Existing law requires the Attorney General to establish and maintain the Violent Crime Information Center to assist, as specified, in the identification and apprehension of persons responsible for specific violent crimes and for the disappearance and exploitation of persons, particularly children and at-risk adults.

This bill would require the Attorney General to convene a working group, as specified, within the Department of Justice Missing and Unidentified Persons Section, to study and propose legislative solutions to the problem of wandering, described as the phenomenon of cognitively impaired persons, including those with Alzheimers disease, dementia, or autism, wandering away from home, care facilities, or other familiar surroundings and becoming lost or confused about their surroundings. The bill would require the working group to prepare and submit a report to the Legislature, as specified.

Date of Hearing: April 19, 2023

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Chris Holden, Chair

ABPCA Bill Id:AB 423

Author:(Maienschein) – As Introduced Ver:February 6, 2023

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

SUMMARY:

This bill requires the Attorney General to convene a working group on “wandering” to study the issue of cognitively impaired people wandering away from home or other familiar surroundings and becoming lost or confused about their surroundings. The bill requires the working group to provide a report of findings and proposed legislation to the Legislature.

Specifically, this bill:

1. Requires the Attorney General to convene this working group within the Missing and Unidentified Persons section of the Department of Justice (DOJ), and to include, to the extent possible, representatives from certain organizations and agencies specified by the bill.
2. Reimburses working group members for travel and other necessary expenses incurred in performance of their duties, but specifies that working group members will not be otherwise compensated.
3. Requires the working group to meet four to six times each year.
4. Requires the working group to prepare and submit a report to the Legislature a report of its discussion, findings, and proposed legislation on specified topics related to wandering, including (a) training for professional and family caregivers; (b) technological solutions; (c) coordination of social services; (d) coordination of law enforcement agencies and resources; and (e) public awareness of wandering.
5. Sunsets the working group on January 1, 2027.

FISCAL EFFECT:

This bill would likely result in general fund costs in the millions of dollars. The DOJ estimates annual costs between $2,776,000 and $5,274,000 for each fiscal year from 2023 to 2027, for staffing, expert consultants, travel costs for staff and working group members, and printing costs for the report to the Legislature. Depending on the scope and depth of the research, the working group created by this bill may be able to fulfill the bill’s requirement with less extensive resources. In comparison, AB 3121 (Weber), Chapter 319, Statutes of 2020, enacted a DOJ taskforce to study reparations. The Budget Act of 2021 allocated $1.1 million dollars to implement the AB 3121 and for DOJ to provide administrative, technical, and legal assistance. The working group created by this bill will likely require similar resources.

COMMENTS:

1. Purpose. According to the author, “AB 423 is an important step in addressing the risk of wandering and protecting the lives of some of our most vulnerable communities. This bill would help California better support the thousands of people living with a cognitive impairment and their family caregivers.”
2. Background. According to the Alzheimer’s Association, it is common for people with dementia to wander or become lost and confused about their location, and about 60% of people with the dementia will wander at least once. Studies show that wandering is also common among children and adults with autism. This is a common and dangerous circumstance that puts significant stress on families and caregivers, and risks harm to wandering individuals. This bill requires the Attorney General to convene a working group to study this issue and propose legislation to help improve outcomes for wandering individuals, including by providing training for caregivers, technological solutions, better coordination between social service providers and law enforcement agencies, and increasing public awareness.
3. Prior Legislation. AB 2175 (B. Rubio), of the 2021-2022 Legislative Session, would have created the California Wandering Prevention Task Force to address wandering by individuals with cognitive impairment and submit a report to the Legislature detailing their findings. AB 2175 was held on this committee’s suspense file.

Analysis Prepared by: Annika Carlson / APPR. / (916) 319-2081

Date of Hearing: March 14, 2023

Counsel: Mureed Rasool

ASSEMBLY COMMITTEE ON

Reginald Byron Jones-Sawyer, Sr., Chair

ABPCA Bill Id:

Author:() – As Ver:

SUMMARY:

Requires the Attorney General (AG) to convene a working group to study the issue of cognitively impaired people who wander away. Specifically, this bill:

1. States that the AG must convene a working group within its Missing and Unidentified Persons Section.
   
2. Provides that the working group will study cognitively impaired people, including those with dementia or autism, who wander away or become confused about their surroundings.
   
3. Mandates that the working group will be chaired by the director responsible for missing persons in California, include no more than 20 members appointed by the AG, and shall include representatives from the following:
   
4. California State Sheriffs’ Association;
   
5. California Highway Patrol’s Emergency Notification and Tactical Alert Center;
   
6. California Firefighters’ Association;
   
7. California Police Chiefs Association;
   
8. California State Association of Counties;
   
9. An organization servicing patients with Alzheimer’s disease;
   
10. An organization servicing persons with autism;
    
11. A family member each of persons with Alzheimer’s and autism;
    
12. California Department of Aging;
    
13. State Department of Social Services that coordinates with adult protective services;
    
14. California Hospital Association;
    
15. L.A. Found initiative;
    
16. Mental Health Services Division of the State Department of Health Care Services;
    
17. League of California Cities;
    
18. State Department of Developmental Services; and,
    
19. Office of the State Long-Term Care Ombudsman.
20. Reimburses members for travel and other necessary expenses, but does not provide compensation for participation in the group.
    
21. Requires the working group to meet from 4 to 6 times a year and to submit a report to the Legislature by June 30, 2026, discussing the following topics:
    
22. Training for professional and family caregivers;
    
23. Technological solutions;
    
24. Coordination of social services and law enforcement resources; and,
    
25. Public awareness of wandering.
    
26. Sunsets the working group on January 1, 2027.

EXISTING LAW:

1. Finds and declares that elders and adults with mental or physical disabilities are restricted in the ability to carry out normal activities or protect their rights and deserve special consideration and protection. (Pen. Code, § 368.)
   
2. Requires the Department of Justice (DOJ) to have a director responsible for coordinating California’s response to missing persons. (Pen. Code, § 14208.)
   
3. Requires the DOJ to operate a statewide hotline to receive information regarding missing children and at-risk adults, make missing persons posters, as specified, and to relay the information to appropriate law enforcement agencies. (Pen. Code, § 14210.)
   
4. Requires all local law agencies, upon receiving a missing-person’s report involving an adolescent or at-risk adult, to broadcast a “Be On the Lookout” bulletin without delay, and to transmit a report to the DOJ. (Pen. Code, § 14211, subds. (b) & (c).)
   
5. Ensures that older individuals and functionally impaired adults receive needed services that will enable them to maintain the maximum independence permitted by their functional ability and remain in their own home or communities for as long as possible. (Welf. & Inst. Code, § 9450.)
   

FISCAL EFFECT:

Unknown

COMMENTS:

1. Author's Statement: According to the author, “AB 423 is an important step in addressing the risk of wandering and protecting the lives of some of our most vulnerable communities. This bill would help California better support the thousands of people living with a cognitive impairment and their family caregivers.”
   
2. Wandering of Individuals with Cognitive Impairment: Wandering, also referred to as elopement, generally occurs when someone leaves a safe area or responsible caregiver; it goes beyond the brief amount a time that a toddler typically might run off from a caregiver. For adults with dementia or Alzheimer’s, the rates of wandering range from 46% to 71%. The majority of patients with dementia failed to remember their way back to the original location where they got lost or initiating a conversation with other people on the street, making the consequences of getting lost be hazardous. (Kelvin K. Tsoi et al. How can we better use Twitter to find a person who got lost due to dementia? (Apr. 18, 2018.) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550184/#CR26> [as of Mar. 6, 2023].) Some literature on the topic has indicated that up to half of adults with dementia who wander and are not found within 24 hours will suffer serious injury or death. (Meredeth A Rowe et al. Persons with dementia missing in the community: Is it wandering or something unique? (Jun. 5, 2011.) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3141319/#B2> [as of Mar. 6, 2023].)
   
   Wandering also poses dangers for children and youth who have autism and intellectual disabilities. The Centers for Disease Control and Prevention (CDC) states that about half of children and youth with autism spectrum disorder were reported to wander, and of those, about a quarter were missing long enough to cause concern and were commonly in danger of drowning or traffic injury. (CDC. Disability and Safety: Information on Wandering (Elopement). ( Sept. 18, 2019.) <https://www.cdc.gov/ncbddd/disabilityandsafety/wandering.html> [as of Mar. 6, 2023].)
   
   These results highlight the urgent need to develop interventions to reduce the risk of elopement, to support families coping with this issue, and to train child care professionals, educators, and first responders who are often involved when elopements occur. This bill would require a working group be convened within the DOJ to study the issue of wandering and offer potential solutions to help try to address it.
   
3. DOJ Missing and Unidentified Persons Section: The DOJ’s Missing and Unidentified Persons Section assists law enforcement agencies throughout California in finding missing persons. It keeps statewide files on missing persons that include dental records, photographs, and descriptions of physical characteristics. (DOJ. Missing and Unidentified Persons Section. <https://oag.ca.gov/missing/mups> [as of Mar. 7, 2023].)
   
   The Missing and Unidentified Persons Section also issues annual reports detailing missing children and adults. (DOJ. Missing Persons Statistics. <https://oag.ca.gov/missing/stats> [as of Mar. 7, 2023].) According to their 2022 report for adults, there were roughly 1,800 dependent adults (i.e. adults with physical or mental limitations such as Alzheimer’s) who went missing each year from 2018 to 2022. (Ibid.) Unfortunately their 2022 report for missing children does not have a category for children with cognitive disabilities. (Ibid.) However, there were approximately 246 children that became lost each year from 2018 to 2022. (Ibid.)
   
   This bill would require that a working group on cognitively impaired people who wander be convened in the DOJ’s Missing and Unidentified Persons Section.
   
4. Argument in Support: According to the bill’s cosponsors, Alzheimer’s Los Angeles, Alzheimer’s Orange County, and Alzheimer’s San Diego, “…Wandering is a term used to describe getting lost and becoming disoriented. It is a common behavior associated with Alzheimer’s disease and other dementias. Often overlooked, wandering is dangerous, and the consequences can be deadly. Over sixty percent of those living with Alzheimer’s disease will wander at some point. Finding a missing person quickly is critical because the survival rate drops dramatically the longer it takes to find the person.
   
   “Wandering or elopement is also a serious safety issue for many children with cognitive impairment or disabilities, such as those with autism spectrum disorder. An estimated 49 percent of children with autism will engage in wandering behavior. Consequences for wandering in children can also be deadly. According to the National Autism Association, in 2011 accidental drowning accounted for 91 percent of the total U.S. deaths reported of children with autism ages 14 and younger, subsequent to wandering or elopement.
   
   “In your district, Alzheimer’s San Diego partnered with the San Diego Sherriff’s Department to create the Take Me Home Registry. This program helps give families peace of mind by allowing them to enroll people with a disability or cognitive impairment like Alzheimer’s disease into a database so that law enforcement can more quickly help return people when they go missing. In neighboring Los Angeles County, the L.A. Found program is also working to address the issue of wandering. The county’s efforts were inspired by the family of Nancy Paulikas, a woman with Alzheimer’s who wandered and whose remains were identified several years later. Her family’s advocacy has resulted in an initiative that has increased community education and awareness, trained thousands of first responders, and connected over a thousand individuals with technology.
   
   “Prevention is the key to addressing the risk of wandering and protecting the lives of some of our most vulnerable Californians. This bill will create a statewide work group led by the California Department of Justice with the goal of creating recommendations to support prevention of wandering as well as recommendations to strengthen first responder agencies’ ability to quickly and effectively find those who have wandered…”
   
5. Current Legislation:
   
   1. AB 21 (Gipson) requires the Commission on Peace Officer Standards and Training (POST) to revise their training for field-training officers (FTOs) on interacting with persons with mental illness or intellectual disabilities to also include instruction on interacting with persons with Alzheimer’s or dementia. AB 21 is currently pending hearing in the Assembly Appropriations Committee.
      
   2. AB 385 (Ta) requires that the State Department of Public Health educate and inform health care providers and other caregivers about providing care to an individual with Alzheimer’s disease or dementia. AB 385 is currently pending hearing in the Assembly Committee on Health.
      
6. Prior Legislation:
   
   1. AB 2175 (Blanca Rubio), of the 2021-2022 Legislative Session, would have created the California Wandering Prevention Task Force to address wandering by individuals with cognitive impairment and submit a report to the Legislature detailing their findings. AB 2175 was held in the Assembly Appropriations Committee.
      
   2. AB 1684 (Voepel) of the 2021-2022 Legislative Session, would have required the State Department of Public Health to educate and inform health care providers and other caregivers about providing care to an individual with Alzheimer’s disease or dementia. AB 1684 was held in the Senate Appropriations Committee.
      

REGISTERED SUPPORT / OPPOSITION:

Support

Alzheimer's Greater Los Angeles (Co-Sponsor)

Alzheimer's Orange County (Co-Sponsor)

Alzheimer's San Diego (Co-Sponsor)

California Public Defenders Association (CPDA)

Los Angeles County

Opposition

None Received.

Analysis Prepared by: