Alzheimer’s Association urges Arkansas to fund early‑detection outreach, Medicaid billing and respite expansion

David Cook, director of government affairs and public policy at the Alzheimer’s Association, told the Senate Children and Youth Committee that Arkansas has made legislative progress on dementia but still faces gaps in diagnosis, treatment access and supports for family caregivers.

Cook said Arkansas lacks local access to the amyloid PET tracer used in one biomarker test, so physicians must refer patients to other states for amyloid PET imaging or rely on spinal‑fluid tests. He emphasized the importance of early detection now that anti‑amyloid treatments have begun arriving: “For the first time in 20 years, we do have a viable treatment that’s out on the market,” Cook said, adding that another drug could be approved soon.

Why it matters: Treatments shown to affect amyloid plaque are most effective in early disease stages, Cook said, so the state needs better screening, clinician education and payer coverage to make those treatments available equitably.

Cook reviewed recent state and federal activity. Arkansas received BOLD grant funding (Building Our Largest Dementia Infrastructure) and in 2022 updated its state Alzheimer’s plan. State legislation established a dementia services coordinator in the Department of Human Services and enacted dementia‑training requirements for home‑care providers and first responders (identified in testimony as Act 70, Act 202 and an Act requiring initial and continuing training for assisted‑living staff). He said the Alzheimer’s and dementia respite grant program — initially funded at $200,000 from a federal block grant through DHS — provided $500 awards to caregivers, allowed two awards per caregiver per year, and set a 25% rural threshold in year one. Cook reported the grant served more than 400 families in year one and had reached 228 families in year two so far, with rural performance above the threshold (32% year one; 39% most recently).

Cook asked the committee for three fiscal‑session actions: $300,000 for targeted public‑awareness campaigns on early detection and diagnosis, Medicaid reimbursement for cognitive‑screening and care‑planning services for non‑Medicare individuals, and a $200,000 state match to expand the respite grant program (bringing the total program to $400,000 if matched). On billing, Cook cited the existing CMS code for cognitive screening and care planning (CPT 99483) and said the federal reimbursement rate is currently low: “CMS has set the reimbursement at $2.75,” he said, noting few clinicians currently use the code.

Committee members pressed Cook on payer coverage and cost concerns. Representative Julie Mayberry and others raised insurer differences for the newly approved medication, noting that Arkansas Medicaid would cover one drug while some private plans and the state employee benefits plan may not; Cook and members agreed more data are needed to examine long‑term fiscal impacts and access barriers. Cost and limited time on the market were highlighted as principal drivers of payer resistance.

Next steps: The association will continue monitoring drug approvals, infrastructure needs for infusion delivery and diagnostic access, and is seeking the legislature’s consideration of the budget requests and Medicaid reimbursement change. The committee did not take a formal vote on the funding requests during the meeting.