Arkansas legislators talk Alzheimer’s fight

Arkansas legislators talk Alzheimer’s fight

LITTLE ROCK — Legislators appeared ready to provide support to fight a “public health crisis” involving Alzheimer’s disease and dementia after a report showed more than 60,000 Arkansans are expected to be diagnosed with the disorder by 2025.

David Cook, a senior public policy manager for the Alzheimer’s Association, provided lawmakers on Monday an update to the Alzheimer’s State Plan during the joint meeting of the Senate Committee on Children and Youth and the House Committee on Aging, Children and Youth, Legislative and Military Affairs.

According to the over 40-page report, an estimated 58,000 Arkansans aged 65 and older are currently living with Alzheimer’s in 2020. That number is expected to climb to 67,000 by 2025.

“As prevalence continues to increase, so does need,” Cook told legislators. “We also know that Alzheimer’s is the most expensive disease to treat and has impacts across state agencies and impacts the workforce, our healthcare workforce, and it has fiscal impact, as it impacts Medicaid spending.”

Cook said one outside variable that might increase spending even more around the state is the effect of long term covid-19. He said early research has indicated that those with long term covid-19 also tend to develop dementia.

“So we don’t really know yet what the impact of covid is going to be on dementia prevalence,” he said. “All we can tell you is that we know it’s going to increase and our forecast numbers for the state of Arkansas are probably low.”

Alzheimer’s disease is a progressive brain disorder that is the most common cause of dementia in older adults. Dementia is not a specific disease, but an overall term that describes a group of symptoms like loss of memory and other mental abilities severe enough to interfere with daily life.

The report stated the number of Arkansans who died due to Alzheimer’s disease reached 1,507 in 2019, an increase of 250.5% since 2000. This ranks as the 6th highest death rate in the United States.

The projected increase in the number of people with Alzheimer’s in Arkansas is due solely to projected increases in the state’s population age 65 and older, the report states. The proportion of Arkansas’ population that is over 60 is growing while the proportion that is under 60 is shrinking.

The U.S. Census Bureau estimates that 26% of Arkansas’ population will be over the age of 60 by the year 2030, an increase of more than 25% from 2012.

Cook said the increase will have an impact on the state’s health care systems, as well as the Medicaid program, which covers the long term care and support for many older residents with dementia.

Alzheimer’s cost the Arkansas Medicaid program $396 million in 2020, and by 2025, those costs are expected to rise by 14.6%, according to the report.

The report also states an estimated 93,000 caregivers, mostly family and women, provided 139 million hours of unpaid care valued at $2.16 billion dollars in 2020.

This disease also has an effect on the caregivers with 73.4% of them dealing with chronic health conditions, 23.4% dealing with depression and 11.4% being in poor physical health themselves.

“That is very telling that we definitely have a health crisis when it comes to this disease in Arkansas,” State Rep. Joy Springer, D-Little Rock, said during the meeting.

While the council has presented legislators with 12 recommendations to address Alzheimer’s and dementia across the state, Cox said the main one that needs to be addressed is establishing the position of Dementia Services Coordinator within the state government.

Other needs, Cook said, include providing dementia training services for law enforcement and first responders; setting dementia training requirements for certified nurses; expanding access to cognitive screenings; establish dementia training requirements for adult protective services, long term care investigators, and ombudsmen; and setting dementia training standards for acute crisis centers.

“If you only leave with one thing today I want you to understand the importance of establishing the position of dementia services coordinator,” Cook said. “This position will help us to get to the next phase of our work and begin implementation of the Alzheimer’s state plan.”

The dementia services coordinator would oversee the state plan process including monitoring the implementation of the plan recommendations, coordinating working groups, evaluating existing Alzheimer’s and dementia-specific programs and services, increasing collaboration of key partners, identifying gaps in services, and increasing awareness of care and support services available to families and individuals.

“Coordination between the public and private sectors is essential to the effective implementation of the Alzheimer’s and Dementia State Plan,” the report states.

Cox said details like how much the position will cost the state and whether it would be housed in the Health Department of the Department of Human Services haven’t been decided yet. He did add the position needs to be funded by the state to allow it to be permanent.

State Rep. Mark Berry, R-Ozark, said there needs to be urgency to having this position created and filled.

“We need to speed that process up because it’s not going to get any better it’s only going to continue to get worse,” he said.

State officials in 2018 created an independent working group to begin the process of updating the Alzheimer’s State Plan. The state’s previous disease plan had not been updated since its initial publication in 2011.

“No activity happened since 2011 hence the need to update the state plan here in Arkansas,” Cox said.

In 2021, the 93rd General Assembly initiated Act 391 which established a permanent Alzheimer’s and Dementia Advisory Council. The council has met monthly to hear from state agencies, providers, caregivers, and field experts to assess the state plan, understand the needs of Arkansas families affected by dementia, identify gaps in available support services, and fulfill statutory obligations included in Act 931 to provide an update to the state legislature on the status of implementation of the state plan.

The report provided on Monday identified four key areas that need to be addressed across the state when it comes to Alzheimer’s and dementia. These areas are public awareness, access to care, family caregiver support and dementia training/workforce development.

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