State Study Shows Progress on Long Term Care, RX, Elder Protection Federal Government Efforts Lagging—Must Help States In Difficult Times

Alzheimer's Association
Monday, 27 January 2003

A wide array of health care initiatives including long term care workforce issues, elder protection, prescription drug coverage and Medicaid were adopted by state legislatures in 2002, according to a new analysis of state legislation released by the Alzheimer's Association. The report, State Policy Clearinghouse State Review 2002 provides information about legislative activity on issues of interest to Alzheimer advocates and allies.

"State governments have been taking a leadership role in developing programs and services for people with Alzheimer's. However, over the next year as state revenues continue to decrease, the federal government must step in and assist,"said Bonnie Hogue, director of federal and state policy for the Alzheimer's Association. "We will never solve the long term care crisis that Alzheimer's poses by relying solely on separate action in the 50 states. We must have a national solution that pulls together all of our resources — federal, state and families — in a system that makes sense."

Report highlights include:

WORKFORCE:

Georgia advocates secured $96,000 for dementia training for caregivers. The funding will be used to support the costs of developing and presenting 26 family and professional workshops across the state.

New Mexico (HJM 90) expands a nursing home staffing study being conducted by the state health department and directs the department to review other states' best practice standards, approaches to acuity-based staffing, methods for measuring compliance with staffing standards, and definition of direct care staff.

New York (S 6084/A9610) provides $1.85 billion to health care facilities (hospitals, nursing homes) over the next three years to help recruit, retain and train health care workers to ensure that health care facilities have adequate staff that are highly trained to provide quality care.

LONG TERM CARE:

Florida (S 1276/H 1761) authorizes the Department of Elderly Affairs to develop an integrated, comprehensive health and long term care service delivery system for individuals' age 65 and older. A pilot project in one or more counties is included as part of the first phase of implementation.

Hawaii (H 2638) establishes the Hawaii Long Term Care Financing Act, to provide a system of universal and affordable long term care. The act creates the Hawaii Long Term Care Benefits Fund to receive long term care income taxes that will cover benefit payments and administrative costs, and provides for a board of trustees to administer the program.

Maine (H 1436/LD 1933) establishes a Blue Ribbon Commission to investigate and analyze the future costs of providing long term health care to elderly and disabled adults; recommends an integrated system of financing the projected costs of these services and requires a report to be submitted to the legislature by November 6, 2003.

ELDER PROTECTION:

Kentucky bill (H 381) ensures that searches will be undertaken promptly upon report of any lost, missing or overdue person, including those with Alzheimer's disease and related dementias.

New Hampshire bill (S 413) establishes a committee to study background checks for nursing home employees.

SPECIAL CARE UNITS:

Kentucky (S 203) requires long term care facilities that advertise special care for persons with Alzheimer's disease or related disorders to provide dementia-specific training to all staff, which includes at least 8 hours of initial training on facility policies, etiology and treatment, disease stages, behavior management, and residents' rights.

Maryland (S 746) requires specified assisted living programs with an Alzheimer's special care unit or program to disclose in writing how care and treatment provided is specialized including a statement of philosophy of care or mission, staff training and staff job titles, admission procedures including screening criteria, assessment and care planning protocol, staffing patterns, a description of the physical environment to support the cognitively impaired, a description of the activities, charges to the resident for services, and discharge procedures.

West Virginia (H 4205) authorizes the state Bureau for Public Health to promulgate legislative rules relating to Alzheimer/dementia special care units and programs.

MEDICAID:

Colorado (H 1029) allows for expansion of Program of All Inclusive Care for Elderly (PACE) and requires the Department of Health Care Policy and Financing to perform a feasibility study, in cooperation with current providers, to identify communities that could support a PACE site.

New Mexico (S 379) establishes 12-member legislative committee to decide how best to provide Medicaid services to the state by examining statutes, constitutional provisions, regulations and court decisions governing the state Medicaid program and related health care programs and will recommend legislation or changes.

Maryland (S 5/H 422) increases the nursing home personal needs allowance to $50 per month in 2003 and $60 per month in 2004

PRESCRIPTION DRUGS:

Hawaii (H 2834) establishes a new prescription drug program called Hawaii Rx. All residents will be eligible for this program and eligibility and enrollment procedures will be established.

Nebraska (L 1148) calls for the Health and Human Services (HHS) Committee of the legislature to consult with various groups to conduct research and provide recommendations to the legislature and the governor on prescription drug assistance.

West Virginia (H 4666) establishes a process within the Department of Health and Human Services to enter into negotiations with pharmaceutical companies for rebates that cannot be accessed through Freedom of Information Act requests or open meetings; provides for the deposit of all moneys received in rebates in the state's Medical Services Fund.

RESEARCH:

California (SJR 37) calls on the President and Congress to invest immediately in various activities to prevent Alzheimer's disease, including increasing the number of large-scale clinical trials, funding research grants, conducting additional research on risk factors, etc.

Florida (S 46e) establishes the Florida Alzheimer's Center and Research Institute at the University of South Florida. The new law directs the state Board of Education to contract with a nonprofit entity to govern and operate the Institute and to conduct research relating to the prevention, treatment, and cure of Alzheimer's disease.

Virginia (S 542) adds agents appointed under advanced directives, spouses, adult children and adult siblings to the list of people authorized to give consent to human research under the definition of legally authorized representative.

For more information, or to contact Alzheimer's Association, see their website at: www.alz.org