Bill Text: CA SB639 | 2023-2024 | Regular Session | Amended

California Senate Bill 639 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Medical professionals: course requirements.

Spectrum: Moderate Partisan Bill (Democrat 8-1)

Status: (Passed) 2024-09-21 - Chaptered by Secretary of State. Chapter 336, Statutes of 2024. [SB639 Detail]

Download: California-2023-SB639-Amended.html

Amended IN Assembly September 08, 2023

Amended IN Assembly August 24, 2023

Amended IN Assembly June 15, 2023

Amended IN Senate March 20, 2023

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill

No. 639

Introduced by Senator Limón
(Coauthors: Senators Blakespear, Newman, Niello, Padilla, Rubio, Wahab, and Wiener)
(Coauthors: Assembly Members Alvarez, Hoover, and Stephanie Nguyen)

February 16, 2023

An act to amend Sections 125275 and 125280 of the Health and Safety Code, and to amend Section 14132.171 of the Welfare and Institutions Code, relating to Alzheimer’s disease.

LEGISLATIVE COUNSEL'S DIGEST

SB 639, as amended, Limón. Alzheimer’s disease.

Existing law requires the State Department of Public Health to administer grants to postsecondary higher educational institutions that establish diagnostic and treatment centers for Alzheimer’s disease, and requires the grant funds to be used for purposes of those diagnostic and treatment centers, as specified. Existing law makes various findings and declarations regarding Alzheimer’s disease and related disorders.

This bill would revise those provisions, including replacing references to “diagnostic and treatment centers” with “diagnostic hubs,” and “related disorders” and “dementia” with “related conditions.” The bill would add additional findings and declarations regarding the impacts of Alzheimer’s disease and dementia over the next 20 years and encouraging the development of diagnostic hubs for Alzheimer’s disease. The bill would declare the purpose of the diagnostic hubs to be, among other things, to increase the training of health care professionals with respect to Alzheimer’s disease and other acquired brain impairments by expanding educational relationships that support primary care, develop thorough care plans, and improve diagnostics so that health care professionals have the requisite training and expertise to know when to refer and feel comfortable with detection and diagnosis of Alzheimer’s disease and related dementia. The bill would require a state department or ~~diagnostic hub~~ partner organization to obtain and maintain approval from the State Department of Health Care Services to host any Dementia Care Aware materials on internet websites not owned by the State Department of Health Care Services. The bill would require the Dementia Care Aware program to collaborate with the State Department of Public Health and the Alzheimer’s diagnostic hubs in the dissemination of cognitive health assessment training to health care providers. The implementation of these provisions would be subject to an appropriation by the Legislature.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

Section 125275 of the Health and Safety Code is amended to read:

125275.

(a) The Legislature finds that Alzheimer’s disease, a devastating disease that destroys certain vital cells of the brain, affects more than 6,500,000 Americans. The Legislature also finds that the impacts of Alzheimer’s disease and related conditions over the next 20 years will increase dramatically. Longer life expectancies and the aging of the large baby boom cohort will lead to an increase in the number and percentage of Californians who will be 65 years of age and older. Because the primary risk factor is older age, substantial increase is anticipated in the numbers of people who will be living with Alzheimer’s disease, and due to the higher prevalence of ~~the Alzheimer’s~~ Alzheimer’s disease in the Black and Latino/a/x communities, these communities will see their rates triple. The Legislature recognizes that the disease has serious emotional, financial, and social consequences for persons living with Alzheimer’s disease and their families.

(b) The Legislature recognizes that the cause of Alzheimer’s disease is presently unknown. However, with significant state and federal investment, clinical treatments are being developed that can slow disease progression and offer the promise of more time. The Legislature finds that existing diagnostic hubs have improved the quality of care available to persons living with Alzheimer’s disease and increased knowledge with respect to Alzheimer’s disease and related conditions. These diagnostic hubs provide clinical opportunities for research and facilitate the collection of essential data regarding Alzheimer’s disease and related conditions, while at the same time providing valuable services such as information and referral, counseling, and training to persons living with Alzheimer’s disease and their families. It is the intent of the Legislature, in enacting this article, to encourage the establishment of geographically dispersed diagnostic hubs for Alzheimer’s disease within every postsecondary higher educational institution with a medical center, as well as satellite locations that will serve regions without a postsecondary higher educational institution with a medical center, which will serve as diagnostic hubs for their regions.

(1) To provide diagnostic and treatment services and improve the quality of care to persons living with Alzheimer’s disease and related conditions.

(2) To increase the training of health care professionals with respect to Alzheimer’s disease and related conditions by expanding educational relationships between diagnostic hubs and primary care providers and practitioners that support primary care, develop thorough care plans, and improve diagnostics so that health care professionals have the requisite training and expertise to know when to refer and feel comfortable with detection and diagnosis of Alzheimer’s disease and related conditions.

(3) To collaborate with the State Department of Health Care Services in its effort to promote Dementia Care Aware, an initiative led by the State Department of Health Care Services.

(4) To collaborate with the State Department of Health Care Services in its effort to continue and expand upon the cognitive health assessment training developed and owned by the State Department of Health Care Services, as outlined in Section 14132.171 of the Welfare and Institutions Code.

(5) To continue and expand upon the cognitive health assessment training and validated tool for Medi-Cal beneficiaries as outlined in Section 14132.171 of the Welfare and Institutions Code.

(6) To create capacity through the work of the hubs to secure access to new Alzheimer’s and related condition clinical therapies coming to the market, consistent with federal requirements.

(7) To provide information to persons diagnosed with dementia and their care partners about home- and community-based services, including area agencies on aging, caregiver resource centers, and aging and disability resource connections.

(d) The diagnostic hubs may collaborate with relevant state departments to provide, where relevant, expertise related to state or federal research, and training, monitoring, consultation, and continuing education to the families of those who are affected by Alzheimer’s disease and related conditions.

(e)A state department or diagnostic hub shall obtain and maintain approval from the State Department of Health Care Services to host any Dementia Care Aware materials, including the cognitive health assessment training described in paragraphs (3) and (4) of subdivision (c), on internet websites not owned by the State Department of Health Care Services. If the State Department of Health Care Services grants that approval, as a condition for utilizing the State Department of Health Care Services’ Dementia Care Aware materials, other state departments and diagnostic hubs shall submit reports to the State Department of Health Care Services, in a form and manner as required by the department, describing the use of Dementia Care Aware materials pursuant to this section.
~~(f)~~

(e) Implementation of this section shall be subject to an appropriation by the Legislature for the purpose of this section and Section 14132.171 of the Welfare and Institutions Code.

(g)The provisions of this section relative to Dementia Care Aware shall be implemented only to the extent any necessary federal approvals are obtained by the State Department of Health Care Services, and federal financial participation under the Medi-Cal program is available and is not otherwise jeopardized.
(h)For purposes of implementing the provisions of this section relative to Dementia Care Aware, the State Department of Health Care Services may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Notwithstanding any other law, contracts entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.

SEC. 2.

Section 125280 of the Health and Safety Code is amended to read:

125280.

(a) Any postsecondary higher educational institution with a medical center may establish diagnostic hubs for Alzheimer’s disease subject to the department’s grants review process.

(b) The department shall administer grants to postsecondary higher educational institutions that establish diagnostic hubs pursuant to subdivision (a).

(c) Alzheimer’s disease grants for the purpose of establishing a diagnostic hub shall be used only for the purposes of this article, including, but not limited to, all of the following:

(1) Salary and benefits for faculty, residents, fellows, and staff of the diagnostic hub.

(2) Costs of supplies and equipment.

(3) Research grants for faculty research to discover the cause of, and a cure for, Alzheimer’s disease.

(4) Research grants for students, residents, and fellows.

(5) General administrative costs of up to 8 percent of the total grant.

(d) The department shall establish criteria for requests for Alzheimer’s disease diagnostic hub grants and Alzheimer’s disease research grants, and for program evaluation.

(e) A grant awarded pursuant to this article shall not be approved for any amount that exceeds 25 percent of the total amount of funds appropriated for this purpose in the 1987–88 Regular Session of the Legislature.

(f) The department shall administer a grant program for the purpose of research into the causes, treatment, cure, strategies for coping with, prevention, incidence, and prevalence of Alzheimer’s disease and related conditions. Priority shall be given to grant applications for feasibility studies, startup grants, and matching funds for federal and privately funded research grants. Consideration shall be given to proposals that link service delivery and collect data relative to patient care and the delivery of social services. This research may include, but is not limited to, examinations and recommendations for the improvement of the family, community-based and health care support systems available to Alzheimer’s disease victims, and their caregivers.

(g) Upon request, the department shall make available to the Legislature information regarding the progress of the grant programs established pursuant to this article.

(h) The department shall reduce any grant pursuant to this article by the amount of any federal funds available for the same purposes to the same grantee.

SEC. 3.

Section 14132.171 of the Welfare and Institutions Code is amended to read:

14132.171.

(a) (1) An annual cognitive health assessment for Medi-Cal beneficiaries who are 65 years of age or older is a covered benefit if they are otherwise ineligible for a similar assessment as part of an annual wellness visit under the Medicare Program. Subject to paragraph (3), the department shall provide reimbursement to a Medi-Cal provider who renders this service.

(2) The payment for the cognitive health assessment developed pursuant to paragraph (1) shall only be available upon appropriation by the Legislature for these purposes.

(3) (A) A Medi-Cal provider shall only be eligible to receive the payment for the benefit specified in paragraph (1) if the provider complies with both of the following requirements:

(i) Completes cognitive health assessment training, as specified and approved by the department.

(ii) Conducts the cognitive health assessment using validated tools, as recommended by the department.

(B) (i) The department shall determine the cognitive health assessment training and validated tools, as described in subparagraph (A), in consultation with the State Department of Public Health’s Alzheimer’s Disease Program (Article 4 (commencing with Section 125275) of Chapter 2 of Part 5 of Division 106 of the Health and Safety Code), that program’s 10 ~~California Alzheimer’s Disease Centers,~~ Alzheimer’s diagnostic hubs, representatives of primary care physician specialties, including, but not limited to, family medicine, and the Alzheimer’s Disease and Related Disorders Advisory Committee of the California Health and Human Services Agency (Chapter 3.1 (commencing with Section 1568.15) of Division 2 of the Health and Safety Code).

(ii) The Dementia Care Aware program shall collaborate with the State Department of Public Health and the Alzheimer’s diagnostic hubs in the dissemination of cognitive health assessment training to health care providers.
~~(ii)~~

(iii) With respect to the validated tools, the department shall select multiple tools. To improve overall accessibility of these tools and minimize access barriers, at least one of those tools shall not carry any restrictions on copyright or trademark.

(b) An annual cognitive health assessment shall identify signs of Alzheimer’s disease or dementia, consistent with the standards for detecting cognitive impairment under the federal Centers for Medicare and Medicaid Services and the recommendations by the American Academy of Neurology.

(1) Consolidate and analyze the data on the administration of the cognitive health assessment in the Medi-Cal managed care and fee-for-service delivery systems.

(2) Post information on the utilization of, and payment for, this benefit on its internet website.

(d) A state department or partner organization shall obtain and maintain approval from the State Department of Health Care Services to host any Dementia Care Aware materials, including the cognitive health assessment training, on internet websites not owned by the State Department of Health Care Services. If the State Department of Health Care Services grants that approval, as a condition for utilizing the State Department of Health Care Services’ Dementia Care Aware materials, other state departments and partner organizations shall submit reports to the State Department of Health Care Services, in a form and manner as required by the department, describing the use of Dementia Care Aware materials pursuant to this section.
(e) The provisions of this section relative to Dementia Care Aware shall be implemented only to the extent any necessary federal approvals are obtained by the State Department of Health Care Services, and federal financial participation under the Medi-Cal program is available and is not otherwise jeopardized.
~~(d)~~

(f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement this section, in whole or in part, by means of all-plan letters, provider bulletins, or similar instructions, without taking any further regulatory action.

~~(e)~~

(g) This section shall be implemented only to the extent any necessary federal approvals are obtained and federal financial participation is available.

~~(f)~~

(h) For purposes of implementing this section, the State Department of Health Care Services may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Notwithstanding any other law, contracts entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services.