PRINTER'S NO. 2863
No. 2072 Session of 2005
INTRODUCED BY PISTELLA, CALTAGIRONE, CAPPELLI, CAWLEY, COHEN,
DeLUCA, FABRIZIO, FREEMAN, GEORGE, GINGRICH, GOODMAN, JAMES,
JOSEPHS, KOTIK, LaGROTTA, MARKOSEK, MUNDY, SIPTROTH, SHANER,
B. SMITH, STABACK, TIGUE, WALKO, WOJNAROSKI, YOUNGBLOOD AND
YUDICHAK, OCTOBER 19, 2005
REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES,
OCTOBER 19, 2005
AN ACT
1 Establishing the Older Adult Health Literacy Program to provide
2 education relating to medical conditions and prescriptions
3 for older adults; and making an appropriation.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 Section 1. Short title.
7 This act shall be known and may be cited as the Older Adult
8 Health Literacy Education Act.
9 Section 2. Legislative findings and declarations.
10 The General Assembly finds and declares as follows:
11 (1) Inadequate health literacy is defined as an
12 inability to obtain, process and understand the basic health
13 information and services needed to make appropriate health
14 decisions.
15 (2) Most informed consent forms and medicine package
16 information inserts are written at a minimum 8th grade
1 reading level and range through a college reading level.
2 (3) Nationwide, 66% of adults over 60 years of age have
3 inadequate or marginal literacy skills.
4 (4) Fifteen percent of the State population is 65 years
5 of age or older.
6 (5) Inadequate health literacy collectively costs states
7 over $10,000,000,000 a year and collectively costs employers
8 over $12,000,000,000 in unnecessary health care expenses.
9 (6) Patients with the poorest health literacy skills
10 collectively spend $10,000,000,000 in out-of-pocket health
11 care expenses.
12 (7) Annual health care costs are four times higher for
13 the low health literacy population.
14 (8) Low health literacy is a significant factor in
15 malpractice claims.
16 (9) The decreasing number of doctors in this
17 Commonwealth may be related to high liability and malpractice
18 costs.
19 (10) Ninety-four percent of medical professionals
20 believe that in general adults with low literacy levels
21 experience a lower quality of care than other patients.
22 (11) As people age, their use of health care services
23 largely increases because they are more likely to suffer from
24 multiple chronic diseases that require more visits to the
25 doctor, lengthier hospital stays, ongoing drug therapy,
26 complicated treatments and long-term care services.
27 (12) Factors affecting the health literacy level of
28 older adults include:
29 (i) Lower educational levels due to fewer years of
30 formal schooling prior to entering the work force.
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1 (ii) Reduction in reading, math and problem-solving
2 abilities from lack of use, stress and anxiety associated
3 with aging and illness.
4 (iii) Sensory changes such as loss of sight or
5 hearing and impaired cognitive function.
6 (13) The Commonwealth should support opportunities for
7 older adults to receive appropriate medication and treatment.
8 (14) The Commonwealth should bear primary responsibility
9 for financing an adult health literacy program.
10 Section 3. Definitions.
11 The following words and phrases when used in this act shall
12 have the meanings given to them in this section unless the
13 context clearly indicates otherwise:
14 "Department." The Department of Aging of the Commonwealth.
15 "Educational sessions." A course specifically targeted at
16 the older adults of this Commonwealth taught by the Older Adult
17 Health Literacy Group at sites volunteered by medical entities
18 or other sites.
19 "Facilitator." A medical entity employee who interacts with
20 older adults.
21 "Health literacy." The ability to obtain, process and
22 understand the basic health information and services needed to
23 make appropriate health decisions.
24 "Medical entity." An institution of the Commonwealth that
25 deals with medical issues, including, but not limited to,
26 hospitals, medical schools, clinics, private practices and
27 county departments of health.
28 "Older Adult Health Literacy Group" or "OAHLG." The group
29 established under section 6.
30 "Older adults." Those persons residing within this
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1 Commonwealth who are 65 years of age or older.
2 Section 4. Program.
3 The Older Adult Health Literacy Program is hereby established
4 within the department in cooperation with the Department of
5 Health to educate older adults of this Commonwealth about
6 prevalent age-related conditions and medications.
7 Section 5. Purpose.
8 The Older Adult Health Literacy Program shall:
9 (1) Provide participating older adults with simplified,
10 helpful information applicable to their medical needs.
11 (2) Provide participating medical entities with
12 educational sessions and resources to educate older adult
13 patients.
14 (3) Provide the information and knowledge for older
15 adults to make more informed health decisions.
16 (4) Reduce stress and anxiety associated with inadequate
17 health literacy.
18 (5) Reduce potential malpractice claims due to more
19 educated patients.
20 (6) Reduce health care costs for the State, employers
21 and patients due to more informed health decisions.
22 Section 6. Educational group.
23 (a) General rule.--The department and the Department of
24 Health shall collaborate to establish a team of professionals
25 for the Older Adult Health Literacy Group (OAHLG).
26 (b) Composition.--The OAHLG shall consist of nine core
27 members appointed by the department.
28 (c) Chairperson.--The OAHLG shall elect its own chairperson.
29 (d) Duties of chairperson.--The chairperson shall lead
30 discussion on all issues related to the mission of the group.
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1 (e) Quorum.--A majority vote of five members of the OAHLG
2 shall be necessary to conduct any business of the OAHLG.
3 (f) Institution of educational program.--The OAHLG shall
4 begin health literacy educational instruction within one year of
5 the effective date of this act.
6 (g) Compilation of medical entities.--The OAHLG shall
7 compile a list of all medical entities for the purpose of:
8 (1) Communicating the group's mission and services.
9 (2) Arranging educational sessions.
10 (3) Sending out information including, but not limited
11 to, health literacy publications, updates and fundraiser
12 requests.
13 (h) Clearinghouse.--The OAHLG shall establish a
14 clearinghouse of collected information relating to older adult
15 health literacy. Information shall include, but is not limited
16 to:
17 (1) Training materials.
18 (2) Videos.
19 (3) Publications.
20 Source documentation shall be made available on the Internet
21 websites of the department and the Department of Health.
22 (i) Advisory committee.--An advisory committee is hereby
23 established and shall consist of 20 members appointed by the
24 Department of Health. The advisory committee shall conduct a
25 minimum of six meetings per calendar year with the OAHLG.
26 Section 7. Curricula.
27 The OAHLG shall create standard curricula for educational
28 sessions that is applicable and sensitive to the health needs of
29 older adults.
30 (1) Curricula addressing medical conditions shall, at a
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1 minimum, discuss the following medical conditions:
2 (i) Heart disease, specifically coronary heart
3 disease.
4 (ii) Hypertension.
5 (iii) Stroke.
6 (iv) Asthma.
7 (v) Sinusitis.
8 (vi) Cancer, specifically prostate cancer.
9 (vii) Diabetes.
10 (viii) Ulcers.
11 (ix) Hearing loss.
12 (x) Arthritis and arthritic symptoms.
13 (2) Curricula addressing medications shall, at a
14 minimum, discuss the following classes of medications:
15 (i) Cardiovascular drugs.
16 (ii) Antihypertensives.
17 (iii) Analgesics.
18 (iv) Antiarthritics.
19 (v) Laxatives.
20 (vi) Antacids.
21 (vii) Sedative-hypnotics and tranquilizers.
22 (viii) Antidepressants.
23 (ix) Cough and cold preparations.
24 (3) Curricula addressing medications shall also address
25 drug-to-drug interaction and drug-to-disease interaction.
26 (4) Educational techniques shall be interactive, age
27 appropriate and easy to understand.
28 (5) Curricula information shall be made available on the
29 Internet website of the Department of Health.
30 Section 8. Health literacy materials.
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1 (a) General rule.--The OAHLG shall collaborate with the
2 department and the Department of Health to create health
3 literacy materials targeting older adults. The health literacy
4 materials addressing medical conditions shall discuss the
5 conditions in section 7(1). The health literacy materials
6 addressing medications shall discuss the classes of medications
7 in section 7(2), including drug-to-drug interaction and drug-to-
8 disease interaction.
9 (b) Educational kits.--Kits shall be assembled, administered
10 and used to assist the educational process for the individual,
11 facilitator and medical entity. The kit components shall
12 include, but are not limited to:
13 (1) Individual kit components:
14 (i) Patient workbooks.
15 (ii) Medication pillbox and instructions.
16 (iii) Calendars.
17 (iv) Conditions and medications overview
18 publications.
19 (2) Facilitator kit components:
20 (i) Facilitator flip charts.
21 (ii) Facilitator guides.
22 (iii) Clearinghouse source documentation.
23 (3) Medical entity kit:
24 (i) Appointment reminder cards.
25 (ii) Overview posters on common conditions and
26 medications.
27 (iii) Conditions and medications overview
28 publications.
29 (c) Availability of publications.--Health literacy
30 publications shall be made available by the OAHLG for download
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1 on the Internet websites of the department and the Department of
2 Health.
3 (d) Format.--All health literacy material copy shall be
4 written by the OAHLG in appropriate format including, but not
5 limited to:
6 (1) Simple, short sentences.
7 (2) Large print.
8 (3) Pictures and examples to illustrate important
9 points.
10 (e) Ordering limits.--The following order limits are
11 established for publications:
12 (1) Private citizen personal use; one order per month
13 limited to 50 pieces per title.
14 (2) Institutions/service providers; 500 pieces per
15 month.
16 (3) Legislative; 1,000 pieces per month.
17 (4) Department of Health or department single-county
18 authorities; unlimited.
19 The OAHLG is authorized to adjust the limits in paragraphs (1),
20 (2), (3) and (4) after one year.
21 Section 9. Reporting.
22 At the conclusion of every two years, the OAHLG shall prepare
23 a comprehensive report outlining the progress and impact of the
24 Older Adult Health Literacy Program. This report shall be
25 presented to the chairmen of the Aging and Older Adult Services
26 Committee and the Health and Human Services Committee of the
27 House of Representatives and the Aging and Youth Committee and
28 the Public Health and Welfare Committee of the Senate no later
29 than August 1 at the end of each two-year period.
30 Section 10. Appropriation.
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1 The sum of $1,000,000, or as much thereof as may be
2 necessary, is hereby appropriated from the Tobacco Settlement
3 Fund for the fiscal year July 1, 2005, to June 30, 2006, to the
4 Department of Aging for implementing the provisions of this act.
5 Section 11. Effective date.
6 This act shall take effect immediately.
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