Alzheimer's Disease and Dementia Advisory Council
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- October 6, 2026
Senator Ricky Hill
Unverified
0:00
Look forward to this. Hopefully we've got some good information we can share. I know we've got several speakers on here, and so we'll get started. Representative Mayberry, is there anything you want to say? No. Okay. Well, we'll move right on to the agenda then, Mr. Cook. Oh, excuse me. Before we go to you, let's back up and do things in the order we're supposed to. Everyone has a copy of the minutes. I've received them. Have you had a chance to look over them? I need a motion.
Okay, got a motion and a second. All in favor, say aye. Aye. All opposed, same sign. Thank
you for that. Okay, now Mr. Cook,
David Cook
Unverified
0:54
where do you? Thank you, Senator Hill. So at the last meeting,
my name is David Cook, for the record, Senior Public Policy Manager for the Alzheimer's Association.
During our last meeting, at the request of co-chairs, we met with a subgroup to do a review of the Alzheimer's state plan as it is currently written. And so this afternoon, I wanted to give you just a little bit of an overview of our time together what our findings were and report them back to you. And the purpose of doing this is just to make sure that we meet our statutory obligation to report on October 1st to the
legislature and also the governor's office, which is, I should have put that on there, but on October 1st of every year, every even number year, we are to report to the state agencies, to the
Department Health Department of Human Services on the status of the implementation of the Alzheimer's State Plan, any of the shortcomings of implementation, what were the barriers to implementing sections of the state plan, and also provide a brief analysis of the status of the agency's implementation, so what the Health
Department is doing in DHS. And of course our other component of the legislation that was passed last session was that every four years the council should issue an updated plan addressing the items that are listed in the statute. And so we are required to update the state plan every four years, but also work in between the interims to make sure that it's implemented. And so we did that just to make sure that this did not end up being a disease plan that sits on a shelf, but something that had some actionable
Speaker 8
2:40
items in it that are actually measurable as
David Cook
Unverified
2:45
well. So I wanted to go over the general outline of the state plan as it is written.
Before we do that, I wanted to let you know about those who participated in our calls. Myself, Jennifer Howlam from the AAAs, Dr. Amy Lee Overton-McCoy from UAMS, Carolyn Berry from Alzheimer's Arkansas, and then Rachel Bunch from the Healthcare Association was unable to make it, so Kat Hamilton from their association sat in on the call.
the general outline of the state plan as you have it before you
is we have a section on you know the introductory section where we talk about a lot of the processes that we had in place prior to having an alzheimer's advisory council which we have of course assembled and so we we did see a need to update that process and also provide an executive summary in that section In section two, we talk specifically about Alzheimer's and dementia.
We address different definitions, also cover the risk factors and the warning signs. As we looked over that material, we didn't see much room to update. The only exception is that none of that information captures what life is like in a post-COVID world. And so we want to talk specifically in that section around COVID-19. and some of the impacts that it might have on the dementia population based on some of the research that we're starting to see come out.
Section three is our section devoted to priority issues, and we've broken that into four different categories. The first section is public awareness. The section on supporting family caregivers. We're going to look at each one of these sections here in just a moment. and then we'll kind of walk through these together I guess. So the general outline again
in section one our subcommittee found that we do need update information to reflect the challenges of influence
by COVID-19 not just the disease challenges but also the challenges that we're seeing that have impacted the health care workforce and that's certainly a priority we want to look at as we go forward. And then in section two, the only needs we saw again were to update the facts and figures report that would reflect the current data. The data that's included in the report, I think, is from 2020. So we'll bring that up to the 2022 report that was issued in March, just to show an accurate picture of what Alzheimer's and dementia looks like here in
arkansas we the original working group again identified four different working or priority areas
public awareness is one of those areas and this is included in the state plan because it's consistent with the healthy brain initiative roadmap one of
the requirements for bold was to make sure we were doing
some public awareness work, just educating the public around different
risk factors associated with the disease, but also not just the general public, but also providers about the importance of early detection and diagnosis. And we also want to make sure that clinicians have the data they need to make referrals to specialists. Under bold funding, the health department has moved some of these priorities uh forward in an expedited manner there's a lot of good work happening because of the bold grants um and just so you know the
initial initial working group um constructed the state plan with bold in mind making sure the state was prepared to receive core capacity funding and now we want to make sure the state plan addresses issues that ensures that the state is prepared to receive the second phase of bold funding, which is enhanced. And so we've been meeting regularly with the health department to talk about some of their needs and what we need to focus on in the upcoming year.
So we can move through some of these. I wanted to kind of give you an update on each one of these priorities, and I'll go through these lists fairly quickly. Our first priority recommendation was to prioritize the state's response to Alzheimer's we we feel like that priority has been achieved because we have permanently authorized the Alzheimer's dementia advisory council we certainly see Alzheimer's dementia being prioritized at the health department and department human services also doing some things that they haven't done before so we are still
seeing some momentum and more people paying attention becoming more aware of the urgent need that we have, particularly since we know that, you know, Arkansas is poised to see an increase of 15.5 percent by 2025. So we see this being an emerging health issue here and certainly a health crisis we need to address. One of the next priorities which we've talked about in here is we've yet to establish a dementia services coordinator, but that's legislation that's forthcoming. We also ask that we direct the health department to incorporate cognitive
health messaging into existing state health priorities. With the bold funding that's come into the state, the chronic disease division has began looking at strategies to begin incorporating messages in existing public health campaigns about the importance of brain health. We do know that science tells us what's good for the heart is good for the brain, And so we see some movement at the health department to begin planning out that strategy of what public awareness will look like just to let the general public know that there are certain risk factors associated with the disease and ways to take care of your brain as well.
we've also one of our other
public awareness pieces with the convenient appropriate state agencies and provide recommendations regarding the integration of cognitive impairment and caregiver support into discharge planning procedures at hospitals this is an issue that we've had conversations with the hospital association
but haven't really moved this priority forward we also have never formalized our support for the minority health commission although we do know the Minority Health Commission is working in the dimension area
doing some really good things with the new program that's supposed to launch this Friday which we'll be able to share more about in the future. Also, this
evaluation piece we put in here to see how telehealth and telemedicine could be used to move public awareness
and education not only, again, on the provider side but also with the general public. And with COVID-19, some of the restrictions we previously had in the state around telehealth have been removed.
So certainly this is an area we need to continue to evaluate and look for opportunities to implement some resources there. And then the last two, just outreach and education minority communities and just, again, that clinician piece to make sure they're equipped are two priorities we have not been able to move forward. There is some coordination happening in these areas, but nothing formal to report. Before I move on from the
Speaker 15
10:15
public awareness piece, are there any questions?
David Cook
Unverified
10:21
Seeing none, I'll continue to go through this. Access and quality of care is certainly an issue that we've talked about. One
of the recommendations we had during the first phase is to just increase the number of slots on the HCBS waiver list to allow more people with dementia to live in assisted living specifically is what we were looking at there. There was legislation introduced but was not able to move forward and then we also one way we've moved the next priority forward is again with the creation of the dementia caregiver
respite grant pilot program and this was one way to you know have a pilot program that would test a different model uh this uh under the dementia caregiver respite program which we talked about last month um we are seeing um quite a bit of traction um i know carolyn's phones are ringing off the hook like ours are as well so uh that's moving forward pretty fast um certainly there's some more areas we could um investigate do some research and maybe some more pilot programs we can look at there as well um i don't want to i'm not going to go too detailed into this
unless questions come up, I'll get to chasing rabbits, and I want to get you guys home in time for dinner, so
I thought that joke would land. This is an ongoing priority, I think, that we need
to continue to look at is that to review existing Medicaid level of care policies and also identify areas to incorporate cognitive decline and determination of need for long-term care and so what we mean by that is basically looking at the assessment tools not only for
long-term care but assisted living and determining how cognition is weighted and is it weighted efficiently enough how other states are approaching cognition to determine level of care needed that is again an issue that we that will be ongoing I don't think there's a stop to that just making sure that we incorporate cognitive decline when we determinate level of care. Continued on this, again, this has been more of a fiscal challenge.
We do see that we need a statewide needs assessment to really determine our current capacity, the availability of services for the dementia population, and then research opportunities to increase access to care in underserved communities. I will tell you, at no cost to the state, there are two research proposals happening with a partnership with the Clinton School where students are actually looking at some of this on the caregiver side for us, and there is other planned research in the coming year through the Clinton School at no cost to the state to look at some more of these barriers to access to care.
So research is happening on this front to give us more of a detailed answer, and we are able to craft this into a needs assessment as well. But a more formal needs assessment needs to be done as well. Evaluating existing HCBS waiver policies, again, that's something that is always ongoing. And then one of the other priorities we had was commission independent external study to explore how acuity-based models impact the access of quality of care.
Acuity-based models are relatively new to our space. We do see some states like Oregon that have recently introduced some research, but no, or excuse me, a policy to incorporate an acuity-based model. I will tell you in the interim, the Nurses Association has convened a group as part of the interim study proposal, and acuity-based staffing models is one of those issues that they have studied and researched. So I do expect some recommendations to come out of that
ISP. Also ongoing is to continue to monitor and evaluate Medicaid waivers. From the Alzheimer's Association's perspective, our HCBS waivers, particularly AR choices, is one that we've kind talked about making sure that that is opened up for those who have younger onset Alzheimer's. The current language presents a challenge for someone with younger onset Alzheimer's to have
access to services. So that's one issue, one example of an issue that we continually look at and work with the agency on. Also, we, ongoing, but I think this could be actually completed. We, We do look at the financial eligibility standards for people with dementia seeking long-term services, and they are, you know, in line with the federal requirements. So I did not really in our initial research did not see room for us to address that issue at this time in the state.
Any questions on access and quality of care?
Senator Ricky Hill
Unverified
15:28
David, I'd like to back up just a second and ask you a couple questions
on this. Whenever you had your planning group put together and y'all got together on this information, was there
David Cook
Unverified
15:40
anyone from DHS involved with that? In the initial? Yes. Yes. Division of Provider Services and Quality Assurance at that point Mark White was involved as
well and the agency came in several times to visit with us on several different issues.
Senator Ricky Hill
Unverified
15:53
good because I think it's vitally important to keep them involved with it as
we go through forward with that. The other question I have for you is I want to back up just a little bit. You mentioned legislation that did not get traction as far as dementia
patients in an assisted living facility. Kind of elaborate a little bit on that. Is that a
David Cook
Unverified
16:15
federal issue instead of a state issue? It would be a state waiver issue. DHS could correct me if I'm wrong. I think the slots for the number of slots for those who could access home and community-based services
are set by the legislature to, I think, control Medicaid spending.
And so there was a couple issues with the number of slots. We've asked that they would increase the number of slots. But also there's language in the existing statute that does not allow for duplication. So once that slot is taken up, even if it's a short-term stay, that slot's already exhausted for the year. So even if someone stays for three months, you know, that slot's already taken up. But we can get into the weeds about that policy. There was a couple other issues that we weren't able to get that done.
Okay, thank you. That was in 2021, I think, that legislation was introduced. It may have been
Senator Ricky Hill
Unverified
17:09
2019, though. Okay. Any other questions for Mr. Cook so far?
David Cook
Unverified
17:16
Go right ahead. Access to care continues to be an
area, as is public awareness, that we need to continue to look at. Particularly one of the reasons why we structured the Dementia Caregiver Respite Grant the way that we thought the best way forward was for the pilot
was that sometimes people who may make too much money for state assistance but not enough to afford in-home care, and this is one approach to make sure that we are providing services that are based on acuity, not just on financial eligibility, you know, because that created, you know, another issue. That's kind of why we ran the pilot this way, and I think that's, again, one example of providing services at a pretty low cost but also providing some initial relief to families who desperately need it.
and as we've said all along as this pilot continues to go we'll learn more about not only who's accessing the services but who isn't and where those services are needed so that was more than you asked for I think
David Cook
Unverified
18:37
looked at was building support for family caregivers again the dementia
caregiver respite grant program is one one of those pilots that satisfied one of these recommendations still an issue we need to continue to look look at and examine and research and build upon as we go forward. Also, we want to make sure we can improve access to and use of evidence and informed interventions, services and support systems for people with dementia and their caregivers, just to make sure that our caregivers are taken care of. We know if we invest in
caregivers, we delay placement and long-term care, which ultimately saves the state money. another issue is connecting caregivers and family members individuals with dementia to information about dementia services again this is ongoing but we have seen some traction on this with the bold grants our grant coordinator position I think I'm stealing Tony's thunder here but our grant coordinator manager has done a really great job in creating some more resources
making sure we have dedicated space on the health department's website but it's again some things that's ongoing that we need to continue to work on to expand, um, just access to, um, to services. And then, uh, the next piece of that, one piece of that was to work in coordination with state agencies and NGOs, um, to develop and deliver no-cost training. I do know some of our, our nonprofits, like Alzheimer's Arkansas, ourselves, and UAMS are doing some work in the field, um,
to give caregiver support and caregiver resources and education. That might be an area that we look at formalizing partnerships to expand those resources and to help one another with our capacity issues that we all have. But we do see some of this expanding and some opportunities ahead of us to move this forward as well. and then the the last uh piece of the the family caregiver was just to regularly survey and assess the needs of family caregivers and that is making sure they have places at the table
and learning from them um and again with the pilot program that's one thing we hope
Representative Julie Mayberry
Unverified
21:04
support last but not least um we've got a question up here got a question up here so um i think we got clarification back with the DD population because originally we were told that a caregiver who is paid could not be the parent or someone living in the home with the DD population so I'm
kind of asking now about the this population the aging population is it still that case help me out with that because if someone's giving up work working part-time backing out their hours
but providing this free care is that still i don't know who can answer that in this group
Speaker 37
21:42
sure so under the pilot program as it's written now our one of our requirements is that the
David Cook
Unverified
21:48
caregiver has to live outside of the home cannot live in so it could be a family member but they have to
Representative Julie Mayberry
Unverified
21:54
live outside the home so a spouse could not be paid to provide that care or a daughter or son
that's living in the home with them cannot be paid under any program
Speaker 39
22:06
under the dementia caregiver respite program pilot program that we have no no i i mean just care
David Cook
Unverified
22:14
i'm i know respite is one of the benefits um under the er choices waiver
i don't know how that's structured i can't answer that question in terms of like whether or not you know someone can get reimbursed someone else can answer that okay
Speaker 43
22:27
what I know is that they cannot live in the home they can be related though they can be
like a cousin a niece but they don't live in the
Representative Julie Mayberry
Unverified
22:38
home okay and Jessica I'm looking at you in the back is that your knowledge is our attorney is that what you because we did figure out that with the DD population that it actually would cover it that's what I was told eventually after several askings. I'm looking around and everyone's staring at me strange. Do you know? Okay. I think the official word I got. Okay.
Speaker 44
23:06
So there are some programs and I know CareLink does a program where you can
Speaker 47
23:13
get paid to like if you get your job you can become a paid caregiver but the spouse and probably for most of them the spouse is a person that cannot be paid like under those funds because you made a vow sickness and health so like some of those programs that you're talking about there is a understanding because when you get married
Speaker 48
23:37
you uh make a vow so you cannot okay what about but if
Representative Julie Mayberry
Unverified
23:44
They're living with the daughter or
Speaker 48
23:46
living with the son? Yes, so children can get paid. People living there can become a
Speaker 47
23:53
paid caregiver under those programs like at CareLink, the program that they have. So you go on to, you take the training, you become an employer of CareLink, and basically your person, your loved one, will become your client. And at that point, you have a choice to only have that person as a client or, you know, pick up other people.
So you're an employee of CareLink, and you are taking care of your loved one. But the stipulation is it cannot be your spouse. So to my understanding,
Speaker 51
24:26
the only person that cannot be paid is the spouse. Okay. And take advantage
Representative Julie Mayberry
Unverified
24:32
of that program. Okay, but that is an option if you qualify for these other services that CareLink would provide. Yes. Okay. thank you okay
Representative Dwight Tosh
Unverified
24:44
okay one other question though you may know that yourself if
you you have to go through the training before you do that before you can be a paid caregiver okay not just say well I'll take care of them right here at home I'm the daughter I'm the cousin whatever
Speaker 43
25:02
yeah no you would have to go through I believe it's 80 hours but I may be wrong is
Speaker 59
25:09
that right it's something It is the standard employee
Speaker 47
25:12
training. So if it is an 80-hour training, like if you were an employee, you have to go through employee training as an employee,
and then you would pick up your person that qualifies for the service as your client and get paid. But, yes, you do have to go through the training. Okay.
Speaker 63
25:41
Any other questions? I think this is really excellent.
Speaker 65
25:45
David, I want to congratulate you. I just have one comment. That is, we now know that traumatic brain injury is a major contributor to cognitive impairment and dementia.
And I wonder if we could just add a little blurb about it because it's not in here. And I remember last time one of the state legislators had asked me about it. So maybe we could just include that. Thank you. Any other comments or
Senator Ricky Hill
Unverified
26:16
questions? Yes, Ms. Berry. Can I just give
Speaker 47
26:21
a little update while we're talking about this? Go right ahead. Okay, so it's really kind of exciting. So for the month of July, which that's how long we've been running,
We had 76 approved applications at $38,000, and 35% of the applications were rural. So it meets the qualifier of 25%. And really, if you kind of think. Can you get just a little closer to the mic? So, yeah, so we had 76 approved applications at $38,000.
Speaker 48
26:52
So that's for one month operating, and we meet the qualifier of 25% rule applications that we made.
Speaker 71
27:00
It's 35%, and based on that number, we will probably last about five months maybe. Okay. Thank you. And I will give her
Speaker 43
27:13
an update. I had three people call us this morning that we're forwarding. That's good. That means the word's getting out. I think all of the AAAs and others are starting to promote that on their different websites and different things, so the message is getting out. Good. Well, thank you all very much
Senator Ricky Hill
Unverified
27:28
for that. Mr. Cook, is there anything else you want to cover?
David Cook
Unverified
27:33
Yeah, I've only got two more slides, so I know the brain can't take more
than what the seat can endure, so my former life as a pastor has taught me to go fast. One of the last sections, again, is dementia training and making sure that our
health care workforce, um, is prepared to meet the rising need of, uh, cases of dementia and, um, and Alzheimer's. Um, we, we are cognizant that the healthcare workforce, um, has many challenges, um, that, that look different than they did prior to COVID-19. So it's certainly something that we
want to account for, um, particularly on the recruitment and retention side of that. Um, there are efforts that we've been a part of to, uh, to work on that issue with other providers and other stakeholders um one of the things that we looked at uh as a original committee is the current statutory requirements for dementia training um and we we um again from the all service association perspective um less concerned about the hours of training and more more concerned
about the content and the quality of training um but but certainly um we we see some opportunities to add dementia-specific training requirements for physicians, nurses, everyone in the health care sector. CNAs currently have a statutory obligation of 15 hours of dementia training, and that's one area we've looked at at the content, and I think that's consistent with the approach
that the CDC wants us to take in terms of the HBI roadmap and bold. but again from the association's perspective content making sure that they're getting the latest evidence-based that's really the only research out there that kind of we can say that that does actually impact delivery of care just because someone has 15 hours of dementia training you know doesn't mean it's good training so we also want to evaluate that we a couple years ago there was legislation passed that amended the broils act that does place that 15 hour
requirement, but it also places an additional requirement, making sure that the person who is doing the CNA training has long-term care experience, which is something that we were, the association, was certainly supportive of. Also, we think, you know, dementia training initiatives for hospital social workers, discharge planners, is certainly another issue and area we need to look at. But please understand we are cognizant that there are a lot of pressure on providers right now, and so working with providers and, um, the agency, uh, who implements these
rules, uh, certainly a priority of ours. Um, we, we know that there are people doing work in the, in the, in the nonprofit space, like, um, UAMS and, and others who are doing some of this caregiver training and some training with, with particular state agencies. Uh, so we certainly want to encourage that continued collaboration. Um, it's a way to provide and deliver high quality training and allow agencies to meet that training requirement without, you know, necessary big fiscal impact. One of the things that we've heard as an association is that,
you know, no training mandates that are unfunded. And so finding ways to keep the cost down is certainly something that we try to prioritize to ease the burden on agencies and providers. um we we do see a lack uh that's not common in other states but um dementia specific trying training requirements are needed for adult protective services but also ombudsman so that's certainly an issue that um from the association's perspective again we'd like to
see move forward um and most likely we'll have some pending legislation around that And then also requiring dementia-specific training for law enforcement and first responders. That's something that we don't really have. We don't have a statutory requirement for here in the state. And one of the other areas that came up is that with the mental health diversion centers that we have across the state, we do know sometimes our dementia population could end up in one of those facilities.
So having a dementia training requirement in those facilities is another issue that we've uncovered. Also, we want to continue to reduce barriers to telehealth. Again, this is an area I think that has changed a lot since the COVID-19 pandemic because a lot of those restrictions were lifted. But we are hearing there's some more areas we could address in that issue as well.
and then um the expansion of initial ongoing dementia training standards for direct care
workers making sure that everyone in long-term care who has ability or opportunities to touch our population is adequately trained and then we've looked at some other possibilities to keep the cost down but implement and deliver portable
certifications for direct care workers in home health and residential long-term care settings. And then even though we have hours spelled out here,
but we wanted to take a look at direct care workers in all long-term care
settings, including administration. There are some statutes in place, particularly for the category of long-term care we have called Alzheimer's special care units, that they have extra training requirements. That's already written in statute. We'd like to see some of that to the other long-term care providers as well and then require direct care workers to receive at least four hours of annual ongoing dementia training and that may be a requirement we want to rephrase as well any other questions on that and then finally the last one on the
Speaker 8
33:26
training and workforce development was again dementia training requirements for long-term care support
Senator Ricky Hill
Unverified
33:41
staff. Thank you, sir. Any questions or
Representative Julie Mayberry
Unverified
33:48
comments? Thank you, Mr. Chair. You
started off by saying it's the content of the training, you know, the quality of it, really, that's more important than the hours. So someone who's been
through this training, can you tell me what goes on during that training? Is it hands-on? Is it reading a manual? Is it interactive? Is it, do you meet someone with dementia in
person? Anyone here help, just help me understand what that training currently looks like? I would,
David Cook
Unverified
34:19
Emily, are you going to? I think yes.
I mean, there's components of each of that, and I'll I'll let Dr. O'Toole
Speaker 88
34:31
before I speak to. So there's multiple different types of training,
and so we do family caregiver training,
Speaker 90
34:37
and it is very hands-on, and it is built upon what the caregivers really at that training feel that they are needing. And it is set up in a home environment. We have simulation labs that are built across the state to make it to where we can teach them as if they are going to go back home and do these skills in a home setting.
And a lot of times it's behaviors that they're having challenges to deal with. And so we are giving them strategies on how to deal with behaviors in non-pharmacological interventions. And so we're basically giving them tools to put in their toolbox strategies. So when we were dealing with first responders and even with family caregivers, we have in the past two years been dealing, working with a virtual reality set
so that they become the individual who has dementia as well as they can flip the role and see what it is to be the caregiver that is burnt out. And that is something that we are actually working with a company to where we are building a co-created response simulation for first responders. So basically from the curriculum that we are teaching first responders
not only what it is to have dementia and what are behaviors and what it is to interact with those with dementia in a crisis or an emergent situation, And we've just started this with the National Guard because we had a nursing home take a direct impact. And so we just started this with the National Guard so that if they are called out into a situation, they would know how to interact with those impacted with dementia.
And we teach them, hopefully, first of all, how to prevent elopements. But if we have them, how do they successfully do search and rescues so that it's not a search and recovery? And there are strategies we know through evidence-based how to effectively find someone. There are patterns. And the biggest tip is from the last point you see them,
go to a 30-degree angle to the south. if you do that you're going to find them and don't stop you go they're not going to turn around don't stop at the thicket don't stop at the drainage ditch don't stop at the barn keep going they're never going to go past a mile unless they're very early in the stages now we'll tell you i've had them get on am on amtrak and be in st louis but that's very very mild that's not typical um so we teach these strategies and so this um virtual reality
they're going to be able to take these skills and apply it in a very safe environment and know are they putting these uh strategies such as ask for the um the pictures of the soles of the treads of the shoes or they know what they're tracking you know is there a gps in the shoes what are these and so they're going to be able to get the clues in the embodied labs in the virtual reality to see can they find someone in a safe environment so when they get in a real crisis
does it become second nature so that's more in the first responders as well as Are they using that therapeutic technique? We have quick tips so that if any first responders get in a crisis, and if you want to take pests around so you can see, it's just quick tips. So if anybody wants to see, you know, they can carry them.
And if they get into a crisis, it has, like, Centers on Aging's number. It has the Alzheimer's Association 24-hour number, you know, that we teach first responders, hey, we're here for you, we want to help you, we have other resources. And when I say first responders, we're talking about police officers, firefighters, paramedics, EMTs. I mean, every little volunteer firefighter, you heard me mention the National Guard,
It is anybody who's on the front line. And then we also are working with DHS right now to close the gap in between long-term care facilities. So that is part of their emergency plan to meet the CMS guidelines and then closing that gap with their local first responder team. We also have education for respite, as we talked about in the last meeting when they presented on the respite program with DHS.
So we also have for students as well as the paraprofessionals, and our programs are very hands-on. Even the 16 hours, we do a 16-hour training of Alzheimer's dementia. And everything we do is very hands-on, and we have ours set up for in a home setting because if anybody learns how to do the skill in the home setting, which is the most restrictive setting, then they're going to be successful
if they're in a hospital long-term care because there is more assistance available at that time. but we do use the virtual reality along with geriatric mannequins so that once they are in the real-life situation, they're ready. Thank you for that.
Speaker 95
41:15
Yes, ma'am. I just want to add to it the provider training for medical students, residents, and fellows.
They all go through our clinics, and they're trained on pharmacological treatment, and pharmacological treatment for delaying dementia and pharmacological treatment for behavioral issues with dementia, non-pharmacological treatment, and the training with the social workers also on how to deal with various issues, social issues with dementia. So they go through the clinic and they have a rotation of a couple of weeks
and they all are mandated, especially the geriatric fellows, to undergo this training. So they actually see the patients, they talk to the caregivers, and they see the complexity of the disease. They interview the patients. They're in with the consultants, with the senior MDs over there, and they see how the management is done. So that is actually the hands-on treatment that we are doing.
But it is a drop in the bucket because we are the memory clinic at the Reynolds Institute. There is nobody else who is doing the treatment of dementia right now. So for all of Arkansas, and people come from all across Arkansas for different kind of memory issues. So we need to have more memory centers where there are qualified geriatricians or neurologists or psychiatrists who are doing this.
We are the only one right
Representative Julie Mayberry
Unverified
43:01
to that? Are there not enough doctors who do that? Or is
there, I mean, obviously there's always a financial barrier, but just give me an idea, what's the
Speaker 95
43:15
main barrier? There are not enough doctors who are, Dr. Waven speaks to this also, but there are not enough trained physicians. There's not enough interest. The doctors who take care of people with memory disorders are the ones who would want to get trained for it,
go into other fields and other specialties which pay them more
Speaker 65
43:44
money. Yes, Dr. Wain. May I comment also? I think those are really excellent points, and we always have to try our very best, even when it doesn't seem like we're making as much progress as we think we are, but we are. We still continue to make progress. I want to comment on the fact that David raised the question about COVID and how things have changed,
And I am pleased to tell you that we're going to be launching a long COVID clinic at UAMS because people are calling to ask, you know. My loved one can't remember. They continue to have brain fog. It's getting worse. So what I want to just share is that COVID-19 really does cause injury to the brain in multiple ways. and some of the pathophysiology and the microscopic and histologic changes
and biochemical changes are similar to that which occurs during Alzheimer's, but it's on a faster timeline. So it is something we all need to come to grips with, and we are going to be offering a long COVID clinic for mostly, I think, for the cognitive changes because the other things are part of the nervous system as well because there's the parasympathetic and the sympathetic nervous system,
which is your autonomic nervous system. And those people are usually younger, and they complain about the fact that their heart races, you know, oftentimes over 100 beats per minute, and they feel like it's running away with them, so to speak. Some of those people don't have permanent cognitive changes, But I'm really talking about the people who are older, who might already be starting to have a little bit of cognitive decline, but not dementia. But then if they get COVID, it's a huge impact.
So we're going to be looking at that. Yeah. Well, it is. I mean, it is. Yeah, it is scary.
Senator Ricky Hill
Unverified
45:57
Thank you for that. David, is there anything else you
David Cook
Unverified
46:01
want to cover for we call DHS up? Yeah, this is it. The subcommittee came back with these recommendations. In terms
of our reporting, just making sure we highlight the successful pieces of the state plan that are already in place, some of the things that we've already achieved. We would also ask that we break up into subcommittees, a subcommittee dedicated to each one of these priority issues,
so public awareness, access to care, dementia training in the health care workforce, and then support systems for family caregivers, and take a look at the recommendations. Each one of these subcommittees take a look at those recommendations, making sure that the existing recommendations are actionable, something that we can
measure. So if there's some verbiage that needs to be changed to make sure they're measurable, to report back on those findings as well. So that's our ask of the council to have first the authority to break up into the four subcommittees
and have these discussions about each one of these recommendation areas to see if there's any edits that we want to make. Since we are making some changes to the state plan to bring it up to date on information, if we want to add some more recommendations that we have not uncovered, we would propose this is the time to do that. But we want to make sure we have input of the council, so that's kind of our recommendation to the council is to have that subcommittee conversation on each one of these four different areas.
So you're voting four different subcommittees? Four different conversations. We're happy to have four different meetings, and whoever wants to, you know, we don't have to formalize the subcommittees, but we can do it that way. However, whatever's, you know, the pleasure of the council. Okay. So do
Senator Ricky Hill
Unverified
47:50
you have any names that you're suggesting? You want volunteers, or how do you want to do that? I
David Cook
Unverified
47:57
would – it would be my preference that we had volunteers. Okay. We'll
Senator Ricky Hill
Unverified
48:03
start with the first one and ask for volunteers.
Speaker 113
48:07
Okay. Public awareness, education. How many do you want, two, three, four? Yeah. I've got three. Yeah. Four? Did you say four? Were you raising your hand to volunteer? No, I was a volunteer. Oh, you're a volunteer. There's your three. All right.
Senator Ricky Hill
Unverified
48:39
Access to care? Access to care. and we do have some that are not here that might be interested as well david if you want to
David Cook
Unverified
49:06
pick some of them to help you on some of that okay it might be best and more efficient to set the four meetings and
invite you know those to the zoom topics and give them to brandon to send out
Could you name the four committees one more time? Sure. Yes, ma'am. So public awareness and education, access to care, access and quality of care, dementia training, and then family
Representative Julie Mayberry
Unverified
49:42
caregiver support. David, are you thinking of having these meetings here or
just like a Zoom meeting, so easy access?
Okay, because that, I think, makes it easier for a lot of people to just kind of tune in and be a part of the
David Cook
Unverified
49:59
discussion. Well, yeah, we'll just hold them virtually. Okay. Our timeline is since October 1st is coming quick, we'll have those done by the first part of September.
Speaker 128
50:29
Each committee is of interest to the Arkansas Minority Health Commission, so wherever you want to put us, please, wherever. My answer to you is
Speaker 130
50:41
yes. Okay. So how does it leave you on your
Senator Ricky Hill
Unverified
50:48
numbers now? Where are you at, David? Are you good? Yeah, we'll put
David Cook
Unverified
50:54
the rest out to the rest of the committee, of those who aren't here today and give others a chance to join as well and um should be good
Senator Ricky Hill
Unverified
51:02
okay and you're going to send the link out to everyone
okay appreciate your time let's move on to the the bold grant with the dhs or adh
Speaker 138
51:19
not dhs thank you senator hill um good afternoon everyone uh tony baylor with the arkansas department of Just want to give you a quick update on the actual BOLD grant and where we are. As far as funding, you know, we did hire the program manager for the grant itself.
And so that person has been in a position roughly about five months now. In addition, we have an MOA with the Clinton School of Public Service. And what they're doing is they're providing a statewide survey and assessment to determine the availability of information on healthy brain education. And so, this is looking at resources and training. And this assessment will be done by the end of September. And one of the things, what we're looking at, key informants,
public providers and caregivers. And so, we're doing interviews, focus groups, and surveys. So, again, this is to give us an opportunity to see what information is out there. And really the objective, you know, two objectives, one, to see what's out there, and then two, to make sure there's no duplication of services or processes or how they can work together. Really, so we make sure that, you know, everybody's getting covered and we're not out kind of,
you know, doing the same thing again and again in the same area. As far as awareness, so we go back to the survey that's been done by the Clinton School for Public Service, and this is so that we can develop a campaign that really addresses all three levels of prevention, you know, which is risk reduction, early diagnosis, and then avoidable hospitalizations. And then in addition, we're looking to increase the number of stakeholders that we have, what
what we call a coalition, that we're currently building a coalition, and this gives us an opportunity to be more broad, and this coalition is really designed to both gather information and disseminate information, so as we learn more about what's across the state, different individuals that are out there, you know, what they're doing, how they're doing it, and we can put all this information together. And then also, the need to integrate communications across, you know, different kinds of activities. be it tobacco use, hypertension, those kind of things,
being able to basically work with those individuals. And now as far as how this council can help with the BOLD grant, one is continue doing what you're doing. There's a wealth of information here already. But then also, as we look at the public systems and environmental changes, you know, those things as they're into the state plan, And that helps us to be better prepared for the next grant phase and the enhanced grant.
And in addition, as I talked about building the stakeholders, increasing the stakeholders, so you all know other individuals that, you know, that are not a part of this council but could very well work or assist in providing information or gathering information or disseminating information that would be very beneficial to us in building that coalition. So right now we have a, the coalition is small, we're about two, two and a half months in, and so we have 18 members. And just to kind of give you an idea of the organization, so we have CareLink is represented,
the city of Benton, Tri-County Rural Health, UAMS, and a couple of different areas. And so we're just looking for individuals to fill the gap so that we make sure that we're covering all sectors. And it's not just about health, it's, you know, we're looking at transportation. We look at housing, so all these different sectors that could in some way come in contact with individuals that are dealing with dementia or Alzheimer's. And so this gives us an opportunity to educate the public as a whole and not just, you know, those who are in a position of care.
Senator Ricky Hill
Unverified
55:24
Thank you. Okay, I appreciate that. Is there any comments or anything y'all would like to make on what David presented a while ago? for
Speaker 140
55:36
any clarification or addition, subtractions to his comments? No, actually, we're right in line because we work with David very
Speaker 142
55:44
closely. So, yeah, we're right in line with him. I'm Christy Sellers. I'm with the Arkansas Department of Health. And so after seeing David's presentation and having some conversations with Tony, and I know you're familiar with Dr. Simon, who sometimes comes to these meetings,
we've kind of been made aware of some of the proposals as far as in the position and some of the legislation moving forward. And we really would like to ask for those of us that are not as familiar with this council, for the council to give us some time to get some clarity and really have a chance to review that state plan and look at what kind of funding we actually have available. This bold grant, you know, the funding ends next year. And if for some reason we don't get the enhanced, you know, funding, then we would like to know, you know, what kind of avenues we might have
and just look forward. So we really would like to have a little bit of time before that gets thrown out everywhere on the health department to have an opportunity to look and review at a higher level because some of our people need a chance to look at this a little more closely. Okay, so are you volunteering to serve on
Senator Ricky Hill
Unverified
56:42
the committee? So you mentioned just a while ago, is that what you're doing? If need be
Speaker 141
56:47
to have that time, then I would be more than happy to do it. But if not, then no. But I think that would help you get familiar
Senator Ricky Hill
Unverified
56:54
with it. You were mentioning that a while ago, so that would be a good opportunity for you,
and you can put the spin on it for that side. So thank you for
Representative Julie Mayberry
Unverified
57:02
volunteering. You are welcome. Yes. Yeah, we want and need your input. I mean, I don't think he's trying to keep anybody out. We just haven't had that involvement. So please. And we totally understand. This was something new, and, you
Speaker 142
57:14
know, when the council was being formed, we were asked for a rep. We tried to do that. But it is evolving and becoming more, I think, intense. And so I think we see that now and just so, yes, now we're here for sure at the table. Well, thank you for that,
Senator Ricky Hill
Unverified
57:27
and we look forward to working with you, and I know David looks
forward to having your assistance. And I see Mr. Gilmore is smiling, too. That means that takes him off the hook. Any other comments y'all like to make or any questions that the committee has or comments for them? Point of clarification that doesn't take Mr. Gilmore off the hook. Point taken. Well, thank y'all very much for that information. and look forward to work with y'all more in the future. And thank you for all that input, Mr. Bailey.
I guess the next thing we have coming right in line with what David mentioned earlier is the
state police. Please state your name and title for
Bill Bryan
Unverified
58:24
the record. I'm Major Stacey Rhodes. I'm with the Arkansas State Police, and I oversee the Silver Alert program. Thank
Speaker 157
58:30
you. My name is Bill Bryan. I'm the colonel of the Arkansas State Police.
Speaker 158
58:37
If it's okay with you, Senator Hill, and Representative Mayberry, I'll go ahead and kind of lead off. It's a pleasure to have appeared before this advisory council. I've been the director of the state police for almost eight years now. But what we want to talk to you today a little bit, Senator Hill, is to kind of talk about what we teach in our troop school. Arkansas State Police has its own troop school. It's 21 weeks long. Where most police departments and sheriff's departments, they go to Alita. So we have kind of our own thing. So first of all, you know, we depend on experts when it comes to dementia and Alzheimer's.
So what we do, we have people from UAMS come in to teach our classes. They're from the Arkansas Geriatric Education Collaborative, AGEC, and it's a two-hour block of instruction. The purpose of this instruction is to provide a general knowledge of response to our elderly population's problems and contacts to deal with those problems. The purpose of this instruction is to familiarize recruits with unique aspects of Alzheimer's disease and the best way to recognize, communicate with, and respond to a person with Alzheimer's.
Basically, they give a good overview of Alzheimer's and dementia. diseases and they discuss the distinct three stages of alzheimer's disease preclinical mild cognitive
Speaker 159
59:56
impairment and alzheimer's dementia they also discuss regular dementia as far as i think they call
Speaker 158
1:00:03
them like the first phase second phase and then the end phase what's really important they teach us how to communicate because you think an arkansas state trooper we're in all 75 counties and we run across everything possible that you want to run into
so i'm glad the lady who handed out those cards because every trooper gets one of these cards and they keep it in their vehicle to help them to negotiate also and i apologize for not bringing enough we have another handout from uams i'll be glad to pass it around and let the committee look at it but it's great to hear the first responder training with the national guard we depend on the National Guard a lot. By state statute, we're an assist agency. And so we assist a lot of police departments and sheriff's departments. And when you're talking about search and rescue, I was
looking through the lesson plan. I know they talked about people with Alzheimer's that wander off, they never come back the same way. So what we do a lot of too is, you know, the last several years we've invested in drones. So we have drones in each of our six AID companies around the state and different highway patrol troops. So we're able to, if a police department or sheriff's office called us and said hey we had somebody with alzheimer's to be able to walk off we're able to get those drones up uh and it's a lot cheaper than flying the helicopter we have a helicopter and uh but the drones are just a great tool for us to help locate people who are missing
so uh you know i brought the lesson plan y'all are welcome to it but all y'all here are experts you pretty pretty much know what we teach first responders but we take it very serious uh dementia i can talk from a personal standpoint that my father-in-law had dementia he was in a memory center and long-term care. So I know firsthand what people have to deal with. So, uh, you know, we care about everybody out there and the state police will do anything we can to help recover those people. Uh, with that, I'll be glad to turn it over to Stacey Rose and we'll take questions from y'all. Okay. Well,
Senator Ricky Hill
Unverified
1:01:51
let's let's see if there's any questions for you before we go on to,
to, to major and go from there. Does anyone have any questions?
Speaker 163
1:02:05
Mr. Cook, please use your mic. Sorry.
David Cook
Unverified
1:02:08
I'll ask a question about the six CIDs. Are they just regionally broken up across
Speaker 158
1:02:13
the state? That's correct. You know, as far as when you talk about a uniformed trooper, we call those troops. We have 12 troops around the state. And then our CID is a criminal investigation division. We have six companies. So the companies really cover more area.
But if you're in a troop area, you know, Highway Patrol, they will be able to contact CID, and we can get those drones up there and get them out. Also, we have a Bell helicopter, and we also have a single-engine aircraft that we can use also. But it's just so much easier to get those drones up, and we have some with night vision, so we'll be able to pick up the body heat if anybody's out in the woods that we're able to do that. So just great tools because a lot of police departments and sheriff's departments, especially rural, they don't have that capability. And we all know it's so important, the faster you find them, the better chance of survival it is.
Speaker 164
1:02:57
So we consider that, and we're willing to help any way
Speaker 48
1:03:05
we can. go ahead miss berry i'm carolyn from alzheimer's arkansas so how is it determined if a person you get a call and a person has alzheimer's or dementia
Speaker 167
1:03:12
now how do we how's it determined yes okay
Speaker 166
1:03:17
i can share the lesson planning and i'm not a medical
Speaker 165
1:03:21
expert i'm just i'm a cop so no i mean i'm just saying from the call how do you how are you how is it determined that from the call that But you're
Speaker 167
1:03:30
getting a call from someone, so how do you determine if that person,
if you take steps for Alzheimer's or dementia? It's
Speaker 168
1:03:36
basically the training. They kind of break the training down for Alzheimer's and dementia, different phases. I can read off
Speaker 165
1:03:43
the lesson plan, but that's how they teach it. I guess I'm
Speaker 47
1:03:48
not very clear. So you get a call, and a gentleman, let's say he's 70 years old, and he is agitated, angry. Maybe he has a weapon or he's angry, and you're going to
Speaker 167
1:03:58
send the police out. How do you determine that the person may or may not have Alzheimer's or dementia?
Speaker 158
1:04:04
Usually we have to gather intelligence when we're out there to see. We have to talk to the family members, neighbors, any type of intelligence we can, or we can reach out maybe to DHSC if they have any intelligence or any records of this or the local sheriff or local police department. We have to depend on that. And I think Major Rhodes will cover when we talk about civil alerts on how we do it for Alzheimer's and different things like that to might be able to clarify. But, again, when we show up on the scene, we just have to make that evaluation. And then, to me, if we need
Speaker 171
1:04:34
help, and I talk to DHS, sometimes we'll just call DHS and, hey, can you help us triage this?
Speaker 47
1:04:40
What do we have? Okay. I was just wondering how, like, so I get people that call me, and a lot of times we know that it's a stigma. so especially wives don't like to tell people that their husbands have dementia. So I was wondering, like, how would you know what steps to take and how would you know if there was a diagnosis? So I was wondering, do you ask if they're older, like, you know, is there any weapons in the home? If they're a certain age, would you say, could they possibly be diagnosed with Alzheimer's and dementia?
Speaker 48
1:05:10
Is there, like, questioning prior to going out? That's what I was wondering. A lot of
Speaker 159
1:05:14
it is, especially in rural Arkansas, the sheriff pretty much knows a lot of
Speaker 158
1:05:18
the people in this county. When you get in an urban population, it's a little different, but we check with those police departments and sheriff's office. Hey, have you answered any calls there before? Or, you know, we could run the criminal history, do different things. If we have that name, date of birth, to help us, you know, make a threat assessment on how to handle it.
Speaker 128
1:05:39
I have a question. Go ahead. I mean, this might be for Sergeant Major Rhodes, but since you've implemented the drone program,
are there any data to say how many times you've actually used it to locate someone for a silver alert, and is there any data on that? So, I can't give you specifics for a
Bill Bryan
Unverified
1:05:57
silver alert. We have used it in basically all missing persons cases, and we've been successful, I
Speaker 178
1:06:02
can think of at least five times off the top of my head where we have been successful using the drone program to locate missing persons. We can follow up with those numbers. Every time we fly the drone, we have to
Speaker 158
1:06:17
do a flight plan and do a report. So we can research that and get you the numbers. But believe it or not, to fly a drone, you have to have a pilot's license. And there's certain restrictions that you can do the drone. But I think we
Senator Ricky Hill
Unverified
1:06:35
have like 17 pilots now that fly the drones.
Speaker 182
1:06:41
any other questions well major roads i guess it's over to you then okay so our silver elope program
Speaker 178
1:06:46
was implemented in 2009 um the protocol that we're operating under now um has been established since 2015
and it's been extremely successful and basically our protocol is let's say and typically they come from the sheriff's departments and the local police agencies, they'll receive a call about a potential Alzheimer patient or a dementia patient. In our protocol, we kind of look on two different levels. So they have to either be legally deemed incompetent, there has to be a documented mental illness diagnosis or mental injury, or strongly suggested by their
loved one or a caregiver that they're showing the on sites of dementia or the on ongoing um dementia the other part of that is it it has to come from someone who really knows the person so it needs to be someone that is the legal guardian a loved one that lives with the person or the caregiver who last saw that person so those are kind of the the things that we look at in evaluating whether or not we'll issue a silver alert um over the last well in 2021 we issued 77 silver alerts
this year alone we have issued 33 and a lot of times we'll get calls from the local agencies and they're just their their loved one you know he's kind of showing some forgetfulness lately I'm not really sure and a lot of times we'll kind of take a look at the age and a lot of times we'll just make judgment calls on that. And a lot of times we'll just err on the side of caution and just go ahead and issue that alert because you just never know. Some of them are really simple decisions to make, but that's kind of the evaluation process that we go through before
Representative Johnny Rye
Unverified
1:08:37
we'll issue the alert. Yes, ma'am. Let me ask you this. What do you do in a situation where no one has a prior record in other words you know all of a sudden uncle phil gets in his pickup and he drives to mississippi and you don't know where
Speaker 185
1:08:59
he's at down there so a lot of times if there's not
Speaker 178
1:09:03
some kind of any other evidence to support because the last thing we want to do is strip
an elderly person of their dignity right and so a lot of times if if there's if we don't have that background a lot of times we won't issue it um if you tell me he's 92 and and he's he has a routine that he's generally sticks with and then he's fallen off of that routine i listen to i listen to the family members a lot on that and if they feel that this is kind of out of out of character we'll go ahead and issue that alert it's a really you know it's it's not an easy decision to make
especially, you know, we had a gentleman just recently, and this was in July, and as you all know, we had a really, really hot July, and there was a gentleman from North Little Rock that left to go to Walmart, and he didn't come back for several hours, many, many hours. His wife got concerned and called, and she said, you know, he's just been really forgetful lately. I just don't know i mean walmart's five miles up the road he hasn't come back um so the first thing that we
did is and i say we this was actually the north little rock police department they tried to call him and he started getting really angry with them and so that was another sign that we kind of used like we probably should just go ahead and issue this alert so we issued the alert started pinging his phone um they were able to call him again and he says hey i'm out of gas but i have no idea where I'm at. And we pinged his phone and were able to find him down a dead-end road in White County, like the northern part of White County. And I tell you all that story is because a lot of times
they're just not cut and dry decisions. But we do everything we can to ensure that we're making the best decision without stripping, you know, the elderly of their dignity. If I might add to that, Representative Ross,
Speaker 169
1:10:53
sometimes what we'll do, if it's not real clear, we're able to put a missing persons out through the fusion center.
Speaker 158
1:11:00
And whoever subscribes to the fusion center, they'll get that email. So, for example, if, you know, you come up missing or something and we know you don't have dementia and all that, we could put a missing persons out.
And whoever subscribes to it, mostly law enforcement will get that. And that's another avenue, but without doing the silver alert. Because when we do the silver alert, it goes to the news media. And then you'll see sometime on the local news media, they'll put silver
Speaker 181
1:11:24
alert. But the other option is we just have a plain missing persons that we can do also through the
Bill Bryan
Unverified
1:11:30
Fugitive Center. And we also, if we can establish that they do have one of those cognitive disorders, we'll
Speaker 178
1:11:36
go ahead and do a missing or endangered adult advisory, and we put that up on all of our social media.
And we found that that really gets a huge distribution across the state with just that social media. Mr.
Speaker 123
1:11:54
Cook. Just had a couple questions in terms of your protocol. Is there, I know
David Cook
Unverified
1:12:00
every case is different, is there a timeline you want, I mean, how many hours do they have to be missing before you issue the alert? No, as soon as we
Bill Bryan
Unverified
1:12:11
get the information, we start evaluating it,
Speaker 178
1:12:14
and we make the decision as quickly as we can. And even so, like right now, we have 11 active silver alerts, and two of those are from before 2011. And so even when we don't find them, we still don't take it off. We still leave it in place. In terms
David Cook
Unverified
1:12:36
of your notification system, you said you use social media. I know the news media gets hit. Are there other means of getting it out to, I know, I guess my understanding is whenever that issue, all the local agencies get that as well, right?
Bill Bryan
Unverified
1:12:53
Yes. So we have a distribution list, and it's basically an email. It's like when we hit
Speaker 178
1:12:59
send, once we have all the information put into the information document, we hit send, and it goes to thousands of people. It goes to the Truckers Association, not just law enforcement, not just media, but there are so many other associations out there that are on the interstates and on all the roads and in all the gas stations. It gets pushed out to a pretty massive group of people.
But we do do that. So the Fusion Center, we send it out to the Fusion Center, and that goes to everybody on their distribution list. And a lot of times if we feel that they may have left the state, We'll get a lot of people that live in West Memphis, and if they cross over, we'll shoot that through our fusion center to the Tennessee fusion center. It gets out there. My last question
David Cook
Unverified
1:13:50
on that is when we do have an AMBER alert, we get text message alerts. Yes.
Has there been any conversations about doing that for a silver alert, sending out a text message using that alert system? And if not, what are the barriers to doing something like that?
Bill Bryan
Unverified
1:14:07
So one of the reasons I feel that we don't do the emergency wireless activation, and so
Speaker 178
1:14:12
Amber Alerts are a lot different than Silver Alerts. When an Amber Alert occurs, we know that a crime has been committed, just hands down, and that kind of makes it a little bit more intensified.
And the other thing is we issue so many Silver Alerts. the last thing that we ever want to do is for people to go, oh, that's another one of those. Because if everything is important, nothing is important, right? And so we've just kind of held back on that just because we want to reserve that for sheer emergencies. And I know that that sounds terrible because a missing loved one is an emergency. But we also
Bill Bryan
Unverified
1:14:54
have to be very cautious about how we use those services.
Senator Ricky Hill
Unverified
1:15:00
Thank you. That's a very good explanation there. I want to ask that question myself, and this will probably be more for Colonel since he's been familiar with his father-in-law having dementia. How do y'all handle the approach whenever a loved one calls in to y'all saying, I've been abused or they're stealing from me? How do y'all go about that so whoever the caregiver is or the child or anyone doesn't feel threatened themselves or they're worried about the loved one making that statement
and getting put through a pretty hard process.
Speaker 181
1:15:37
How do you all go about handling that? Usually our first phone calls to
Speaker 158
1:15:41
the DHS, to Adult Protective Services. I mean, they're their expert in that field. You know, again, we're an assist agency. As far as most of the time we run across these people, it's going to be on the interstate. Occasionally we do assist other sheriff's offices and police departments going to residents and neighborhoods. But in something like that, the abuse, we're mandated reporters, so we would have to contact Adult Protective Services and notify that and then request their assistance.
Speaker 48
1:16:08
Mary. Okay, I have one more question. I'm Carolyn, again, from Alzheimer's, Arkansas. So from my understanding for an alert, a civil alert, a person has to have, like, legally have their guardianship, like, taking their rights away. So
Speaker 165
1:16:25
are you saying, like, without a diagnosis, really, like, there can be no, really, a silver alert not issued for someone?
Bill Bryan
Unverified
1:16:35
No. So basically three things. We've got three options. Legally deemed incompetent of handling their own affairs.
Speaker 178
1:16:41
Having a documented mental illness, like of a cognitive disorder or from an injury. I think we talked about, you know, people being involved in car accidents and stuff like that. And the third is if the loved one strongly suspects that they're showing the early onset of dementia. If I could add one thing
Speaker 158
1:17:03
to your question a while ago.
When they make the notification of the police department or the sheriff's department, it's a one-page form, and they send it to our Troop A command center here in Little Rock, and then Stacy would make the call right away. So it's usually not much of a delay. If we get that form and make that assessment, then it's made right away. We don't say he's got to be gone for, you know, four hours, eight hours. If the police department,
Speaker 181
1:17:27
sheriff's department sends that in, then we make that evaluation off of that
Speaker 47
1:17:34
form that they send in. One more question. So after, if you decide not to do it, how long before you reevaluate?
Speaker 48
1:17:41
Like the family, if they stay out longer, you will reevaluate after a certain amount of
Bill Bryan
Unverified
1:17:47
time? Absolutely, especially if they've garnered other information. So a lot of times that you'll have someone who the family, you know, like, well, I think, I don't know. I just don't know. And if they're uncertain, we may, let's say that we just decide not to activate the alert. But in the meantime, they go and they start contacting other loved ones, and they find that he's been seeing a particular physician, and the physician says, oh, yes, I've been treating him for this.
And then they can either, you know, they'll call us and say, hey, we've gotten additional information, and here it is, and then
Speaker 190
1:18:19
we'll decide from there. It's not just a no and go. It's, you know, it's a constant evaluation. And please keep in mind that we were
Speaker 171
1:18:27
able to do the missing person. Not if we were doing the silver alert. We can still do the missing person right away and get that accomplished and get that out there.
Speaker 43
1:18:40
Go ahead. I just want to say that I had to use that, this whole process in 2012,
and it went I mean obviously I thought my dad was trying to become famous by doing all this but he was found within an hour and a half and one thing is that with my dad he was faster than anybody could ever figure out because he was just walking and so thank you for what you do and
Speaker 208
1:19:11
the officer handled it amazingly so thank you
Speaker 43
1:19:15
we did we did but it's really emotional for everybody because i've been through this
and um it couldn't have been done uh better my dad actually was looking for my mother and thought he knew right where she was which was not where she was but the officer just went along with it and that's sometimes you have to just go where they're at and he knew how to do that so thank you very much
Representative Julie Mayberry
Unverified
1:19:44
I have two kind of very different questions I'm going to go hopefully with the easier one one is while we have you here at the table and I
always try to think legislatively is there anything legislatively on your wish list that we need to do to help in this
Speaker 158
1:20:05
right now Well, Stacey, do you have anything as far as silver alerts? We've worked very hard on updating the silver alert and the amber alerts because, as Stacey said, when you start doing the wireless thing and stuff like that, because even on the amber alerts, you know, we have to get information beside, like, a white male, 22-year.
We need a vehicle description, something, because when we do that, we also put it on the highway safety signs out, the electronic billboard. So I think as far as I'm concerned, but she does it every day, so I'll defer to
Speaker 185
1:20:39
her. Oh, my gosh. Put me on the spot. I could always use more money, but I'm just really struggling with
Bill Bryan
Unverified
1:20:47
the thing to spend it on. Can we get shoes? No, I'm really going to have to give that some thought. Our program, you know, I'm constantly reevaluating, especially our amber alerts and our silver alerts.
Speaker 178
1:21:00
Can we make it better? Is there a way to get it better? And, you know, and our civil alert has been really, really, it's been really, really successful, you know, from the groundwork that were laid way before I, you know, ever got to this position. But I'll definitely give that some thought. Okay. Or anything that we need to add into the state plan along
Representative Julie Mayberry
Unverified
1:21:19
that line? I mean, this is the time to be talking about it. So, you know, if you don't think of it right now, you go to sleep and you wake up in the morning and go, oh,
Speaker 182
1:21:30
It'll be at 3 a.m. when I don't have anything
Senator Ricky Hill
Unverified
1:21:33
to write with. We'll send it to Colonel, then
Speaker 176
1:21:37
he'll get it to us later on. While we're here, I just want to thank the legislators. Our pay raise just came in last Friday, so every trooper
Speaker 47
1:21:49
is very happy, so I want to say thank you. So this is about, I'm Carolyn again, this is about Smart 911. like do so I've like in years past if you don't know what smart 911 you kind of like read you
upload and fill out information before you call first responders and then your information should pop up is that widely used in a lot of communities and my question would be like why not and how could we get it so the question I asked prior to like getting
Speaker 48
1:22:18
people to sign up so So if my loved one did have dementia or any other kind of disease, like it would pop up, like Carolyn's missing and she has whatever I have.
And that way, you know, you would already have prior information. Is that widely used across our state? And if not, how could we, like, kind of make that more accessible and usable
Speaker 47
1:22:42
for first responders and our community as a whole? All right. She's looking at me like she wants me to
Speaker 158
1:22:52
the smart 9-1-1 is mostly for your local police departments and sheriff's office instead of the state police. So usually if they get something like that, they can transfer us.
Now, we are just going to the new CAD system, computer-assisted dispatch for us, and I'll have to check the availability on that. We've only installed it in Troop A and Troop L, but I will follow up on that if it has that capability. You know, one thing that we did do, working with RDOT and local cellular carriers, If you do need the state police, all you have to do is dial star ASP, and that will automatically connect you to the nearest troop location. So if you're in a residence and you're not sure how to get a hold of state police, dial star ASP and it will automatically go to that troop area, or 277.
Speaker 182
1:23:35
But ASP is easier to remember. You know, I know that y'all were talking about conducting training, and
Speaker 178
1:23:43
we always get questions of, you know, how can the general public help you, help them? And, you know, one of the things that I think about is when you're training caregivers or if y'all do any kind of training for loved ones, you know, is to make sure that they keep notes if they do have to report their loved one missing is knowing their bank accounts and so many different things that we kind of look at
to help track them, you know, to kind of monitor their movements. You know, just stuff like that is really helpful to have that handy, especially when they start suspecting that someone is starting to see that cognitive disassociation. That would be just really helpful. Just thought I would add that. And to our troopers, you know, unfortunately, and Stacey can
Speaker 158
1:24:26
give you the numbers, that we do issue civil alerts and we find the people deceased. And that's tough on our troopers when they go out there and find people who are missing and then they're deceased.
Bill Bryan
Unverified
1:24:38
But, for example, how many? So last year we issued 77. we found three that were deceased and the young woman here that was talking about how
Speaker 178
1:24:47
they go to the left you know and there was a woman up in Bella Vista who just walked away from her home y'all probably remember that and she was in I think like 1500 feet of her house and she wasn't found for like two weeks and so you know you can look at that as three but the other you know 74
were successful um you know those but we want to make that number zero right we want to make that number zero and um I don't know what what we could have done in that situation is maybe if we'd had the drones up there in that particular case we might have been able to to find her especially with the FLIR we've got a drone with FLIR that and it was in January I think whenever she and you know she does exposure um anyway I certainly don't want to end on that song Representative Mayberry has more questions for you.
Representative Julie Mayberry
Unverified
1:25:39
I've got at least two more. So kind of following this line, something that just popped into my head, and there's a little cobweb up there, so help me. Don't we already have some type of sticker that can go on the back of the vehicle when there's like a communication impediment or something like that? Is there something along that? Can it be used? I know when you have autism, there's a sticker on the car tag that would let a trooper know before coming to the vehicle that a little warning,
is that in place for something like this? I know
Speaker 158
1:26:12
we worked with the deaf and blind school, and we put our stuff on our computer to let you know the sticker that the person driving is deaf. So there is some things, and I can follow up exactly, because I know in our class, looking at the curriculum, we also teach a class on autism for
Representative Julie Mayberry
Unverified
1:26:30
two hours. Well, I believe there is a sticker for autism. So that they can know in advance that they're approaching a vehicle that might have someone who might react a little differently
than someone else and to know that in advance.
And I'm just wondering if there's something like that when we're dealing with Alzheimer's and dementia. They might not be the driver of the vehicle, but they might be in the vehicle, and it just gives them a little warning ahead of time. I don't know if any state has done that at all. I'll follow up on that and get back to you and let you know. And this kind of goes along with that question because I'm, what can a family do, and this, I realize you are not the one that goes to the home, but you are part of first responders, so help me figure out who I need to ask this question to if you can't answer it.
but let's just say someone has called 911 and they're saying because there's paranoia that goes along with Alzheimer's accusing someone of taking their money accusing someone of wanting to do harm to them poison them what have you and in their mind it is very real and so if you know that your loved one is beginning to be like that and have those situations, should the family be proactive
and reach out to the departments in advance and say, I want to let you know what's going on in my home in case someone calls? This is kind of like the smart 911, but should they go further if there's local police that might
respond, or are you opening up a can of worms? Yes. Okay. You know, I would defer, but, you
Speaker 158
1:28:12
know, I think that's why this training is so important. If you look at this, the curriculum we have here, it talks exactly about those things,
how they turn on the people carrying, how they accuse them of different things. So that training is important, you know. I would refer to, you know, almost that jurisdiction where that person is at are, again,
Speaker 182
1:28:34
DHS. Can I just say something? So Major Hollingsworth, who was
Speaker 178
1:28:39
the major that used to do silver alerts before I did, his mother-in-law actually had Alzheimer's and reported they had gone, he and his wife had gone to their house and taken her keys away because she was 85
and she was getting out and she was crashing and, you know, and just leaving and driving home. So So they went and they took her keys away, and she filed a report on him for stealing her car. So, and he did, you know, he went to the police department, and, you know, sometimes it is, hey, you're going to, you know, if you respond to this, I think it would be helpful if they know that stuff's going on and allowing law enforcement to kind of have some background if they do start getting those calls about my car stolen and stuff like that.
Speaker 232
1:29:26
That would be my recommendation. Okay. Thank
Speaker 90
1:29:33
you. Melanie, go ahead. So in the virtual reality equipment, we actually have these scenarios that they actually have to go through and how it makes the individuals being trained, how they understand that the auditory and visual information is mixed up
and how they're not hearing or seeing and the brain's not receiving the information correctly and how it gets that they're going to receive those 911 calls. And so there's actually scenarios in the virtual reality training equipment that all these scenarios play out. that we actually have in our training okay because it's got to be very hard
Representative Julie Mayberry
Unverified
1:30:20
to assess because in some situations there could be abuse and they're taking advantage
of mom and stealing the money and trying
to do harm to her and she's completely sane and
then you know the reverse could be happening so just how do you how do you assess that right when
Speaker 234
1:30:38
i'm talking with dhs uh this afternoon i
Speaker 158
1:30:41
mean they basically said you know sometimes it's just best to report it be safe than sorry and then they work through the process go ahead david
David Cook
Unverified
1:30:53
i just um just for clarification i think when you started
you mentioned that um you're speaking that the the training that you offer to the state police
correct it's not the same with alita there's there's different standards my
Speaker 171
1:31:06
understanding they have two days of uh training for crisis intervention and i think all times is part of that i haven't seen
Speaker 158
1:31:13
their curriculum but that's my understanding they have two days of crisis intervention they consider this crisis intervention training thank you thank you any other questions
Senator Ricky Hill
Unverified
1:31:20
or comments colonel major appreciate y'all's time and thank y'all for coming and it was very helpful thank you sir any other business that we have to discuss today
i guess uh our next meeting we need to kind of get a date for that will be the what we need to look at first
Mr. Cook I guess we'll kind of look at you since you're getting the state plan together what uh how soon do
David Cook
Unverified
1:32:03
you think we need to meet probably as early in September as we can
Senator Ricky Hill
Unverified
1:32:06
okay you want to get with uh Brandon with Brandon and kind of put a couple of dates and then kind of shoot an email
Representative Julie Mayberry
Unverified
1:32:23
out to everyone? Yes, sir. Okay, does that sound good to you? Go ahead. I was just going to share, because I have not had a chance to tell you, Senator Hill, either. I did speak to Representative Charlene Fite, who is over children, aging, youth, and military affairs. This was actually her bill that put this committee together,
and I asked if we could bring forth total discussion either in November or December, and she told me yes, that she'd love to have us come before the committee and share whatever we have presented.
Senator Ricky Hill
Unverified
1:32:53
Okay. Thank you for that. Appreciate it. With no other business to take care of, this meeting is adjourned.
Agenda
A. Call to Order
B. Consideration to Approve Minutes from the July 11, 2022, Meeting [Exhibit B]
C. Discussion of the Alzheimer’s Disease and Dementia Arkansas State Plan [Exhibit C]
D. Update on the BOLD Grant Implementation
E. Arkansas State Police Operating Protocol for Silver Alerts
F. Other Business
G. Adjournment: Next meeting September 2022
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — ALZHEIMER'S DISEASE AND DEMENTIA ADVISORY COUNCIL, Aug 1, 2022 | Agenda | 1 | Official source ↗ |
| Exhibit B - 7.11.22 Minutes | Exhibit | 1 | Official source ↗ |
| Exhibit C1 - Alzheimer's and Dementia State Plan | Exhibit | 44 | Official source ↗ |
| Exhibit C2 - Alzheimer's State Plan Presentation | Exhibit | 15 | Official source ↗ |
| Handout 1 - Dementia Quick Tips | Exhibit | 2 | Official source ↗ |
Speakers
Senator Ricky Hill
Unverified
David Cook
Unverified
Speaker 8
Speaker 15
Speaker 32
Speaker 34
Representative Julie Mayberry
Unverified
Speaker 37
Speaker 39
Speaker 43
Speaker 44
Speaker 47
Speaker 48
Speaker 51
Representative Dwight Tosh
Unverified
Speaker 59
Speaker 61
Speaker 63
Speaker 65
Speaker 71
Speaker 88
Speaker 90
Speaker 95
Speaker 98
Speaker 113
Speaker 128
Speaker 130
Speaker 138
Speaker 140
Speaker 142
Speaker 141
Bill Bryan
Unverified
Speaker 157
Speaker 158
Speaker 159
Speaker 163
Speaker 164
Speaker 167
Speaker 166
Speaker 165
Speaker 168
Speaker 171
Speaker 178
Speaker 182
Representative Johnny Rye
Unverified
Speaker 185
Speaker 169
Speaker 181
Speaker 123
Speaker 68
Speaker 190
Speaker 208
Speaker 211
Speaker 176
Speaker 232
Speaker 234