also require each agency to maintain an Alzheimers and dementia specialist to provide information, assistance, referrals, and options counseling to families. If an agency lacks the capacity to maintain a specialist, the bill would authorize the agency to contract with a qualified local entity to provide these services, as specified. The bill would specify that it would be implemented only to the extent that funds are appropriated by the Legislature for its purposes.

Existing law establishes the California Department of Aging in the California Health and Human Services Agency. Existing law requires the department to designate various private nonprofit or public agencies as area agencies on aging to work for the interests of older Californians within a planning and service area and provide a broad array of social and nutritional services. Existing law requires the department to provide leadership to those agencies in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments and requires those agencies to function as the community link at the local level for the development of those services. Existing law requires each area agency on aging to maintain a professional staff that is supplemented by volunteers, governed by a board of directors or elected officials, and whose activities are reviewed by an advisory council consisting primarily of older individuals from the community.

Existing law requires the department to adopt policies and guidelines to carry out the purposes of the Alzheimers Day Care-Resource Center Program, program, whereby direct services contractors receive funding to provide services to meet the special care needs of, and address the behavioral problems of, individuals with Alzheimers disease or a disease of a related type.

This bill would require each area agency on aging to develop an evidence-based or evidence-informed core training program relating to Alzheimers disease and dementia, and any additional training based on local needs. The bill would also require each agency to maintain an Alzheimers and dementia specialist to provide information, assistance, referrals, and options counseling to families. If an agency lacks the capacity to maintain a specialist, the bill would authorize the agency to contract with a qualified local entity to provide these services, as specified. The bill would specify that it would be implemented only to the extent that funds are appropriated by the Legislature for its purposes.

Existing law establishes the California Department of Aging in the California Health and Human Services Agency. Existing law requires the department to designate various private nonprofit or public agencies as area agencies on aging to work for the interests of older Californians within a planning and service area and provide a broad array of social and nutritional services. Existing law requires the department to provide leadership to those agencies in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments and requires those agencies to function as the community link at the local level for the development of those services. Existing law requires each area agency on aging to maintain a professional staff that is supplemented by volunteers, governed by a board of directors or elected officials, and whose activities are reviewed by an advisory council consisting primarily of older individuals from the community.

Existing law requires the department to adopt policies and guidelines to carry out the purposes of the Alzheimers Day Care-Resource Center Program, whereby direct services contractors receive funding to provide services to meet the special care needs of, and address the behavioral problems of, individuals with Alzheimers disease or a disease of a related type.

This bill would require each area agency on aging to develop an evidence-based or evidence-informed core training program relating to Alzheimers disease and dementia, and any additional training based on local needs. The bill would also require each agency to maintain an Alzheimers and dementia specialist to provide information, assistance, referrals, and options counseling to families. If an agency lacks the capacity to maintain a specialist, the bill would authorize the agency to contract with a qualified local entity to provide these services, as specified.

Existing law establishes the California Department of Aging in the California Health and Human Services Agency. Existing law requires the department to designate various private nonprofit or public agencies as area agencies on aging to work for the interests of older Californians within a planning and service area and provide a broad array of social and nutritional services. Existing law requires the department to provide leadership to those agencies in developing systems of home- and community-based services that maintain individuals in their own homes or least restrictive homelike environments and requires those agencies to function as the community link at the local level for the development of those services. Existing law requires each area agency on aging to maintain a professional staff that is supplemented by volunteers, governed by a board of directors or elected officials, and whose activities are reviewed by an advisory council consisting primarily of older individuals from the community.

Existing law requires the department to adopt policies and guidelines to carry out the purposes of the Alzheimers Day Care-Resource Center Program, whereby direct services contractors receive funding to provide services to meet the special care needs of, and address the behavioral problems of, individuals with Alzheimers disease or a disease of a related type.

This bill would require each area agency on aging to maintain an Alzheimers and dementia specialist to provide information, assistance, referrals, and options to families.

SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2017 - 2018 Regular Session

AB 614 (Limón) - Area agency on aging: Alzheimer’s disease and dementia: training and services

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

AB 614 would require each Area Agency on Aging to develop a training program for its staff relating to Alzheimer’s disease and to maintain an Alzheimer’s and dementia specialist on staff.

Fiscal Impact:

• Ongoing cost pressure of about $4 million per year for Area Agencies on Aging to maintain a staff position dedicated to Alzheimer’s disease and dementia (federal funds and/or General Fund).
• Minor costs are anticipated for the Department of Aging to oversee the requirements of the bill on Area Agencies on Aging.

Background:

Under the federal Older Americans Act, Area Agencies on Aging are eligible to receive federal funding in order to provide information and referral services to older adults and their caregivers. There are 33 Area Agencies on Aging designated by the state Department of Aging to receive federal funds and state funds for this purpose. Area Agencies on Aging are either local government entities or non-profit entities.

The majority of funding for Area Agencies on Aging comes from federal funds that are distributed by the Department of Aging. In 2017-18, Area Agencies on Aging will receive $126 million in federal funds and $8 million from the General Fund. (The federal funds for this purpose require a modest match in state funds.)

Proposed Law:

AB 614 would require each Area Agency on Aging to develop a training program for its staff relating to Alzheimer’s disease and to maintain an Alzheimer’s and dementia specialist on staff.

The bill would only be implemented upon appropriation of funds by the Legislature, including any necessary funds for oversight by the Department of Aging.

The provisions of the bill would sunset on July 1, 2023.

Related Legislation:

AB 1200 (Cervantes) would establish an Aging and Disability Resource Connection Program. That bill will be heard in this committee.

Staff Comments:

Under current practice, the vast majority of funding for Area Agencies on Aging comes from the federal government. The requirements of the bill would only apply to Area Agencies on Aging to the extent that money was appropriated by the Legislature for the purposes of the bill. In theory, the Legislature could appropriate a specific portion of available federal funds to implement the bill in a future year. However, that would likely result in Area Agencies on Aging no performing some other duty currently funded with the available federal funds. In practice, it is likely that this bill would only be implemented if the Legislature were to appropriate additional General Fund money.

Not all Area Agencies on Aging are local government entities. Because the requirements of the bill would apply both to Area Agencies on Aging that are local government entities and Area Agencies on Aging that are incorporated as non-profit entities, the bill would not create a reimbursable state mandate. (Laws that apply generally to local government agencies as well as non-governmental agencies are not considered to impose a reimbursable state mandate.)

-- END --

SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: AB 614

SUBJECT: Area agency on aging: Alzheimer’s disease and dementia: training and services

SUMMARY:

1. Requires each Area Agency on Aging, in consultation with local organizations with expertise in Alzheimer’s care to develop an evidence-based or evidence-informed core training program relating to Alzheimer’s disease and dementia, and any additional training based on local needs only to the extent that funds are appropriated by the Legislature for that purpose.

Existing law:

1. Establishes the California Department of Aging (CDA) to administer programs under the Older Americans Act of 1965 including providing ongoing oversight, monitoring, and service quality evaluation to ensure that service providers are meeting standards of service performance established by CDA including, but is not limited to, all of the following:
   1. Setting program standards and providing standard materials for training;
   2. Providing technical assistance to area agencies on aging, program managers, staff, and volunteers providing services;
   3. Development of the state plan on aging according to federal law;
   4. Maintain a clearinghouse of information related to the interests and needs of older individuals and provide referral services, if appropriate;
   5. Maintain management information and reporting system; including a data base on service utilization patterns and demographic characteristics of the older population to be cross-classified by age, sex, race, and other information required for the planning process, and eliminate redundant and unnecessary reporting requirements;
   6. Encourage and support the involvement of volunteers in services to older individuals;
   7. Seek ways to utilize the private sector to assume greater responsibility in meeting the needs of older individuals; and,
   8. Encourage internships to be coordinated with schools of gerontology or related disciplines, including internships for older individuals.
      
2. Requires CDA to have primary responsibility for information received and dispersed to an Area Agency on Aging (AAA).
   
3. Defines AAA, pursuant to regulation, as an identifiable private nonprofit or public agency designated by CDA which works for the interests of older Californians within a planning service area. Requires the AAA to engage in community planning, coordination and program development, and, through contractual arrangements, provide a broad array of social and nutritional services.

This bill:

1. Requires each AAA, in consultation with a qualified local Alzheimer’s organization or other community stakeholders with expertise in Alzheimer’s research or care, including, but not limited to, the local chapter of the Alzheimer’s Association, universities, and caregiver organizations, to develop an evidence-based or evidence-informed core training program relating to Alzheimer’s disease and dementia, and any additional training based on local needs.
   
2. Requires each AAA to maintain an Alzheimer’s and dementia specialist to provide information, assistance, referrals, and options counseling to families.
3. Permits an AAA that lacks the capacity to maintain an Alzheimer’s and dementia specialist, to contract with a qualified local entity to provide the services described in 1) above.
4. Requires the AAA to coordinate with the qualified local entity in implementing the agency’s regular services and the specialist services.
5. Requires this bill to be implemented only to the extent that funds are appropriated by the Legislature for that purpose.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, this bill results in state cost pressure of about $5 million General Fund (GF) annually, assuming it costs about $150,000 per AAA to maintain staff and Alzheimer's training function. Because not all AAAs are public entities - some are non-profits - these local costs do not result in a state-reimbursable mandate. However, mandating this function in law reasonably puts pressure on the state to fund its cost.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, AAAs are on the front line to connect constituents with services. Since AAAs are already the experts on local community resources it’s a natural fit for them to provide assistance and referrals as well as options counseling. Information, assistance, as well as counseling about Alzheimer’s services will fill a much needed gap for family members and caregivers and help individuals with Alzheimer’s disease and related dementia to live in the community. Alzheimer's is the fifth leading cause of death in California and the only one in the top ten without a proven cause, preventative action or cure. According to the Alzheimer’s Association, the number of Alzheimer’s cases is growing rapidly across the entire United States population, and could nearly triple by 2050 to 13.8 million.
   
2. AAAs. CDA contracts with and provides leadership and direction to AAAs which coordinate a wide array of services to seniors and adults with disabilities at the community level and serve as the focal point for local aging concerns. The Senior Information and Assistance Program (I&A) is the main entry point to services within each AAA. I&A staff assess individuals' needs and link them to local services or provide referrals to programs in other communities with the goal of helping seniors remain in their own homes and maintain a high quality of life for as long as possible. A toll-free information line is part of this where a caller can dial 1-800-510-2020 (using a land-line phone) and be automatically connected with the local I&A service provider. If information is needed about other areas, the caller will be referred to service providers in those regions. I&A staff are also responsible for following-up to ensure individuals have obtained services.
   
3. Alzheimer’s disease. Dementia is a general term for memory loss and other cognitive problems that are serious enough to interfere with daily life. According to the California Department of Public Health (DPH), Alzheimer's disease is a type of dementia that causes problems with memory, thinking and behavior.  Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.  Alzheimer's disease accounts for 60% to 80% of dementia cases.  According to the Centers for Disease Control, in 2013, as many as five million Americans were living with Alzheimer’s disease. The number of people with the disease doubles every five years beyond age 65. By 2050, this number is projected to rise to 14 million, a nearly three-fold increase. Alzheimer’s disease is one of the top ten leading causes of death in the United States. Death rates for Alzheimer’s disease are increasing, unlike heart disease and cancer death rates that are on the decline. Dementia, including Alzheimer’s disease, has been shown to be underreported in death certificates and therefore the proportion of older people who die from Alzheimer’s may be considerably higher.
   
4. Caretakers. Currently there is no cure for Alzheimer's, but treatments for symptoms are available and research continues.  Although current Alzheimer's treatments cannot stop the disease from progressing, they can temporarily slow the worsening of dementia symptoms, and improve quality of life for those with Alzheimer's and their caregivers. Currently, the vast majority of individuals living with Alzheimer’s disease are cared for at home by family members. Although most people willingly provide care to their loved ones and friends, caring for a person with Alzheimer’s disease at home is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. As the disease gets worse, people living with Alzheimer’s disease often need more intensive care.
5. Alzheimer’s Disease Program. Since 1985, DPH’s Alzheimer's Disease Program (ADP) has awarded over $19.7 million to scientists engaged in the study of Alzheimer's disease and related disorders. These Alzheimer's Disease Research Awards (ADRA) have encompassed the areas of basic science, diagnosis, treatment, epidemiology, behavioral management, and caregiving. They have been supported by both the State GF and by the Alzheimer's Disease and Related Disorders Research Fund (ADRDF). In 1987, taxpayers were authorized to contribute amounts on their tax returns, in excess of any tax liability, to establish a fund for research related to Alzheimer's disease. From 1989 to 2009, the ADRAs were supported by both the State GF and the ADRDF. The GF allocation for Alzheimer’s disease budgeted in 2015-16 was $2,818,000, in 2016-17 was $5,318,000 and in 2017-18 was $2,818,000. The Legislature augmented the 2016-17 budget by $2.5 million GF one-time to be distributed to the Alzheimer diagnostic and treatment centers to determine the standard of care in early and accurate diagnosis and to provide outreach on these standards. These funds are available for encumbrance or expenditure until June 30, 2019. The Legislature adopted trailer bill language and budget bill language to implement this proposal. In September of 2016 ADP announced its intent to award seven research grants totaling $1,840,000.
6. Alzheimer’s Disease and Related Disorders Advisory Committee. The Alzheimer’s Disease and Related Disorders Advisory Committee (ADRDAC) was established within the California Health and Human Services Agency (CHHS) in 1988 to provide ongoing advice and assistance on program needs and priorities of persons impacted by Alzheimer’s disease and related dementia disorders. ADRDAC members represent consumers, family members, providers and advocates. Members serve on a volunteer basis without compensation. In 2011, the CHHS, in partnership with external stakeholders, released the California State Plan for Alzheimer’s Disease, which provides a set of goals, recommendations and strategies to reduce the risk of dementia through the promotion of brain health and to improve care and support for all who are affected. 
7. Related legislation. AB 1200 (Cervantes) establishes an Aging and Disability Resource Connection program to provide information to consumers and their families on available long-term services and supports (LTSS) programs and to assist older adults, caregivers, and persons with disabilities in accessing LTSS programs at the local level. AB 1200 is set to be heard in the Senate Health Committee on July 12, 2017.
8. Prior legislation. SB 613 (Allen, Chapter 577, Statutes of 2015) requires the DPH to convene a workgroup to update the 2008 Guidelines for Alzheimer’s Disease Management in California to address changes in the health care system, and requires DPH to submit a report of the updates and recommendations from the working group to the Legislature on or before March 1, 2017.

SB 97 (Committee on Budget, Chapter 11, Statutes of 2015) among many other provisions requires appropriations for funding for the Alzheimer’s Research Centers to be used for direct services, including, but not limited to, diagnostic screening, case management, disease management, support for caregivers, and related services necessary for positive client outcomes.

AB 1744 (Brown of 2014) would have required, until January 1, 2018, CDA 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 AAA, 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.”

SB 491 (Alquist, Chapter 339, Statutes of 2008) established California’s State Plan for Alzheimer’s disease under CHHS. The State Plan called for an update to the 2008 physician Guideline and made physician education a top priority for California.

1. Support. California Association of Area Agencies on Aging strongly supports this bill because, information, assistance as well as counseling about Alzheimer’s services will fill a much needed gap for family members and caregivers and help individuals with Alzheimer’s disease and related dementia to live in the community. Ventura County Board of Supervisors writes that AAAs are in a unique position to address this growing issue and serve those with Alzheimer’s, and since AAAs are already the experts on local community resources it’s a natural fit for them to provide assistance and referrals as well as options counseling. Alzheimer’s Greater Los Angeles supports this bill with adopted amendments requiring the local AAAs to develop evidence-based training programs in consultation with a qualified local Alzheimer’s organization or other community stakeholder with expertise in Alzheimer’s research or care. Alameda County Board of Supervisors indicates that family members and caregivers are desperately seeking information, assistance, and connection to local services and resources. In 2020 Alameda County will be home to more than 260,000 adults over the age of 65, and by 2030, one in five residents will be in the 65 plus age group. The Alameda AAA serves approximately 65,000 older adults a year.
   
2. Amendments. The author requests the committee adopt amendments to ensure that any appropriation to support this bill include funding for CDA’s administrative operations and add a sunset date of July 1, 2023.

SUPPORT AND OPPOSITION:

Support: California Association of Area Agencies on Aging (sponsor)

Agency on Aging-Area 4

Alameda County Board of Supervisors

Alzheimer’s Association

Alzheimer’s Greater Los Angeles

California Commission on Aging

County of Riverside

National Association of Social Workers, California Chapter

Riverside County Board of Supervisors

Sonoma County Area Agency on Aging

Ventura County Board of Supervisors

One individual

Oppose: None received

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ASSEMBLY THIRD READING

ATR Bill Id:AB 614

Author:(Limón)

As Amended Ver:May 26, 2017

Majority vote

SUMMARY: This bill requires each Area Agencies on Aging (AAA) to maintain an Alzheimer's and dementia specialist to provide information, assistance, referrals, and options counseling to families. Specifically, this bill:

1. Requires each AAA to maintain an Alzheimer's and dementia specialist to provide information, assistance, referrals, and options counseling to families.
2. Requires each area agency on aging, in consultation with their local chapter of the Alzheimer's Association or other community stakeholders with expertise in Alzheimer's research or care, including universities, caregiver organizations, and health care systems, to develop an evidence-based or evidence-informed core training program relating to Alzheimer's disease and dementia and any additional training based on local needs.
3. Requires that if the area agency on aging lacks the capacity to maintain an Alzheimer's specialist, it may contract with a qualified local entity to provide the service.
4. Specifies that the provisions of this bill shall be implemented only to the extent that funds are appropriated by the Legislature.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, this bill results in state cost pressure of about $5 million GF annually, assuming it costs about $150,000 per AAA to maintain staff and Alzheimer's training function. Because not all AAAs are public entities - some are non-profits - these local costs do not result in a state-reimbursable mandate. However, mandating this function in law reasonably puts pressure on the state to fund its cost.

COMMENTS:

Author's Statement: The author states, "Area Agencies on Aging (AAAs) are on the front line to connect constituents with services. Since AAAs are already the experts on local community resources it's a natural fit for them to provide assistance and referrals as well as options counseling. Information, assistance, as well as counseling about Alzheimer's services will fill a much needed gap for family members and caregivers and help individuals with Alzheimer's disease and related dementia to live in the community.

"Alzheimer's is the 5th leading cause of death in California and the only one in the top ten without a proven cause, preventative action or cure. According to the Alzheimer's Association, the number of Alzheimer's cases is growing rapidly across the entire United States population, and could nearly triple by 2050 to 13.8 million."

Background: Alzheimer's is the most common form of dementia, which is a general term for memory loss and other intellectual abilities that interfere with daily life. Alzheimer's disease accounts for 60% to 80% of dementia cases. Alzheimer's is not a normal part of aging, up to 5% of people with the disease have early signs appears when they are in their 40s or 50s.

The California Association of Area Agencies on Aging (C4A) is a non-profit organization representing California's 33 area agencies on aging. The association is an advocate for meeting the needs of seniors and adults with disabilities, with the purpose to implement the provisions and intent of the Older Americans Act and the Older Californians Act.

Area agencies on aging, established by the Federal Older Americans Act in 1965, receive federal, state, and local funds to contract with local organizations for service to seniors. There are 33 area agencies on aging designated by the California Department of Aging as the local Planning Services Agencies.

Federal and state law requires AAAs to provide information and referral services to older adults and their caregivers.

Analysis Prepared by: Barry Brewer / AGING & L.T.C. / (916) 319-3990 FN: 0000666

Date of Hearing: May 3, 2017

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

ABPCA Bill Id:AB 614

Author:(Limón) – As Amended Ver:March 23, 2017

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill requires each local Area Agency on Aging (AAA) to maintain an Alzheimer’s and dementia specialist to provide information, assistance, referrals, and options counseling to families. It also allows them to contract for the function.

FISCAL EFFECT:

This bill results in state cost pressure of about $5 million GF annually, assuming it costs about $150,000 per AAA to maintain staff an Alzheimer's training function. Because not all AAAs are public entities—some are non-profits—these local costs do not result in a state-reimbursable mandate. However, mandating this function in law reasonably puts pressure on the state to fund its cost.

COMMENTS:

1. Purpose. According to the author, requiring AAAs to provide information, assistance, and counseling about Alzheimer’s services will fill a gap for family members and caregivers, and help individuals with Alzheimer’s disease and related dementia to live in the community. This bill is sponsored by the California Association of Area Agencies on Aging (C4A), a non-profit organization representing California’s 33 AAAs.
2. Background. Alzheimer’s is the most common form of dementia, which is a general term for memory loss and other intellectual abilities that interfere with daily life. Alzheimer’s disease accounts for 60% to 80% of dementia cases.

AAAs, established by the Federal Older Americans Act, receive federal, state, and local funds to contract with local organizations for service to seniors. There are 33 AAAs designated by the California Department of Aging. Federal and state law requires AAAs to provide information and referral services to older adults and their caregivers. This bill establishes more specific Alzheimer's-related requirements.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing: April 18, 2017

ASSEMBLY COMMITTEE ON AGING AND LONG-TERM CARE

Ash Kalra, Chair

ABPCA Bill Id:AB 614 (

Author:Limón) – As Amended Ver:March 23, 2017

SUBJECT: Area agency on aging: Alzheimer’s disease and dementia: training and services.

SUMMARY: This bill requires each Area Agencies on Aging (AAA) to maintain an Alzheimer’s and dementia specialist to provide information, assistance, referrals, and options counseling to families. Specifically, this bill:

1. Requires each AAA to maintain an Alzheimer’s and dementia specialist to provide information, assistance, referrals, and options counseling to families.
2. Requires each area agency on aging, in consultation with their local chapter of the Alzheimer’s Association, to develop an evidence-based or evidence-informed core training program relating to Alzheimer’s disease and dementia and any additional training based on local needs.
3. Requires that if the area agency on aging lacks the capacity to maintain an Alzheimer’s specialist, it may contract with a qualified local entity to provide the service.

EXISTING LAW:

1. Establishes the California Department of Aging (CDA) in the California Health and Human Services Agency.
2. Requires CDA to provide leadership to those agencies in developing systems of home and community-based services that maintain individuals in their own homes or least restrictive homelike environments, and requires those agencies to function as the community link at the local level for the development of those services.
3. Requires CDA to designate various private nonprofit or public agencies as area agencies on aging to work for the interests of older Californians within a planning and service area, and provide a broad array of social and nutritional services.
4. Requires each area agency on aging to maintain a professional staff that is supplemented by volunteers, governed by a board of directors or elected officials, and whose activities are reviewed by an advisory council consisting primarily of older individuals from the community.
5. Requires CDA to adopt policies and guidelines to carry out the purposes of the Alzheimer’s Day Care-Resource Center Program, whereby direct services contractors receive funding to provide services to meet the special care needs of, and address the behavioral problems of, individuals with Alzheimer’s disease or a disease of a related type.

FISCAL EFFECT: Unknown.

COMMENTS:

Author’s Statement: The author states, “Area Agencies on Aging (AAAs) are on the front line to connect constituents with services. Since AAAs are already the experts on local community resources it’s a natural fit for them to provide assistance and referrals as well as options counseling. Information, assistance, as well as counseling about Alzheimer’s services will fill a much needed gap for family members and caregivers and help individuals with Alzheimer’s disease and related dementia to live in the community.

“Alzheimer’s is the 5th leading cause of death in California and the only one in the top ten without a proven cause, preventative action or cure. According to the Alzheimer’s Association, the number of Alzheimer’s cases is growing rapidly across the entire United States population, and could nearly triple by 2050 to 13.8 million.”

Background: Alzheimer’s is the most common form of dementia, which is a general term for memory loss and other intellectual abilities that interfere with daily life. Alzheimer’s disease accounts for 60% to 80% of dementia cases. Alzheimer's is not a normal part of aging, up to 5% of people with the disease have early signs appears when they are in their 40s or 50s.

The California Association of Area Agencies on Aging (C4A) is a non-profit organization representing California’s 33 area agencies on aging. The association is an advocate for meeting the needs of seniors and adults with disabilities, with the purpose to implement the provisions and intent of the Older Americans Act and the Older Californians Act.

Area agencies on aging, established by the Federal Older Americans Act in 1965, receive federal, state, and local funds to contract with local organizations for service to seniors. There are 33 area agencies on aging designated by the California Department of Aging as the local Planning Services Agencies.

Federal and state law requires AAAs to provide information and referral services to older adults and their caregivers.

Arguments in Support: California Association of Area Agencies on Aging state in their letter, “Area agencies on aging are the primary source for information of senior services in every community and connect services to those most in need, including individuals with Alzheimer’s. … Since area agencies on aging are already the experts on local community resources it’s a natural fit for them to provide assistance and referrals as well as options counseling.

“C4A strongly supports AB 614 because information, assistance, as well as counseling about Alzheimer’s services will fill a much needed gap for family members and caregivers and help individuals with Alzheimer’s disease and related dementia to live in the community.”

Arguments in Opposition: None.

REGISTERED SUPPORT / OPPOSITION:

Support

Agency on Aging/Area 4

California Association of Area Agencies on Aging (C4A)

California Commission on Aging

National Association of Social Workers, California Chapter (NASW-CA)

Sonoma County Area Agency on Aging

One individual.

Opposition

None on file.

Analysis Prepared by: Barry Brewer / AGING & L.T.C. / (916) 319-3990