The Alzheimer’s Association, through the Alzheimer’s Impact Movement (AIM) is leading the way to advance policies to improve access to quality health care services for individuals living with Alzheimer's. Policymakers must enact policies that provide better health and long-term coverage to ensure high-quality, cost-effective care for the millions of people who face this disease every day. Important progress has been made but the agenda ahead remains immense.
Educating Providers about care planning through Medicare
Since 2017, Medicare has covered care planning for individuals with cognitive impairment including dementia. Clinicians now have the time and resources to provide a comprehensive set of care planning services to people with cognitive impairment and their caregivers. However, in the first year, fewer than 1 percent of seniors living with Alzheimer’s received the care planning benefit. To rectify this, the Association and AIM advanced the Improving HOPE for Alzheimer’s Act which will increase education and outreach to providers about Alzheimer’s and dementia care planning services through Medicare and give clinicians the knowledge and the tools to better help their patients and families living with dementia. The Improving HOPE for Alzheimer’s Act was signed into law in December 2020.
Addressing Alzheimer’s as a public health crisis
“Alzheimer’s is the most under-recognized threat to public health in the 21st century.”
– Dr. David Satcher, former U.S. Surgeon General
Working with bipartisan Congressional champions the Alzheimer's Association, through AIM, was instrumental in the development and passage of the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act (S. 2076/H.R. 4256). The bill, signed into law in December 2018, creates an Alzheimer's public health infrastructure across the country to implement effective Alzheimer's interventions, such as:
- Increasing early detection and diagnosis
- Reducing risk and preventing avoidable hospitalizations.
The BOLD Infrastructure for Alzheimer's Act will also increase implementation of the Centers for Disease Control and Prevention's (CDC) Public Health Road Map nationwide by:
- Establishing Alzheimer's centers of excellence
- Providing cooperative agreements to public health departments
- Increasing data collection, analysis and timely reporting
In December 2020, Congress took the next step and allocated $15 million to fund the BOLD Infrastructure for Alzheimer’s Act in fiscal year 2021.
Healthy Brain Initiative (HBI) National Public Health Road Map
The Alzheimer’s Association is working at the state level to implement the the Centers for Disease Control and Prevention (CDC) Healthy Brain Initiative (HBI) National Public Health Road Map. The HBI Road Map includes action items for state and local public health departments to promote cognitive functioning, address cognitive impairment and help meet the needs of caregivers. This includes:
- Data collection through the Behavioral Risk Factor Surveillance System (BRFSS): Obtaining a more definitive picture of Alzheimer's is essential to any successful strategy to combat the disease. Through the CDC’s data collection program, BRFSS, states are collecting important data on the impact of cognitive impairment and Alzheimer’s. The Alzheimer’s Association is working to encourage states to collect this data.
- Early Diagnosis of Alzheimer’s: Fewer than half of all people who have been diagnosed with Alzheimer’s disease, or their caregivers, are aware of the diagnosis. Early detection and diagnosis — and knowing of the diagnosis — are essential to ensuring the best medical care and outcomes for those affected by the disease. The Alzheimer’s Association is committed to increase the percentage of individuals with the disease or their caregivers who are aware of the diagnosis through public health campaigns and health care provider education.
- Risk Reduction: There is a growing scientific consensus that regular physical activity, management of certain cardiovascular risk factors (such as diabetes, smoking and hypertension) and avoidance of traumatic brain injury can reduce the risk of cognitive decline. Studies show these factors may also reduce the risk of dementia. Especially in the absence of a disease-modifying treatment, public health action must be taken to increase public awareness and education about known and potentially modifiable risk factors of cognitive decline and dementia. Learn more.
Today, more than 1 in 4 seniors with Alzheimer's and other dementias is on Medicaid. In its later stages, those who have the disease require an extraordinarily high level of hands-on care, often for years. Medicaid is the only public program that covers these long-term nursing home stays. Medicaid also covers home and community-based services which are critical for people with dementia, particularly in the early and middle stages of the disease.
It is imperative that those living with this devastating disease have access to affordable, quality care. The Alzheimer’s Association and AIM are working to strengthen Medicaid and improve coverage for those living with Alzheimer’s and other dementias. While Medicaid spending constitutes one of the largest items in most state budgets — and most states continue to face severe fiscal constraints — state policymakers must ensure that critical benefits are preserved. Learn more.
Ensuring a quality workforce
People with Alzheimer's and other dementias receive care and support from a wide variety of health and long-term care professionals. But, the medical, psychological, and social care needs of those living with dementia often make care delivery challenging and more demanding than for those with other health conditions. As our nation ages and the demand for such care increases, more must be done to ensure an adequately trained workforce.
Dementia training policies
To best serve those with Alzheimer's, state governments also must act. The Alzheimer’s Association is working with governors and state legislatures to implement policies that would recruit and retain professionals in the health care and direct care workforces, and require competency-based dementia training for staff involved in the delivery of care for those living with dementia.