Alzheimer's Disease and Dementia Advisory Council
Video
Transcript
5 documents
Machine transcript
May contain errors. Verify important quotations against the official video.
About transcript accuracy
- Source
- SliQ live captions
- Model
- SliQ live ASR
- Processing date
- October 2, 2026
Representative Les Warren
Unverified
3:18
Good morning good to see everybody here this morning we'll call this meeting to order. Alzheimer's disease and dementia advisory
council we're glad to have a meeting and get to dive into some things this morning first item though we need to get a motion to approve our minutes from the August 12th meeting which I'm sorry that I had to miss my wife had a doctor's appointment and I was her driver. she's not driving
yet so anyway has anybody have you had a chance to look at the minutes OK can I have a motion any discussion any questions corrections ok I'll Kenya did you have a question Oh OK all right
we've got a motion all right motion the 2. any discussion all those in favor say aye
any opposed same sign? right motion carries all right all right next item item C. is a discussion of Arkansas state plan So where's my Mister Cook there you are do you wanna come to the table or you want to just do it from there? right come to the table and introduce yourself and we'll
begin our discussion and now everybody should have been handed to handouts the first is
Speaker 10
5:14
are you talking this one right you should be looking
Speaker 19
5:40
he's going to explain this first Oh, I'm sorry you should have an exhibit C Right exhibit C guys let's go to that first David Cook the all
David Cook
Unverified
6:01
with the y'all Sumer association and the director of government affairs here at the Arkansas chapter so everyone should have exhibit C this is the handout that was made available
to you at the last meeting there was some changes requested cause senator clint penzo was actually referred to as senate senior Perez so I had to change that so I did get your name corrected this is also reflects the priority areas that we approved in a in a previous meeting in July and so the updated state plan priorities that we approved as a council we're again to advance risk reduction brain
health early detection diagnosis again we singled out the importance of enhancing family caregiver support and the other two priority areas again are ensuring access to diagnostics and treatment as that landscape changes and then supporting access and quality of care and when we pick these priorities and voted on them I did preface it by saying we want to make sure our state plan reflects what's happening in the research space also
shared that we were in a very different place than we were when we wrote the first state plan or the second state plan that was published in 2021 now that we have biomarkers and we also have treatments it's it's very essential that we make sure our our plan is is following what's happening in the research space. and so I wanted to make sure that you know we just you had time to review this and make any kind of additions or any suggestions for or any corrections that you might have
seen but I'll just kind of walk through this really quick of course the beginning is is just an executive summary and then we get into just the priority areas I did on page seven just talk about some of the things that we improved during the last state plan we really did a good job collectively just advancing those priorities and so I appreciate all the work and the support of the council we
make quite a bit of headway which was different than the first state plan that the state adopted in 2011. and then of course there's a the the membership list there and then I what I have done in this version is to just give the summary areas for each priority area and so I just kind of gave some background I talk about prevalence and then of course the objectives section is is left blank for us to just to discuss that further today as well
and that's really the gest of this and so what I would like to ask the the council to do is to approve at least this portion of the state plan as written unless there are amendments or questions or things that you see that might have
been omitted that I didn't recognize
Representative Les Warren
Unverified
9:09
OK does anyone have any questions OK.
jodi Anne hitcher Am I missing it oh there you are there you go. David thanks for your work on
Speaker 29
9:29
question pretty much every time but I'm gonna ask it again are you considering or how should we consider making one of the objectives that insurance companies actually have to pay for the treatments and the therapeutics and the tests that we find that are actually
working for the people and and should that be an objective that we consider including in this or should it be education to insurance companies etc. as you know with the big changes we're about to have with our homeme ending at the end of the year and then some other things as we're trying to figure out how we're going to keep our hospitals stable and patients with access to care how can we make sure that those insurance companies are pulling their weight by paying for the things that we know our doctors are prescribing for our patients. really appreciate that questionjody and I think that's exactly an objective that I'm
David Cook
Unverified
10:18
looking for especially when we look at access to diagnostic and treatment if if someone provides insurance coverage for treatment but they're not covering diagnostics that's not adequate treatment. you know if they're vice versa as well if they're covering diagnostic tools and not not the treatment and that's not adequate coverage as well. so I think there's a component to educate clinicians you know one thing that we do wed I did share last month is that we know the bluelue Cross and Blueshields actually covering one of the
treatments and the diagnostic services and so I think looking at insurance coverage public and private payers making sure there's adequate coverage in place because that that certainly is an access barrier that we're seeing in the state. So yet in the objective section I think I have one specific to that thought OK I'll just I'm going to follow
Representative Les Warren
Unverified
11:10
up on thatjody and I really appreciate you bringing that up and I don't think there's any surprise to the committee but
hospitals are trying to just keep it in the black and we've had a number of hospitals who have shut down in the last year and providing care for the state of Arkansas is becoming very difficult the number one problem is the reimbursement rate in Arkansas is the lowest of any state
and lower than Puerto Rico it's insane that we're looking at that but it is making it extremely difficult for even the best managers to keep hospitals in the black then you you have issues like we have drugs that I think are starting to have definite positive results especially for
Alzheimer's. and yet we can't get them approved for patients to take so it may not happen but I I appreciate you bringing that up todyM because I'd love that to be an objective force because if it's out there we need to at least fight the battle to see what we can do to get it approved
where insurances take it and I know the other battle is that insurance rates are just continuing to go up. I know companies are looking at who do we go with this is the cheapest but it is thousands more than what we paid last year so we've got multifaceted issues within the healthcare field that we are dealing with
across the state hospitals doctors it's getting difficult to attract toplevel doctors to our state they can go across the state line and get paid more it's hard to compete so I I'd love to see that as an
objective and thank you and doctorjordan you have something to
Speaker 36
13:50
share just I we've already just mentioned my
my you mentioned the lack of neurologists and know over here in the conway area it's hard to get in you know you have a person that's experiencing memory problems and just getting to see a neurologist might take6 months and given the need for rapid evaluation in order to be put on some of these medications that's a real access problem so providers the number of providers that can actually give the medication is part of the access problem.
but I also concur with the insurance issue I was in a support group just last night and a family member was telling me that she has to take her husband off the cascau I think it's cassola how you pronounce it but she's not gonna be able to have him take that anymore because of the cost so she was looking at thousands of dollars a month and that's with insurance so it was reimbursing but it wasn't reimbursing what they needed and so I concur with that issue
of having insurance step up to the plate and pay for these treatments. just in
David Cook
Unverified
15:06
terms of a follow up to that would draw your attention to page 14 the second paragraph it starts with health plans where that was the phrase I was looking forjodiian earlier I just I pulled it from our report this year but health plans that cover the medication but not the services need needed to qualify a patient or administer it safely do not provide meaningful treatment access so that was that was where I tried
to highlight that there and to doctorctor Jordan's point I think in in addition to the
insurance barrier access to to specialists and and diagnostics is a challenge I I think with the diagnostic space evolving
so quickly we're gonna move some of these biomarker tests in the primary care. it's very important that pcps APRns and
PAs that are filling that gap or educated on how to use the diagnostics and when to refer on to a specialist we just had the FDA approve another blood test for PA217 so now being able to test for amyloid and the and the tau protein is gonna be significant and that's all great but there's many reasons while you know your towel levels could be elevated or you could have positive for amyloid. you could have a cardiac issue and to gets
elevated when you have kidney issues and so it's very important that doctors understand how to use a blood test and when to refer on because not knowing how to use them is also creating a bottleneck to get into diagnostics we have some clinicians in the state that again I haven't surveyed all of them but there's three that you know are regionally located all of them facing the same issues getting a lot of referrals from primary care and realizing that you know some of these tests and these patients won't qualify
for treatment and so understanding when to order and when to refer on is is another piece of this that we need to kind of look at and and I think one of the other things that Naomi and I have discussed and I've discussed with others is how do we expand access to treatment sites and is there some existing infrastructure in the state using hospitals especially rural hospitals that may have been able to you know like inanuren County just where I'm I
live we we do chemotherapy there. well that's an infusionbased therapy so why can't that hospital be qualified to you know provide access to those treatments and will that create some sort of money stream for the rural hospitals that they'll be able to recoup some of these things so I mean those are I think the novel ideas that we have to look at here in Arkansas to get creative and and that's really been our approach to mitigating this disease here is how do we utilize our existing infrastructure to push forward some of these prior
Representative Les Warren
Unverified
18:07
So I will follow up after Doctor Jordan's comments on objectives should one of the objectives be to recruit more neurologists to Arkansas or is that just Andjo may be more qualified to speak to this to me because
Speaker 42
18:22
you see how I punted that over there to me I think one of the problems we have with recruitment is once
Speaker 29
18:39
again the reimbursement. So you've already said it really well. you can go across state lines the average discharge patient in Texas, they get $17,000 on the average discharge Here in Arkansas it's 8800. So when you think about those things recruiting specialists means you have to be able to cover the cost of the professionals who are taking care of our patients and and that's super, super important. I'll add that premiums that employers pay to your question earlier are about the same in Arkansas, Texas, Okla ho ma Missouri and yet our reimbursement is just significantly lower. so we've got to figure out what that
delta is and then use that delta to recruit the professionals who are going to take care of our patients. I think most of you know this the most expensive part of a hospital isn't the building. it's the professionals in it who are the healers and the caretakers. and so we've got to be able to recruit the best and the brightest and then we also have to work with the medical board to make sure that the credentialing process that then the physicians have to go through is time ly enough to that when we recruit the doctors they're in networks in insurance networks and they're in the ability to
get privileges inside those hospitals and also to be able to work in the community on their own and get reimbursed for the stuff that they do even outside of the hospital space. so there are a lot of hurdles there. I think if if you're gonna build yourself an objective that you're going to measure. you have to take into account what we have control of and what we don't have control of so it might be that your objective is you know to strive toward or identify barriers to the recruitment process versus having the
objective being that we have more neurologists actually in the state because I think that's going to be a long
Speaker 32
20:18
term process that's way more complicated than just what our recommendations in in this state plan can do.
Representative Les Warren
Unverified
20:26
and the more dig into this Jody Anne the more I'm realizing that this is probably going to be a federal
issue because and we can't fix the reimbursement issue at the state level the reimbursement issues got to be
fixed at the federal level and of course I would just do a blended reimbursement right across the country but there are some states that would really object to that but that's too bad because some states are really getting CusS payments and states like Arkansas are getting really low payments and that's really sad the doctors are performing the
same procedures and not getting the same reimbursement for those procedures I don't understand that but I think that maybe probably some of our effort's gonna have to be put into advocacy at the federal
level so OK. anybody else have anything on that? OK I'm sorry
Speaker 49
21:44
kimberly Kinder with Alzheimer's Arkansas but one of the things that I have seen historically is within orthopedics neurology within the pain system. advanced practice providers are what fill the gap. So orthopedists have enormous loads of patients they cannot see them all but they see them and then they pass them off in a PA or an APRN or someone sees them and pretty much sees them throughout that cycle after that until they need to follow back up with the actual physician. So what I don't see
is any initiative or objective to get APps to be a big piece of this puzzle one they're out there and willing and able to get the training I think. so part of the difficulty is in enticing a neurologist, especially a geriatric specialized neurologist to come to the state of Arkansas but APps can fill a huge gap in being able to already be present in Arkansas residents here and it would be the training that would be required to get them up to
par to be able to fill that thank you any other
Representative Les Warren
Unverified
22:55
comments or questions OK David do you want to proceed Yeah I think that's where my
Speaker 53
23:01
head is too is is the at least to help it doesn't help
David Cook
Unverified
23:06
with with access to specialists but what can we control what can we move the needle on and I think it's it's really just making sure those allied health professionals have access to to
training and how to do you know a cognitive test how to use these these biomarker tests and I mean pcps have heavy caseloads and they're diverting it out we've expanded scope here in Arkansas to allow AP R n s to fill that and so education of the pairprofessions I think is critical for us if they're going to be the front line um, many of our patients first stop is an APR and and so do they know that they have to have a cognitive test before they order a blood test and how do you do that and when to referral I think those are the things where my mind is if we
can help streamline some of these diagnostics in the pcp space
that'll help and then but you gotta be able to chew gum and walk at the same time so you you got the specialist issue too I think Arkansas has56 geriatricians we're way behind. we needed to increase it by 130% by 2035 and I just don't see the path there
yet because you can't you definitely can't legislate more bodies OK? do you feel like you've
David Cook
Unverified
24:23
well I I think that's a separate discussion that we can get to the objectives because some of the objectives that have been mentioned are included in handout number 2 so we can get into that in just a minute I I think our first step is what I would like is I would like to make a motion that we approve at least the general outline of the state plan as it is written in the objective areas so that at least this this piece of the state plan is approved and we can focus on the objective piece next.
Representative Les Warren
Unverified
24:55
do y'all have any more questions before we proceed with that
OK then I will entertain a motion to approve this part of the state plan
all right got a motion have a second all right jody in all
right any discussion all those in favor say aye OKok I heard that oh that's good. I was just
looking where it came from. OK. any opposed same sign? OK, motion carries all right so do you want to proceed then with the item D if you do
David Cook
Unverified
25:41
have handout one this is a document that has been put together by the the
bold center of excellence that the Alzheimer's association has and the CDc and these are just this is just a resource about
advancing dementia risk reduction for people who are doing state plans so here's some suggested recommendations that do encourage you guys to review. I did pull some of these things out and put them into the objective section that you have and hand out to I am not asking for approval of the objectives that they're written. I just wanted to give you these as some possibilities for us to get started and what it could look like I certainly have other ideas that we could add
into that but just kind of going through these section at a time we'll start first on risk reduction brain health early detection and diagnosis and also the care planning services. so the first objective we we mentioned some of this in the first state plan or the last state plan just how do we integrate brain health and risk reduction into some of the chronic disease mitigation that the state's already doing really well. so you don't
have to necessarily create a new program or or plan we can integrate some of this messaging into our existing campaigns and I know that umrtie and Naomi have had some conversations about this already and so I thought that was an important objective also we continue to use the the burffa Cdl and the the caregiver modules on a rotating basis. that's already embedded at the health department so I wanted us to continue to do that and then
how do we use that data to help move forward some of our other priorities as well so making sure that we not only collect the data but we're using it to inform our decisions too and then the other one is just increasing use of the the medicare annual wellness visit when someone's age65 and they they go in every year for their wellness visit. There is a cognitive screening that's part of that benefit plan. and so making sure we we continue to educate consumers about the importance of being
proactive in your brain health and your cognition as you age. but in addition to seniors we need to take that to people under the age of65 because we know that you know dementia and and Alzheimer's is getting diagnosed earlier and as we get better at diagnosing the disease we'll see more of those trends continue to follow. because we just have so much public health risk here in Arkansas so prevalence is not gonna slow down. and then number4, again that goes back to just expanding
provider education on the importance of early detection diagnosis and how do they incorporate brain health into their regular practice you know based on the science I shared before we there's a lot of things that we know about risk reduction and so how do we get that into everyday clinical practice as part of you know a a clinician's just again every they they do it they try to warn their their patients all the time to quit smoking but you can be proactive to increase your brain health as well so how do we
integrate that in the pcp space and then just ensure that people who have received a dementia diagnosis they have some care planning services and they can get connected to community resources these again are are broad enough areas that gives us some flexibility but just as an example on this last 11 of the ways we're trying to bridge that gap is by establishing these dementia resource centers across the state one of the things that
legislators have asked me for is how do we have a or create a onestop shop where someone who is preclinical doesn't have any symptoms and to the very end of end of life care can go to get resources and services throughout the continuum of the disease and how do we make sure people are referred to specialists and referral's good but how do we close those referral loops to make sure patients have the caregiving services that they need in the care navigation that they need because we say at the Alzheimer's association all
the time this is a devastating disease and I don't think anybody should deserve to have to go through it alone. there should be access to services in these care planning services across the continuum
and so how do we expand that so these first are are just broad enough that again gives us flexibility inside but happy to take questions on this first section to see if there's anything that you guys see
your notice or other things that we need to be thinking about Doctor Jordan did you have a question
Representative Les Warren
Unverified
30:34
We may have lost connection with her ok right so David and I had a a visit last night ok and I'm going I'm going to bring this up because I think
it's a good point of discussion for us I love that we get included in the
other diseases heart disease diabetes, some other diseases but I also want to see us get information out that is specific to Alzheimer's and as I was talking to David last night you know it's been 10 years since I lost my mom to Alzheimer's but I think there's a lot more out there you know he was talking about how smoking also is a
factor with Alzheimer's well I I know my mom smoked for40 years before she had three sons and a husband who dogged her into quitting at about45 years old so it's the education could still improve out there as far as everything that we could do I I told David that because of my connection
I have these mind games that I play multiple times a day because I'm trying to make sure I keep the mind sharp and but I want us to be sure that we are getting our own story out there as to ok here are things that we can be doing you know, diet exercise and one thing that he hit me with that
it really just hit hard because of having gone through COVId is the interactive part that is so important for keeping you talking to people doing things with other people the isolation that we had during COID
and how many kids are just at home in front of a computer we've lost so much of the interaction of childhood and I know that there's still a lot I'm not saying that's all been lost but I think that there are things that we could be saying and sharing that things can be done to help us avoid Alzheimer's and dementia are we really doing everything
from childhood forward to make sure we do that get out of your apartment and go interact so I don't know if I'm the only one that's like thinking are we really doing everything to get the Alzheimer's story out there so am I the only one I I just
think that we need to make sure we get
everything we can be doing to slow this disease down and let's get our story out there so anyway I just had to put my two cents in Any
other comments on that Yes in dy let me try that again
Speaker 68
34:55
you're good I wanted to add I believe that it's part of all of our due diligence for the for the people that we have so my members that I have that we put out that message and say we need to generate as much awareness and education as possible so that's something that I realized that my association was probably lacking and that is a new thing that I've incorporated in our administrator program is that we do two hours of dementia training
so I want to challenge everyone to do that to kind of take on that your piece of where you're at and your professionalism that you Thank you. that's good information you know we
Representative Les Warren
Unverified
35:43
started when when this committee or council first formed we
had this big push about how are we going to get information out to all parts of
the state and we had a big push for data or sheets to be sent so I don't know if we ever really got that information out or not I see
Speaker 71
36:10
a response coming I think a lot of that's
David Cook
Unverified
36:16
happened programmatically just with with nonprofits just trying to do work and and expand reach across the state just as another comment to what you you said uhpresentative Warren is
I think one of the things that we we sometimes overlook is that there's still a stigma attached to Alzheimer's and dementia those are like bud buzzwords buzzwords and I think framing it is is being proactive around brain health is a lot less intimidating and so I mean I've been at health fairs before you know we've got Alzheimer's association branded stuff and people will kind of walk past our table and just kind of do an xx like because nobody wants it right? but brain health is a
very different conversation. you know and so how do we you know by raising awareness we reduce stigma and when you reduce stigma people are more proactive to go out and seek help. I mean look at what we've done to revolutionize the mental health space over the last 10 or 15 years. when I was a kid we didn't talk about depression anxiety we certainly didn't talk about mental health but now it's a it's a pretty normal conversation. we some of you that have been in
this room for a while have I may sound like a broken record I've been harping on this but that's one way we we do encourage people
again to just be more practive on their brain health how do we again reduce the stigma and again do the same thing in mental health and brain health I said that backwards but you
Speaker 75
37:56
I wonder as it relates to community programs and education what the
Speaker 77
38:03
plans are for a translating the the information into Marshalise as you know there's a large marshallese population in northwest Arkansas and expanding into northeast Arkansas and so I wondered if there are plans to translate the information into Marshalise I see where it's being translated intospanish language but what about marshalise? thank you for that question I know I
David Cook
Unverified
38:26
can't speak for others but our associations's really made some inroads in the marshallese community. and
what we've been trying to identify as
a a marshallese educator that can deliver some of this content because relationships are critical and and not only the Marshallese community but even some African American communities, how do you find those champions that can help you know introduce you to that so we we've made some inroads it's just really slow but it's certainly something that we need to think about and and how do we continue our partnership with you as well to make sure we're
getting out to those underserved communities too but that's something that we've we've we're definitely working on right other questions
Representative Les Warren
Unverified
39:14
of David? OK now I don't think
this is an action item so greatly appreciate your work on this and our state plan so we just need to continue to move forward
is there anything else that you see that needs to be done
David Cook
Unverified
39:39
David? Oh yeah we we still have3 more priority
David Cook
Unverified
39:46
going well on the enhancing caregiver support. again I was very moved and proud of our council for singling this out as a single priority in the first state plan. so I thought it could should continue in terms of support services that are are funded by the state
you know we we do have our 1915c waivers that provide a variety of services for people with dementia diagnosis but we also have a pilot program that is concluded its fourth year. that provides dementia respites grants micro grants to family caregivers of individuals with dementia this has been a very successful program. with incredible reach and I certainly want to give our partners at All Sumers Arkansas, I mentioned just of all the work that they've done to get the
grants out and they've done this without any kind of admin cost recouped so they've really taken it out of their own personal budget the last four years. and despite those challenges I've been able to maintain a36% rural threshold. So what we told the legislature when we asked for this initial funding is that we would try to target those families who typically fall through the grap the gaps of services so those are families that maybe make too much to qualify for Medicaid but not enough to be
able to afford the cost of in home care. and over 94% of our recipients they they fall within those income brackets and so we are reaching the people that we promised to reach. we also wanted to make sure that those funds didn't say concentrated in the urban areas and so we established a30% rural threshold so that means30% of the funds had to go to rural communities and we've averaged34 to36%. over the last four years or I
should say Alzheimer's Arkansas's averaged that it is currently being funded by a social services block grants and so the SsBG funding has traditionally been 200,000 the future of SSBG is uncertain and so if that goes away then so does the program and when we think about comparing our funding amount with other states you know, Mississippi funds their grants at350,000. we were kind of stuck at the 200
mark, uh, which was fair for the pilot. I would I would say that Kansas appropriated 850 annually last year. and then Missouri's kind of an outlier because they do a lot more with their program but they started with a half a million, they're up to4 million annually now but there's also has opened up for other services what we would like to see in the future of the dementia respite grant we would like to see an annual appropriation that's adequately funded and also we would like to give the
caregivers a little bit more flexibility in how they spend we know the majority of our recipients use it specifically for respite. but when you get into the stories of why these people take respite it's even more heartbreaking. some of them are you know they're just trying to get a break so they can
go to the doctor themselves that's a majority of the recipients say that or they're taking care of other family duties that they hadn't, but the most impactful sometimes you're
very lucky to work on a policy and then you can feel the
impact right away. it's a very rare, but sometimes you do something and you you feel it pretty quick. within the first month of this program being active we had a woman who was 84 years old, coming to our office with her husband who was obviously in latest
stage Alzheimer's and she told me with tears in her eyes that this is the first time in 8 years I've been able to go on a girl's trip with my daughters because of this and so it's it's those kind of people that we are
helping across the state and so I I want you to be mindful of that we would like to see this become permanent and again in terms of flexibility for caregivers, we'd also like them to be able to use some of these funds to be able to pay for some of the other ancillary caregiver expenses maybe it's adult diapers, maybe it's a copay for a doctor's visit. and and so we just haven't been able to open that up because the funding limit is so low, but weu we would need more funding to increase even the grant amount
to750 that would be more help for caregivers and kind of give them a little flexibility second to that again this is broad but I would like for us to collectively work with Dhs and the mention service coordinator in Jhop on how do we build more of a comprehensive caregiver support network so in addition to the respite grants if we get an application that someone may be Medicaid eligible how do we push them over to waiver services to make sure this is reserved for that pocket
of family. so taking a more comprehensive approach to to respite in addition to the funds making sure they have knowledge about support groups and other support services as well so that's certainly a high priority of
of ours at the association and I would expect legislation this next year for that one I'm comfortable saying
Speaker 53
45:04
that because clint said yes so senator Penzo said yes
David Cook
Unverified
45:15
the other again really focusing on caregiver navigation and caregiver supports you
know some some don't know who to call
and so again that's the important part of I think expanding dementiaour centers and making sure that people know what services are available to them and also
I think some states are also investing in care navigation care navigators one of the the programs we see launching across
the states are this role of a dementia care specialist so don't res don't confuse it with the dementia services coordinator what the care specialist does is really just they just help families navigate healthcare system they you know they provide referrals they make sure those referral loops are closed. they help get them connected to services
maybe a family comes in and says hey, I don't you know my husband could stay home but I need a a ramp built and so who
who in the area can do that and how do you bring people together to provide those those other ancillary services that are needed and then in addition just expanding access to caregiver education that's more programmatic that the nonprofits are partnering to do and then expand access to dementiao centers. we do have a pilot in northwest Arkansas it is a a collaborative effort with the the Schmitingenter which is
part of the UN Centers onagging they were much more equipped in some of the other centers to provide some of these services so we have launched a demeo dementiasourceent and so families can come in and have access to some of their education but any any nonprofits or any program that's providing service to aging communities is represented in that that resource center and so our families have a need to get connected to those those
services as well. in the Schmitingent we do also provide support groups and they do some caregiver education and some other things as well. it is our hope that we expand that model across the state so that again people have access to these these service points and the support system. right any questions on
Speaker 64
47:42
priority two David I think you're doing well you even out anything
David Cook
Unverified
47:53
you don't have to answer today that's why I wanted to give you some runway to
Representative Les Warren
Unverified
47:59
think about these things. in the next couple of weeks but you definitely got clint and me thinking I'm sorry to miss you you
David Cook
Unverified
48:09
definitely got clint and me going I should have said Senator Penzo apologize for that good
priority number3 just this this goes back to ensuring access to not only treatments but diagnostics so
I think one of the things we need to continue to review how how medicaid's you know the the state benefits plan commercial providers how are they providing coverage for diagnostics and and treatments not just the treatments but also the diagnostic services just on that note we did have legislation last session to require the the state employee benefits division to cover FDA approved treatments
and we're able to get it through one chamber we couldn't get it through the next but the the goal of that was just making sure that that our state employees had access to treatment. it's covered on the medicaid portion but on the state employee benefits so one
of the the asks I do have outstanding to the benefits division is whether or not the coverage determination that was made by Blue Cross and Blue Shield has an impact
on state employees because it's a medical benefit they are still trying to find that answer for me. but that's something I'm
interested in we should be interested in looking at as well and this really gets to the heartbeat of Jody Ann's question making sure that there's adequate coverage if you have coverage to treatment but not diagnostics you don't have adequate coverage one example of that is our state medicaid programme medicaid because of the Cms ruling has to cover treatments FDA approved treatments but our Medicaid programme does not currently
cover diagnostics the the medicare billing code also exists in the medicaid space and that would give people under the age of65 access to cognitive screening and also care planning services and so diagnostics is really not adequately
covered under Medicaid at this time but treatments are and so that's really an example of one payer that is not really providing a sufficient access. just continue to address some of the inconsistent
coverage of the FDA approved amyloid therapies that we're seeing across Arkansas payers. trying to expand access to rural rural access to cognitive evaluation through telehealth provider support and referral networks. I made that broad but what I'm really getting at here is we've we've talked about establishing something like memory nets so that physicians in rural areas have access to specialist similar to what we have done in stroke we've done a really good job
in the state to mitigate stroke. and so why can't we take that model and apply it to our space and create more of a memory network so these clinicians have access to education and guidance and support, whether it's diagnosing a case or trying to figure out how to use the biomarker testing. this model has been very successful in states like Georgia. they've had theirs for a while it
is a long term goal for the state something that we should look at
during the next version of the state plan again education of
of of pcps the pair of professionals. I think this gets to what Kimberly had mentioned a moment ago just making sure that these pair professionals understand how to use a blood test and then I think more of a study on our port is just really try to to map out where access to ett is currently
here in Arkansas. I am really excited to share with you
pet imaging is expanding here in the state Eli Lilly is now manufacturing I can't even remember the name of it
but anyways the the dye that you trace your dye starts with an A that they use for amyloid pets so now that's being manufactured in the state
that increases access to pet that we didn't have before. and then also try to figure out where MRI monitoring is where the infusion services are, and so this is something
that the dementia coordinator Naomi is starting to collect in her shop and so I think a larger study just to be able to see where those ax o s points are will help us see where the gaps are and how do we use some of the existing infrastructure to cover some of those gaps and then making sure that again our our residents in the state understand you know the the benefits of treatment but also the risk associated with that
because there are some some risk but again we feel really confident about the clinical protocols that are in place to screen patients that may have a higher risk of developing
aurea or brain bleeds on treatment so if you really comfortable how clinicians are
screening that what is happening in the space now that is probably going to change the way treatments are prescribed there is some clinical trials happening now that will allow us to are
nowc clinicians to biologically stage Alzheimer's disease and so you get into stage one or stage two if you can biologically stage the disease then you can figure out which patients you should target and get on treatment quicker and and who's going to have the higher success rate so research is changing every day that's going to also impact all these priorities but especially priority number3 so as we look at these it's important to keep them broad enough that gives us flexibility over the next four years
and with that I'm happy to take questions on priority number3. right do
Representative Les Warren
Unverified
54:17
we have any oh I know we do. doctorctor Jordan do you have a question No OKok I thought you did. I'm sorry ok does anybody else have a question on priority three OK continue on to priority4
David Cook
Unverified
54:39
Priity4 is very similar to our you know one of the parties we had in the the first the the last state plan and so just supporting access and quality of care I I would really like us as a council to try to figure out a way to evaluates some of the dementia s training standards that we've put in place we've changed dementia training
standards for home care providers for assisted
livings for memory care and so I'm trying to figure out and would love the council's support on just studying what the
impact has been on quality of care there's quality improvements with the training we do hear from providers quite frequently about implementation challenges they've had and so we've as the association have tried to provide some nocost training to satisfy some of these requirements and so now I I think just spending some time
evaluating what impact it's had across the state there is a gap in the home care space that I think we I didn't address in this objective section but it's something that we need to consider one of the gaps that that does concern me is that on the homecare space the dementia training requirements that we've passed the statute they only applied to those providers in the state that are required to
have a license. and right now the way that Arkansas statute is written only providers who accept Medicaid are required to be licensed in the state of Arkansas. and that does concern me cause we talk quite often about the importance of protecting the border and I don't think there's a border that's more sacred than the threshold of our homes when we let somebody to come in and care for our loved ones especially vulnerable adults so that's something that we need to think about cleaning up as well. because the private get private
pay folks aren't required to have their folks trained, and not subject to the same screening that the Medicaid providers who have to have a license are. so think the the playing field should be leveled there again this gets back to strengthening recruitment training and and retention of direct care workforce certain people with dementia so from you knowc andA's all the way up to the specialist we've already shared about the challenges that are involved in that
again, how do we improve care coordination and information when an individual is trans transferred between care settings so especially if they're institutionalized and are trans are having a transfer for behaviors how do we protect that patient and resident making sure that it's not something that keeps them from getting placed somewhere else and so continuing to work with the ombudsman office just to make sure that there's some care coordination in place and I think you guys could be a really great ally in that because of the stories that they see.
and then how do we strengthen protections of Arkansans with dementia from abuse neglect and financial exploitation the attorney general's office has done a lot to push some legislation I know Representativeing a few sessions ago enhanced some protections for aging and those who are diagnosed with dementia and so making sure that the the vulnerable folks are protected from the different types of exploitation that happens
I think also looking at expanding HCBS services whether that's increasing reimbursement rates in the HFS side or just making sure that there's access points for home and community based services that empower families to make care decisions and may prevent premature placement in long term care. and then just to ensure that you know on the first responder side they're they're prepared to serve individuals with dementia and so when we think
about crisis management how do we make sure for our first responders are trained the UMSenters on agging and Doctor Ir McCoy's done a really good job of training some of these first responders in terms of how to address wandering issues and has a really amazing program training program that I would love for her to share at some point just so you can see what content they are
getting they're actually able to do virtual reality scenarios just like regular law enforcement and I think
that's that's gonna pay huge dividends. as we've again increased dementia training standards for our law enforcement personnel and first responders here interested to also look
at the impact that that's making across the state OK any
Representative Les Warren
Unverified
59:44
questions of David on priority OK now maybe I can say you're through
Yes I am through without any questions yes sir well
now let me say we appreciate the entire report and you work on the plan so does any action need to be taken on this
David Cook
Unverified
1:00:11
Not today. I I wouldn't really just ask the council members and with your permission Brandon to email this out to the council members who weren't able to attend a day. and ask for their their feedback ahead of
the next meeting so we can think about approval. Again these are very broad there's some other specific ones that I would like to include in a future report, and but these are again broad enough for us to and measurable as well. I tried to make it measurable too as well. I would actually specifically
ask you guys to look through the partner list because I just kind of pulled the likely partners that could help move some of these things forward too as well so ok no other questions thank you
Representative Les Warren
Unverified
1:00:56
very much David. all right so
that takes us to item D which is a discussion of legislative changes to the existing
statute which that was something that I brought up. I wanted to see who all was actually taking part in our council and if we had people who were not so what I want to do is go through our list and I'm
just gonna go through and give me your feedback. I know RachelBunch has been involved kimberlyender is she involved? OK that's you ok that's what I thought. I didn't check you off though OK. Davidritopher McCoy he's been involved he's not here today is he
David Cook
Unverified
1:01:57
coy satisfies AERPs slot on the on the
board and I know he works out of state but I have contacted him trying to get him to engage but he does fill that role for AAarp. Has he attended any
Speaker 50
1:02:19
meetings? no sir OK can youjodyian Gohar Azhar doctor
Representative Les Warren
Unverified
1:02:29
she's here not today but he's ok all right. Jennifer Hallam Toots Me by no toots do
Speaker 14
1:02:52
we know if Toots has attended a meeting none that's what I'm wanting to find out
Representative Les Warren
Unverified
1:02:59
up David sorry I know Doctor Jeanie Way Amy Lee we're good. Doctor Sue Griffin Does anyone know Doctor
Sue Griffin? Yesir I do. she is a dementia
Speaker 93
1:03:30
Alzheimer's researcher at UMs so it's been we know if she's been here? She has but it has been a while. OK, so we need to
Speaker 65
1:03:38
give her OK I can just make a call right thank er ry
Representative Les Warren
Unverified
1:03:53
Jordan, rtie Sellers, Ja Hill, Mindy Briantz, Tatata Owen Owen B. Charlotte
naomi Atkinson OK, that's good we just have a couple
I actually visited with someone on the rawlsoundation they act like they want to get involved so I've got one person we've got a group at Baptist they have a an Alzheimer's dementia division Doctor Davis would like to
join us I know he's from Rustville and you speak very highly of him. so I'm just looking for if someone's not going to be involved I'd like for us to tweak the legislation to make it where we can get people who are involved because I don't want to waste it spot on this so if you have anybody else that you think would be a good contributor to this please
let me know but I am going to look to try and add someone from the baptist program
to our council so OK so Rachel's watching online Rachel I hear you so Doctor Jordan would you like to
Speaker 99
1:05:38
say something what about the dementia care coordinator for the state who is that can you tell me
Speaker 36
1:05:58
who the she's here oh ok and I'd like to just apologize that I have not been able I came down to Hot Springs but I thought the meeting was at one last week so I apologize for missing that meeting last last month well no problem I hope I will be coming
I will be coming in person from now on as best I can. Well, you're here
Speaker 59
1:06:16
today and we appreciate that and we'll look forward to having you here I hope you enjoyed hot springs last week anyway all right anybody else was
Speaker 103
1:06:25
kind of a shock when I went down there it was like where is everybody but anyway ok all right any other comments
Representative Les Warren
Unverified
1:06:30
on that? I'll work with Cclint and we'll see what we can get done
in the legislative session that should be a pretty easy tweak if we need to do something there so
ok let's talk about future agenda items and meeting dates I
know that we need to our deadline for report is due October 1st so we'll need to have one more meeting before October 1st so that we can get the report voted out approved
so what does I guess September look like for everybody y ' all want to meet toward the end of September last week of September. how does that look for everyone? OK so
Representative Les Warren
Unverified
1:08:33
The week of the 21st through the 25th what does that look like for everyone? today's
a Tuesday. Do you want to do it on the September 22nd does that work for everybody 10 a.m. OK, let's
just aim for august 20 I mean I'm sorry September 22 at 10 a.m. back here
right what about agenda items Anybody got any requests Mr Cook
Speaker 73
1:09:25
I I just think it needs to be state plan heavy because it's you know we we're up against the deadline of October 1st my opinion that's good by me
Representative Les Warren
Unverified
1:09:35
why don't we just focus on state plan only and we can have a short meeting and if anybody wants to bring up anything else we'll do it OK anything else to come before our council if not we stand adjourned thank you for being here
Agenda
A. Call to Order
B. Consideration to Approve Minutes from August 12, 2026, Meeting [Exhibit B]
C. Discussion of Arkansas State Plan [Exhibit C]
D. Discussion of Legislative Changes to Existing Statute
E. Discussion of Future Agenda Items and Meeting Dates
F. Other Business
G. Adjournment
Documents
Speakers
Representative Les Warren
Unverified
Speaker 10
Speaker 12
Speaker 19
David Cook
Unverified
Speaker 27
Speaker 29
Speaker 36
Speaker 42
Speaker 32
Speaker 49
Speaker 53
Speaker 56
Speaker 68
Speaker 71
Speaker 73
Speaker 75
Speaker 77
Speaker 79
Speaker 64
Speaker 50
Speaker 14
Speaker 93
Speaker 65
Speaker 99
Speaker 59
Speaker 103
Speaker 107
Speaker 108