The Legislature hereby declares the following:

(a)COPD is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and severe adult asthma, and is characterized by increasing difficulty in breathing, coughing up large amounts of mucus, wheezing, shortness of breath, and chest tightening.

(b)COPD is incurable, but it can be managed to slow the progression of the disease.

(c)Approximately 6.4 percent of Americans (an estimated 15.7 million adults) have been diagnosed with COPD. It is estimated that another 15 million are undiagnosed or developing COPD. Approximately 1 in 10 American adults have symptoms of COPD including coughing, wheezing, and shortness of breath.

(d)California alone has an estimated 1,100,000 adults with the disease (4 percent of the state’s population). Three-fifths of Californians with COPD (59.1 percent) are women, compared to 56 percent nationally, and more than two-fifths (43.7 percent) belong to minority populations.

(e)More than one-third of Californians with COPD (35.7 percent) live below 130 percent of the federal poverty level; another 20.5 percent live between 131 and 249 percent of the federal poverty level.

(f)Nationally, COPD is the fourth leading cause of death. In California, it is the fifth. But in southern California, COPD is the fourth leading cause of death in the County of Los Angeles (accounting for nearly 29 out of every 100,000 deaths), and the third leading cause of death in the County of San Bernardino (60 per 100,000 deaths) and the County of Riverside (49 per 100,000 deaths).

(g)Estimates are that as many as 50 percent of those with COPD do not know that they have the disease. Marked underdiagnosis of COPD drives unnecessarily high rates of emergency room visits and hospital admissions for uncontrolled flare-ups. Approximately 43 percent of Los Angeles County residents report having seen a doctor for COPD-related symptoms without a diagnosis over a 12-month period.

(h)Individuals with chronic lung conditions such as COPD are at higher risk for complications, severe illness, and poorer outcomes if they contract COVID-19, as COVID-19 affects the respiratory system. Having existing lung damage from COPD means it is more difficult for a COPD patient’s lungs to fight off an infection.

(i)Increasing awareness among Californians about COPD, particularly those who do not know they may have this chronic disease, is critical to ensuring that vulnerable residents are aware of the need to manage their lung health and take the necessary precautions to remain safe during the worldwide COVID-19 pandemic.

(j)With hospitals facing historic surges of patients due to the COVID-19 pandemic, increasing public awareness of COPD at this time is especially critical, as it will reduce hospital admissions for those with uncontrolled COPD flare-ups, thereby decreasing the burden placed on hospitals and health care providers addressing the pandemic.

(k)The most common cause of COPD is smoking, though exposure to secondhand smoke, air pollution, and occupational chemical fumes or dust may also lead to the disease. A rare genetic condition, known as alpha-1 antitrypsin deficiency, is also known to cause this disease and is usually the cause of COPD in children.

(l)COPD is diagnosed with a simple spirometry test in which a person blows into a tube connected to a small machine called a spirometer that measures how much air an individual’s lungs hold and how quickly each person can exhale. Unfortunately, this inexpensive diagnostic tool remains underutilized. Approximately one-third of California’s adults with COPD (30.4 percent) reported never having received a breathing test (spirometry), which is the only approved method for diagnosing COPD.

(m)Compared to Californians without COPD, twice as many Californians with COPD reported that the cost of health care was an obstacle to receiving medical care (27.7 percent versus 14.7 percent).

(n)Among Californians with COPD, 19.4 percent do not have a personal health care provider. Californians with COPD fare less well than their counterparts without COPD.

(o)Around two-fifths (42.9 percent) of Californians with COPD have seen a doctor for symptoms related to COPD, and 17.5 percent have visited an emergency room or been admitted to the hospital due to COPD, in the last 12 months.

(p)Approximately two-fifths (42.8 percent) of surveyed Californians with COPD report poor or fair health status, compared to 17.4 percent among those without COPD.

(q)Nearly one-third (29 percent) of surveyed Californians with COPD report poor mental health, compared to 10.5 percent among those without COPD.

(r)While one-third of adults with COPD in California are 65 years of age and older, one-fourth (25.4 percent) of adults with COPD in California are under 45 years of age.

For purposes of this chapter:

(a)“Chronic obstructive pulmonary disease” (COPD) is an umbrella term used to describe progressive lung diseases, most commonly caused by smoking, and include emphysema, chronic bronchitis, and severe adult asthma, and is characterized by increasing difficulty in breathing, coughing up large amounts of mucus, wheezing, shortness of breath, and chest tightening.

(b)“Department” means the State Department of Public Health.

(a)Subject to subdivision (b), the department shall conduct the COPD Provider Awareness Campaign to improve provider education aimed at promoting early diagnosis of COPD, options for screening and testing, current research on the causes of COPD, current research on COPD triggers, the ease and minimal cost of using spirometry testing to diagnose individuals with COPD, the importance of testing COPD patients for Alpha-1 Antitrypsin Deficiency as recommended by the National Heart, Lung and Blood Institute’s COPD National Action Plan, and the much lower cost to treat patients diagnosed with stage 1 or mild COPD versus those diagnosed at a later stage.

(b)The department may partner with, or subcontract to, local, regional, or California-based national nonprofit organizations to conduct the COPD Provider Awareness Campaign. These organizations shall have experience providing public and provider education on COPD. The department shall maximize reliance on existing provider communication opportunities, potentially including, but not limited to, seeking partnerships to do all of the following:

(1)Include information in newsletters or guidance to providers that is issued by the department or other state or local agencies.

(2)Include information in publications published by provider membership organizations.

(3)Enhance COPD-related educational offerings by providers of continuing medical education.

The department shall target the COPD Provider Awareness Campaign, as required by Section 104215, to primary care providers, including primary care physicians and physician assistants, to increase knowledge of COPD diagnosis and treatment among primary care providers.