Senate Standing Committee on Business, Professions and Economic Development

Okay. Welcome to the Senate Committee on Business, Professions and Economic Development, one of several committees performing a lightning round this morning. We will come to order in 60 seconds. Members in the building who are part of the Senate Committee on Business, Professions and Economic Development. We need you for a quorum. Please make your way to room 2200.

We're in 2200. It's a different room than usual. Please head down here, and if you are an author on our agenda today, hopefully you are within steps of our door. 60 seconds we will start.

All right, we're going to call the business, professions and Economic Development Committee meeting of Wednesday, August 28 to order, see if we can knock this out again. One more reminder, Senators who are on the Business, Professions, Economic Development Committee, we need you in room 2200 so that we can establish a quorum.

That being said, we have one Bill on the agenda today, and we have the author here with us. Senator Limon, we don't have the quorum. We'll call it as soon as we do, but go ahead and present your Bill to us.

Thank you, Madam Chair and Members. Alzheimer's disease is a growing public health crisis. A 2020 report conducted by the Alzheimer's Association revealed that primary care physicians see a growing issue presented by dementia and feel unprepared.

This Bill adds Alzheimer's and dementia training as an option to the existing continuing education requirement for physicians who have a patient population of which over 25% are 65 years old or older and applies the same requirement to physician assistants and nurse practitioners, SB 639 will ensure that healthcare professionals are equipped for dementia detection and diagnoses statewide.

Great. Thank you very much. You have some lead witnesses with you?

We do. Thank you.

Go right ahead. Please introduce yourselves. You each have two minutes. Go right ahead.

Good morning, Chair Ashby and members of the Committee, thank you for your time today. My name is Melissa Wass, and I am here from Sacramento to express my support for SB 639 by Senator Monique Limon, which ensures that primary care providers who treat older Californians receive dementia training.

In 2013, my mother was diagnosed with Alzheimer's, making the beginning of a long journey of heartbreak for my family. For eight years, my wife and I cared for her around the clock. We were her caregivers, her advocates, and our companions as we watched the woman we love slowly slip away from us.

A particularly heart wrenching moment occurred about a week before my mother passed. Hospice informed us that she could no longer swallow, and we were Faced with an unimaginable decision, either insert a feeding tube, prolonging her suffering, or withhold food knowing she would soon pass.

We chose to honor my mother's dignity by not inserting a feeding tube, hoping to make her final days as peaceful as possible. But what happened in her last moments was something none of us were prepared for.

On the morning of her death, the hospice NP told us my mother's time had come. My wife and I held her hand, saying our final goodbyes. After she was pronounced dead, something unexpected occurred. My mother started to breathe again. This happened three times, each more agonizing than the last. And the NP refused to administer more morphine.

The NP seemed unprepared and admitted she was freaked out. She realized she had never seen someone die directly from Alzheimer's, as my mother had no other health issues. My mother's passing was the most painful experience of my life, made worse by the lack of support and expertise we needed.

The NP didn't have the training to manage the unique symptoms of end stage Alzheimer's. Because of that, my mother, my wife and I endured unnecessary suffering. This is why I'm here today asking for your support in passing the Bill. Alzheimer's disease is a devastating illness that requires specialized knowledge and compassionate care.

Our NP's and PAs are on the front lines, caring for patients like my mother in need specialized training. I urge you to vote I on SB 639. By passing this Bill, you support continued education for healthcare professionals and ensure families like mine receive the guidance and care they need in their darkest hours.

You are giving dignity to those suffering from Alzheimer's and peace to those who love them. Thank you.

Thank you so much for sharing your story and your mom's story with us. I'm going to pause before we go to the second witness and establish a quorum.

[Roll Call]

Okay, go ahead.

Yeah, I'm Eric Dowdy I'm with the Alzheimer's Association. Just proud to sponsor the Bill and urge your support. Thank you.

Great. Thank you. Are there others in the room in support of the Bill who would like to provide me, too testimony now? If so, please come to the mic, give us your name and organization. Seeing none, are there any in the room who oppose the Bill? Seeing no one will come back to the.

We'll come to the council Dais. Here. Sorry, we're not a city council. We're coming back to the Senate dais. Senator Eggman and then Senator Archuleta.

Thank you, Senator, for bringing this forward. And I just want to thank you for sharing your pain and your story and the courage to make other people's passing better. I'd move the Bill.

Great. Go ahead. Senator Archuleta, thank you.

And my condolences to your family, yourself and your wife. And it's a deeply, deeply sad story, but well received, and it's so important. And, Senator, I want to thank you for bringing this forward because as we all know, our population is getting older in the inner cities as well as our communities.

They are stronger, longer, and we need the expertise. And I appreciate the Bill and I will be supporting it. Thank you.

Thank you. Any other colleagues wishing to speak? Senator Niello?

Thank you, Madam Chair. I didn't hear the testimony, but I have met with Members of the Alzheimer's organization, and I certainly, well, I don't really have necessarily sympathy with the issue. I have empathy because I'm your target audience in a sense, by virtue of age. But my concern is that all practitioners in the medical community have shortages.

I don't think that care for elders is unique that way.

And so my concern is that just like we're seeing multiple provisions for the advantage for licensure of people in certain groups, I'm concerned that we're going to see that in this area, too, where there is a shortage of medical practitioners in other medical disciplines that would do the same thing, require additional education to the point where we begin to prescribe what the continuing education should be for practitioners, as opposed to the profession deciding what they needed.

Number one, and I guess a question, well, a couple of questions is. How.

Senator Niello, I'm just going to ask you to be as succinct as possible because we have multiple members who have at least two or three other committees to get to.

I know, and I do, too, but this is an important issue.

It sure is.

and I apologize for that. I didn't want to have to ask all these questions exactly for that reason. I've got four Committee meetings today, so.

But my question is how will we know what the concentration is in any particular practice and therefore how to require the 20% education? And secondly, what's the position of the Medical Association on this? They appear to be neutral, I guess.

Right. So I think on most. So I've been running bills on Alzheimer's and dementia for eight years.

So just to be clear, I run a Bill in this space for eight years, and one of the things that I've learned when it comes to training is that neutral is actually a good place to be in particular, because I think that when you look at the physicians, they're looking at, you know, everyone's practice is different.

So I, you know, we've been working for two years on this particular Bill. That's why it has a lower number. This Bill has been in progress. And so what we have is the ability to, you know, to have this training.

I think that you will see in many professions that we offer different subject matter trainings for licensure, and that is very common. So this Bill doesn't do anything different than what we do for other professions. And I think that, as we see, there is a general consensus that this is a growing issue.

So that's not actually what's the debate, right. The debate is about the training program and whether or not it makes sense and how, you know, your question about how will we know the practitioners, they know who their population is, and so this is a question that they have the ability to answer. I don't know.

I can't tell you who sees who, but they can.

Thank you, Senator Niello, are you good? Okay. Senator Roth?

Well, I just want to say, you know, unfortunately, we have a shortage of healthcare professionals all around the issue. We particularly have a shortage of specialists in some of these areas, whether it's behavioral health or this one.

And our internal medicine folks and our family practitioners and the nurse practitioners and pas who see patients in areas where specialists do not exist are going to have to train up to help us deal with the health crisis that we're in. And this is one example that you are addressing with this Bill.

There are others in behavioral health. There are probably others in some of the other specialties as well. And the family physicians and the internists that I've spoken to welcome the opportunity to display their skills in these areas, in the more specialized areas. And so I commend you for the Bill, and I'm going to be an aye.

Thank you. All right. I think I'm going to close us out here and then give the Senator a chance to make her closing statement. I still have to steady myself as an elected official when this topic comes up because I took that same journey as you with my dad. And it's very on the surface for me, too.

And I don't think that we can in any way make the situation worse by making sure that healthcare professionals have more training for the specific needs of Alzheimer's and dementia. It's a horrible disease to watch a loved one exit this world with. I've been there exactly where you were for that final breath.

I know exactly how your heart feels. There's no doubt in my mind that the State of California is quite fortunate to have a champion like Senator Limon who takes this up every year. I, quite frankly, couldn't do it because I'd be already in tears. So I'm gonna stop talking now. Let her close you.

But you certainly have my support and my kinship in a club that neither one of us would like to be in.

Thank you. And thank you for those comments. I think a lot of us have personal experiences and stories, not just when it relates to dementia and Alzheimer's, but also for the work we do. And so this is one of them, certainly.

I lost a loved one who I actually cared for and know what it's like in the final moments and days. And when you have to start sharing a room, when you have to start sharing a bed and putting mats on the floor to make sure that they don't leave. And, you know, you're warned. The list goes on.

So this is a very near and dear issue to me, and I continue to be committed to it. But I'm so thankful to the supporters and to my colleagues for the support. I respectfully ask for an aye vote.

All right, we have a motion from Senator Eggman. Would you please call the roll?

Motion is that the Assembly amendments be concurred in. [Roll Call]

Motion passes, thank you very much. We're adjourned.