Alzheimer's Disease and Dementia Advisory Council
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- October 2, 2026
Speaker 3
0:31
we're gonna give it just a couple more minutes and then we'll get going folks
good morning Welcome to the Alzheimer's disease and dementia advisory council. I think I
Representative Les Warren
Unverified
5:00
hit the gavel a little bit too hard for a couple of ladies next to me but if they were not awake they are now so good to have everyone here this morning and we don't have a long agenda but we will start with seeing a a quorum
and then we will consider approval of our minutes. so have you all looked at the minutes OK do we have any corrections or changes to those minutes? OK, I'll entertain a motion to approve the minutes motion in the second. any discussion? all those in favor say aye any opposed same sign the men stand approved so
next we will move into a discussion of the Arkansas state plan so David, do you want to come to the
table please? and justin fyi Senator Penzo is on his way he called me just a few minutes ago he went to get in his truck and someone had bashed a window in
so the police are with him filling out the form and he said I will be there but it'll be a few minutes late so I'll shift over and let him finish chairing the meeting but he is on his way he did not forget the meeting so David apparently does not want to come to the table
I tried to stall as long as I could but I ran out of material. I guess I should have called on Senator Flippo because he's always got material so will it we'll just call it a gift and end with that OK? all right well you identify yourself David Cook a director
Speaker 14
7:38
of government affairs for the Alzheimer's association all right you are recognized to
Speaker 15
7:46
present your plan. The laptop is password protected Brandon work oh ok we were waiting on
Speaker 17
7:55
technical support I think what we're waiting for tech support
David Cook
Unverified
8:10
because my presentation's locked on if you'd like to sing for us or
David Cook
Unverified
8:26
I could come up with a little ditty pretty quick I think while while we are waiting for assistance I do want to draw your attention to priority number3 under the objective sections because there will be an amendment I was working on the state plan there was some formatting issues I was trying to clean up
yesterday and Naomi just pointed out that I did leave an objective off inadvertently and it it is specific to a mapping where where Arkansas currently has pet imaging MRI monitoring infusion services and dementia specialist or or care services and so one of the objectives that I presented to you last month was to map our available services also identify
the gaps and then the objective was to utilize some of the existing infrastructure to close some of those gaps in terms of access to infusion centers and that that is a project that we will work jointly with the UMS Centers on agging on the Alzheimer's association and DhS with the dementiaervis coordinator and I think the Arkansas department of Health is also named in that it is a just a just a objective that got left off inadvertently but that will I will ask the the the council to
when when the time comes approve the amendment or the state plan with that pending amendment. it looks like we've got an
Speaker 5
10:24
it's the power Poweroint on here or we would just go through the
David Cook
Unverified
10:48
the state plan as a pD I did have a PowerPoint but I guess it didn't get loaded in so apologize for that
the added areas that we didn't have last time of course the covers been updated and then the table of contents has been added in there as well. one other thing to note there is a brief letter from the Arkansas Department of Health that discusses the partnership with between the department of health and the dementia services coordinator that will be added in as an appendix item as well this version of the state
plan this updates it was very important for us to make sure that when we did make updates to the objectives and the priority areas we took into consideration the advancements that have happened in Alzheimer's research since the the previous version of the state plan and so we we talked briefly about some of those advancements that that have really changed the landscape one of those of course is access to early detection diagnosis and we'll talk a little bit more about that in just a few
moments I do want to hit the highlights of just the impact of Alzheimer's disease across the state of Arkansas you know based on our population study with the census in 2020 we we recognize there are over60,000 Arkansans over the age of65. currently living with Alzheimer's disease that number does not include those individuals who may be living with a younger onset diagnosis or those living with another form of de ment ia we've spoke at length about
the impact on family caregivers we know there's over 175 family caregivers here in Arkansas who in 2025 provided over 268 million hours of care so caregivers play a significant role in delivery of of care across our state so we've talked at length about the importance of supporting family caregivers as well based on those statistics one of the other things I'll draw your attention to is just the workforce shortages you know we we have currently60
geriatricians by 2050 the demand is to increase that by61%. so certainly more efforts in this plan are highlighted about the importance of not only the recruitment but the retention of the direct care workforce and extending beyond that making sure that we are recruiting and retaining geriatricians and attracting erry tri c ian s to the state given the fact that the state has also made a lot of headway and ensuring that we are attracting people to retire to the state we want to make sure
that we have the infrastructure to care for that influx of aging populations across the state of Arkansas. Um, again this plan builds on some of the progress we've had earlier in the previous version of the state plan just the council we've talked about this at length but just the support of the council being able to move through legislation that helped us delivers on some of the priorities why identified in the previous state plan
but to ensure that this state plan reflects some of the advancements in in research we did updates the the the priority areas and we've already approved this as a council but just to remind you of that our our four priorities are again advancing risk reduction brain health early detection and diagnosis and we wanted to make sure in this priority area we identified objectives that of course reflect some of the latest developments in research we know that
since the previous state plan we now have treatments to slow progression of the disease we also know quite a bit more about risk reduction in terms of some of the things that we can change and modifiable risk factors and so we leaned heavily on trying to make sure that when we developed objectives again reflect some of the advancements we've seen in research in this space the council since we began our work in 2018 as always
sought to prioritize family caregivers and of course we continue to do that in this version of the state plan by identifying a single priority that just enhances support for family caregivers across the state and then our following our our last two priority areas again ensuring access to diagnostics and treatments again making sure that the the plan reflects the advancements in research in this space as well you know we we
now have bloodbased biomarkers and so the ability to identify and diagnose the disease earlier it certainly accelerating as the research moves we now of course also have treatments so we talked specifically about looking at insurance coverage and when we determine whether or not an insurance coverage is adequate we want to make sure those policies cover the wrapparound services in terms of diagnostics but also access to treatment and so part of that priority
amendment that we I just mentioned deals with not just you know it's great to have treatment but we want to make sure people can access that reasonably and so one of the things that we wanted to work on is mapping some of those gaps and then how do we close those gaps with some of the existing infrastructure and that's something that we want to to work on during the next four years. and then we wanna make sure access to care is available for people and regardless of their zip code but also make sure that care is
is is quality care as well and one of those other access points we need to to continue to monitor is is diagnostics. as I've I've talked with Naomi you know the the coordinator we we both agreed that this these objectives are highly ambitious over the next four years it does require the council to work together and collaborate on some of these efforts but nothing outside of the realm of possibility again we we left the objectives
broad enough so it gives us some flexibility to not only you know change and adjust priorities when needed but also the flexibility to to move where the research takes us so as again researchers changing every day in this space so we need to have the flexibility to adjust the plan to some of the new research developments that no doubt we will see in the next four years. Any questions on the priority Clear as mud
Senator Clint Penzo
Unverified
17:45
right. thank you Mr. Cook are there no questions for anything've got quite a
Speaker 44
18:05
question As number4 and the ensuring access it's kind of a little bit confusing as to what's the difference I know I
know in the thirdrd3 priority it says ensuring access to diagnostics and treatment and then it says supporting access in the fourth one that's it may be a minor thing but it was something that I was just had that question about the difference the wording seems similar for priority3 and4 that was just a comment I don't really have anything else to say beyond that
David Cook
Unverified
18:37
No I appreciate that comment and Doctor Jordan you know on on priority re we're really focusing on the diagnostic and treatment space, on thex
access and quality of care we're looking at more of of care across the continuum in terms of long term care HCBS services and things like that but thank you for that Um, each one of the sections you guys have seen this before we did approve most of the content that's there there has been nothing changed in terms of the
content areas that lead up to the objectives. I would like to spend the rest of the time just looking at the objective areas in each priority area the objectives in each priority area excuse me under risk reduction brain health I will not read all of these in their entirety but I'll hit the highlights and just talk about the why behind this. but on risk reduction, brain health, early detection diagnosis and care planning we have made made some
headway there's deeper collaboration between the health department and DhS really trying to figure out how do we integrate brain health messaging and some to our some of our existing chronic disease strategies and so lots of conversations will be had about how do we you know use our existing the existing public service announcements or public health campaigns and how do we integrate brain health to normalize the conversation around brain health and again
speaking about brain health doesn't carry the stigma that Alzheimer's and dementia does and so if we can be pro proactive around risk we can change and influence the conversation and get ourkansans to be more practical around their brain health and seek out detection and diagnosis when they do recognized memory concerns the arkansas department of Health is currently running both of our specific modules inside theharis factor surveillance system the
cognitive recline module and the caregiver modules are being ran on an alternated cycle. and so it's when we collect that data we wanted to add a priority here making sure that we're utilizing that data to inform policy decisions but also that the council's aware of what we're seeing some of the trends we're seeing across the state both in the Cdl and the caregiver space. u a M S and I have discussed this Doctor Overton McCoy and I had a
conversation about this earlier but they have already done some of this trying to incentivize and increase the use of the medicare annual wellness visit. we want to continue to track that status and identify strategies that help us and increase the use of that code whether it's you know patient awareness clinician awareness umuMs and the hronic Disease Council and the healthal department already partnered on a project and so just building on the some of the
existing work there to help us continue to make sure that people are aware of the code and also providers are being proactive and offering this to their patients we are seeing some clinic clinicians across the state be very effective just this is you know part of the patient file when they turn a certain age they're automatically gonna do this and so we'd like to see that to be a standard practice across the state again it we we talked a lot
about the you know the the direct care workforce in Arkansas and how we've done a lot to expand scope for APrns and PAs and also identified my concern that the clinicians that are not attached to major health systems don't have access to the same information as their colleagues who are. so making sure that we we are proactive and educating providers on the importance of early detection diagnosis when they need to
make a referral but also incorporating risk reduction into their clinical practice and so provider education is key and then finally in that section just making sure that people who do receive a diagnosis of dementia I've also been offered care planning services and are connected to community support services. again there's a variety of strategies that we're working on to incorporate this into everyday practice one of
those I think is you know the dementiasour dementiaourents as well expanding that footprint so and also some things that DhS is doing in terms of developing a basically care navigation system using some of their infrastructure so there's some things that are moving in this priority area but certainly more that we can do as well in this space and I will pause there for any questions on those objectives
Speaker 44
24:06
I don't mean to be full of questions today do I'm just wondering about some of this data that's being collected if if included in the outcome if we could say something about report to the advisory committee because it would be kind of nice to know some of the information that's collected from some of this data
David Cook
Unverified
24:28
in addition to the burfa or the other data that identified the wellness annual wellness visits would be interesting.
I am I I will go back in and make that that note to include data reporting to the council guess we need to ask for Approval or amendment to the plan on that section Let's wait till the and if there's any
Senator Clint Penzo
Unverified
25:32
additional we'll we'll get them at that time
David Cook
Unverified
25:46
the heading and the material there is the same looking at the specific objectives one of those is to just ensure of course currently we are using a a pilot program that uses SsGB funding to provide this this respite service across the state. we've been operating in that
capacity for the last four years. and as we've mentioned before, our our dis disease space really has not got 10 any SGR support, we we really tried to do more with less. we would like to see the state invest like some of our neighboring states have in a permanent dementia respite grant program. just to ensure our our caregivers have access
to respite something that the state could be proud of to to build upon in the coming years you know Kansas funds their program at $850,000 annually and that's probably one that's most like ours and we've we've been capped at 200,000 based on the SsUB draw to operate this program Mississippi is at350,000 now and then our neighbors in Tennessee across the river or at a million dollars annually now
granite Tennessee has more of a prevalence than we and but just kind of a a ballpark of how other states are investing in services like this also one of the things that the legislature continues to ask us for is a onestop shop for caregivers. and so that's something that DHS is working on as well just establishing a single caregiver navigation system so families know where to access treatments when to
ask access treatment and that you know families aren't waiting till crisis comes to access care and support services there there's avail ability across the continuum from you know mild cognitive impairment to advance Alzheimer's disease. people have nowhere to go at every stage of the disease expanding evidencebased caregiver education and support groups and the more underserved and and rural counties and so that's something that can be moved programmatically between the work that we're doing with the
centers on aging and some of the other nonprofit work being done by the association on on Alzheimer's Arkansas as well. again one of those priorities that's in essential to family caregiver support is expanding a pilot that we've began in northwest Arkansas establishing a dementiaour center that's something that we'd like to expand across the state. and so we are working with the Schmeingenter right now on the pilot we're also working
on collecting data and and we'll have some more presentations on that as we get some more data in place just to kind of talk about the reach of the resource center, how valuable they are and how important it is to expand that footprint across the state and that is something we can do for with a very limited fiscal impact as well and then what increasingly these these get a little bit more ambitious and I think really having a discussion around establishing a pilot
dementia care specialist program um, very different than to missis dementiaervices coordinator, that coordinator is housed inside a state agency with the care specialists are according to the the model that I I personally dream of we would have a care specialist in each one of the centers on aging or excuse me, each one of the dementiaour centers just to help families navigate the healthcare system, refer them to community services but
also it's very essential to have someone in place to help close the referral loop so making sure people when they do receive a referral they do follow up you could use kind of a a community health worker to fill that space as well so but I would like to see us pilot that in year two or three of the state plan, which may be an ambitious goal but one that we're up for. In the other questions on community support for caregivers, family
David Cook
Unverified
30:41
about that the priority number3 just ensuring access diagnostics and and and treatments one of the the tasks is is make sure we continue to monitor the different payers and how
they are covering diagnostics how they're covering treatments but also all the wrapparound services that are needed in terms of you know ongoing monitoring with MRIs and so one of the things we looked at is is checking that through mapping that was an amendment I mentioned to you previously but you know when we we looked at some of these coverage gaps that that of course always lead to policy things that we need to do policy wise to make sure
those gaps are closed but that's something we can we need to continue to monitor and Doctor Jordan to your point report back to the council on what our findings are and how do we we close those gaps you know number two kind of builds on that just in address any inconsistent coverage of FDA approved amyloid therapies across Arkansas payers so once we identify the gaps how do we close those again, expanding access to to
cognitive evaluation to telehealth provider support and referral networks was was number3 you know under that broad category was one of those strategies like developing a hub and spoke model similar to the mitigation we do in stroke. so building a system where some of these r providers have someone they can lean on for consultation when they are evaluating cases
we also highlighted that bloodbased biomarkers have made their way to the primary care space, what does concern us is that clinicians all aren't always educated on how to use those bloodbased biomarker tests and then several cases in northwest Arkansas, you know the pcp refers once once they get a positive biomarker test they refer it to a specialist on the specialist has to review all those cases and in 11 instance again this is
this is an outlier this is one case of 100 cases he received only about30 could go on to more evaluation and so it's important again to educate those rural providers who aren't connected to major health systems on the appropriate use of bloodbased biomarkers, and you know when when to refer that that patient on to a specialist. that will be an ongoing issue especially as the the
research space in bloodbased biomarkers continues to evolve. you know before we were just testing for amyloid but now we can test for tau as well and so that that space is going to accelerate if I was just reading tea leaves even a year from now we'll be in a much different space than we are right now it's just moving that quick. and then even a clinician that's attached to a major health system you can't expect them to to keep up
with everything. So ongoing clinician education is key and then making sure families, consumers they have clear information on available treatments and and all the risks and benefits that are associated with the available treatments as well
Speaker 66
34:57
so I can the same verbiage from the measurable outcomes. So on page 15 expand access to dementiao centers across the state. you said funding secured for a pilot center and on page 17 that same
verbiage was carried forward for educate primary care providers. it's just a typo. It is a
David Cook
Unverified
35:24
typo that deliverable should Reidad guidance issued and providers
Speaker 40
35:29
trained with refer referrals tracked with the data existed yes yes yeah it's it's just a typo will
David Cook
Unverified
35:47
that's again me trying to format these boxes and I copied and paste stuff and that was a mistake on my part. right under the excess and quality of
care priority the majority of our objectives live here and so I'll kind of go through those as well over the the previous state plan we were able to advance legislation that established dementia training for assisted living communities law enforcement home care providers and even enhancing some of the requirements for facilities who choose to have an Alzheimer's special care unit
and so one of the questions we we have is whether or not that dementia training is improving care outcomes and so continue to evaluate some of the impact of our dementia training standards and that's something that the coordinator is is working on sorry to keep calling you the coordinator Naomi but but I know she's working on something there as well strength and recruitment training and retention of the direct care workforce serving
people with dementia again making sure there's growth across the board and how do we come up with strategies develop strategies to incentivize retention and and again I think some of our partners in the room are doing some great job to to recruit to that workforce I think AHA's you know they're they're nursing training program is amazing and and and and filling some of these gaps how do we continue to build on things like that
also improving care coordination when patients are transferred between care settings so someone is discharged from one facility to the other how do we make sure there's there's good care coordination along the way this would also include hospital to home as well. just making sure people have access to the services that they need as well. I think monitoring access and expanding access to HCBS services is is a priority that we had in the first state plan and I brought it back for this one as well. just making
sure that there's another carryover deliverable there. I apologize that's a typo but just monitoring access points to to HEBS services and and closing those gaps where services aren't available this is something we've continued to work on with various partners but stri making sure we strengthen protection of our of Arkansans with dementia from abuse, neglect and financial exploit exploitation we have done
some legislation around that but just continue to identifying gaps and monitoring to make sure that you know the dementia population is protected we have done a lot in the space in terms of training first responders and our law enforcement community certainly there's a need to expand that to other first responders and emergency personnel but just we want to make sure that emergency departments or dementia capable
as well and so I know that the UMS centers on agging is doing some of that training and so how do we build upon some of those training mandates and get them into some of the other areas that are needed strength and community confidence in home care memory care choices by closing any gaps that we see in existing licensure standards or any kind of disclosure requirements that need to be added and that'll just be identifying some of the gaps that we see in and coming up with strategies to close those gaps
and then established consistent dementia capable training standards for clinical and paraprofessions who are caring for persons with dementia so that is where most of our dementia training legislation would live under you know identifying some of the dementia training standards across care settings identifying those gaps and and closing them a policy solutions any questions on that section?
Our final section is is really the 227 policy recommendations I did get Brandon noticed this but they are a little bit more broad than I've put in the past. but expanding access to cognitive assessments more specifically one of the things that the gaps that we're immediately looking to close is the one that exists in Medicaid's Medicaid has yet to establish a reimbursement code, or reimbursement for Cp code 99483
which is the the cognitive assessment code. it's available to our our Medicare population but for those individuals under the age of65 who may have memory issues there is no coverage on the medicaid side of that but Medicaid does you know they do because of the Cms rule they do provide coverage for FDA approved treatments but again the cognitive assessment benefit is not included under that and so
the the when we look at usage of this code across the states especially in Kentucky I think Kentucky is paid400 claims in the past five or six years. so the fiscal impact is really minimal for this but it's something that we have been asking the medicaid department to close for the last five years so we're still working on that as well expanding access to the caregiver respite support. this is where again establishing a permanent dementia respite
grant program would live I would expect legislative to file legislation specific to the to to the respite program, this session strengthening dementia training for healthcare providers the two clinical areas that we are proposing that we look at this session is PAs and APRns just adding a continuing education
requirements to those clinicians who are serving individuals with dementia, um, without adding to their current existing continuing education requirements we'd like these incorporated into their existing ones and also not doing anything to impact their scope of practice but just making sure that that is mandated in the continuing ed because things are moving so quickly in this space. you know, making sure there's consumer protections in in home
care one of the things that I have mentioned is that we do require a licensure for medicaid providers but not for those individuals or those companies who may be just private pay we don't have a licensure standard for that so that is really concerning. and then also just expanding access to FDA approved treatments more specifically we're looking at the state employee benefits even though Bluecross has
changed their coverage determination we're still not confident that that has any impact on the state employee benefits division and so we are waiting for some verification on that. but I would expect us to move on that issue as well the session. Thank you Mr Cook
Senator Clint Penzo
Unverified
44:07
and. does anybody have any questions about anything in there
Speaker 79
44:22
Hey David thanks for your work on this. there are a number of it's probably just me being the way I am but there are a number of period issues ellipse issues commas those kinds of things. So I've marked mine up to help you when you're going through to kind of fix your objectives and make sure they're correct just to make sure all of that's correct before you hand it to council for their appro Anyone else
Speaker 51
44:54
this question none of those are like content changing just grammatical things OK. well
Senator Clint Penzo
Unverified
45:01
what I'd like to do is that objection do the three amendments that we had and vote on those one of the third one was just a typo first two I don't know if we want to restate what they what they were and then we'll we'll vote on it
David Cook
Unverified
45:28
So amendment number one under priority
area number one was just to cu include data reporting to the council where we have shown in the report that we were going to collect data so that was one of the amendments amendment wo came in page
Naomi yours was 17, right Yeah, the typo was a carryover on page 17 and this one And then under enhancing access or s yeah enhancing access to diagnostics and treatment. there was a priority
that was inadvertently left off and that that objective should say mapping where Arkansas currently has peT imaging MRI monitoring infusion therapies and dementia specialist and then also the deliverable was identifying those gaps and utilizing existing infrastructure to close some of those access point gaps so we we recognize
Senator Clint Penzo
Unverified
47:20
Um, so all in favor say aye opposed
motion passes next we'll vote on approving the Arkansas Alzheimer's and dementia state plan as amended all in favor say aye opposed motion carries state plan has been adopted next item on the agenda is a discussion of potential legislation I don't know if
p re s ent ative warren would like to take over on this
Representative Les Warren
Unverified
47:58
think as far as basically we've got our legislation in place what I'd like to do is look at it from a perspective of if we have positions which Brandon and I are going to meet that have not been fulfilling the appointment then I would like to see us get a couple of people I know Baptist hospitalspital has
a dementia Alzheimer's caregiver type department so we need to try and include someone from there if you guys have any other suggestions I would ask you to get those to me but we need people who are truly wanting to be engaged in this process I think David's done a great job on our plan but the more people that we can get that understand this disease
that are passionate about this disease the better we're going to be about getting the message out into the entire state and seeing some results from what's available so I would just ask you if you've got names of anybody get those to me and I know um'm I'm looking at Doctor Davis from Baptist that's the only name I have right now but any other names that'd be
welcome if you if you want to get with me after the meeting
and share that But I would I would ask that you would just allow Senator
Penzo and myself to work on just amending the existing legislation to delete some that
aren't active and add any appointments that we think would be beneficial to the council. thank you Representative Warren
Senator Clint Penzo
Unverified
50:01
is there any other business we need to discuss today do
you have any additional comments about anything else? No sir. OK. Nobody's got anything we'll go ahead and adjourn the meeting thank you oh I just want some
Speaker 76
50:18
clarity on our process that we've updated the state plan do we just I'll
David Cook
Unverified
50:23
make the added the the changes today and then we mail that back out over to to the council
Senator Clint Penzo
Unverified
50:32
if if we could have everything into Mr Smith here by the twentyeighth. that would be great. that
way we can get he can do his thing and get it submitted by the first.
David Cook
Unverified
50:44
I I would feel more comfortable with the council got to look at the state plan with the amendments at least via
Senator Clint Penzo
Unverified
50:52
email OK yeah and then if anybody's got any objections or anything let me know and then we'll reevaluate at that time. OK. all right we're good
Agenda
A. Call to Order
B. Consideration to Approve Minutes from August 25, 2026, Meeting [Exhibit B]
C. Discussion of Arkansas State Plan [Exhibit C] - David Cook, Director of Government Affairs, Alzheimer’s Association, Arkansas Chapter
D. Discussion of Potential Legislation
E. Other Business
F. Adjournment
Documents
Speakers
Speaker 3
Representative Les Warren
Unverified
Speaker 14
Speaker 15
Speaker 17
David Cook
Unverified
Speaker 5
Senator Clint Penzo
Unverified
Speaker 44
Speaker 40
Speaker 61
Speaker 66
Speaker 47
Speaker 79
Speaker 51
Speaker 76