Primed for implementation: HBI Road Map

Action W-3 — Educate public health professionals about the best available evidence on dementia (including detection) and dementia caregiving, the role of public health, and sources of information, tools and assistance to support public health action.

Learn More
A strong, competent and robust health care and public health workforce is essential to address the rising tide of Alzheimer’s and other dementias. Public health officials must ensure that health care providers — including primary and specialty care clinicians — are trained to recognize the early warning signs of cognitive impairment, refer families impacted by dementia to care and support services, and advise patients how they may reduce the risk of cognitive decline and possibly dementia.

Additionally, public health must ensure competent and capable holistic health systems that can work across an entire population to improve health and well-being of those impacted by dementia. By enacting policies and mobilizing partnerships, public health can work side-by-side with an array of health care organizations, nonprofits and health systems to improve the health of communities across an entire population.  

The dementia care workforce includes nurses, home health professionals, social workers, pharmacists, physicians, community health workers, first responders among others. Each profession has specialized knowledge and competencies that, if shared, could help other professionals become more effective in their particular roles. By expanding interprofessional training, public health practitioners can facilitate the transfer of knowledge and skills, support team-based care, and encourage improved quality of care.

Public health can prepare professionals to promote the health and well-being of people living with dementia and caregivers. One way to address these topics is by integrating cognitive functioning and caregiving into existing health promotion and chronic disease efforts. For example, public health can provide professionals with easy-to-understand materials for consumers about ways to reduce the risk of cognitive decline to consumers. Public health also can conduct outreach to health professionals about the importance of promoting caregivers’ health and supporting their role in managing dementia. At the same time, public health can ensure that professionals who interact with caregivers understand how to safely care for someone living with dementia.

More and more public health departments are partnering with community health workers (CHWs). Community Health Workers: A Resource for Healthy Aging and Addressing Dementia explores how these professionals can promote healthy aging and help address some of the challenges related to Alzheimer’s and all dementia. Created by the Alzheimer’s Association and Association of State and Territorial Health Officials, this resource guide provides an easy way for health departments to learn about available training, education, frameworks and tools to build partnerships with CHWs. Users will also find examples of state health department initiatives to train and support CHWs as they educate their communities about healthy aging and cognitive health, provide supportive services, encourage early detection of cognitive impairment and dementia, and help caregivers for people living with dementia access available support.

To help the public health community educate, train, and build the competencies of providers, the Alzheimer’s Association and the Centers for Disease Control and Prevention (CDC) developed this topic-specific issue map — Educating and Training Professionals. It offers compelling data on the topic, a primer explaining the need for action, suggests related HBI Road Map actions, and provides case studies to demonstrate successful implementation.

Learn more:

  • The American College of Preventive Medicine (ACPM) created an online course for physicians about the benefits of addressing blood pressure management as a way to reduce the risk of cognitive decline.
  • Public Health Live! — from the School of Public Health at SUNY’s University of Albany — catalogs previous webinars focused on the intersection of chronic disease and dementia.
  • Alzheimer’s Association’s information for professionals at

Curriculum for use in schools of public health

To help educate the future public health workforce, A Public Health Approach to Alzheimer’s and Other Dementias is a free, introductory curriculum intended to increase awareness of the impact of Alzheimer’s and other dementias as well as the role of public health in addressing this crisis.

Learn More

Advance care planning

An early and accurate diagnosis of Alzheimer’s allows individuals living with dementia and their families to better prepare for many aspects of the future. Advance care planning allows people living with dementia to document their wishes for care, finances and legal matters. They also have the opportunity to designate a care team, power of attorney and guardianship when warranted. The sooner planning starts, the more the individual with dementia can participate and express his or her own preferences. Knowing the individual’s wishes helps eliminate guesswork for families and caregivers and allows the individual with dementia to designate a surrogate decision-maker when necessary.

Clinicians can be reimbursed for providing comprehensive care planning services to individuals with cognitive impairment. Reimbursable under CPT billing codes 99483, care planning services include cognitive and safety evaluations, a caregiver interview, and planning for palliative care needs. The public health community must ensure clinicians are trained on these reimbursable care planning services for people with cognitive impairment and their caregivers.  

Learn more: Care planning for cognitive impairment

State success: Training professionals in Utah and Colorado

The Utah Department of Health trained hundreds of health professionals, caregivers and people living with dementia about effective communication strategies for people with cognitive impairment and ways to promote independence. Read the case study to learn more.

In Colorado, the Department of Public Health and Environment partnered with the Alzheimer’s Association to provide training to Emergency Medical Services (EMS) personnel about the unique communication and behavioral challenges posted by cognitive impairment and dementia. Ready the full case study to learn more. 

State-specific action you can take

Communities are taking public health action against Alzheimer’s and other dementias. Find out how the disease impacts your state and what you can do to make Alzheimer's the next public health success story.

Learn More

Featured Resources

Alzheimer's Association & Centers for Disease Control and Prevention Planning for Action: Initial Steps for implementing the Healthy Brain Initiative Road Map
Centers for Disease Control and Prevention Dissemination Guide
Health Resources and Services Administration Training Curriculum: Alzheimer’s Disease and Related Dementias

Select Filters
Search for resources to expand health system capacity below:

Select Filters
Find examples of expanded health system capacity below:

AK Department of Health and Social Services Department of Health and Social Services briefed public health and aging stakeholders about applying public health approaches to Alzheimer’s disease, including Road Map action items.
AZ Arizona Department of Health Services Arizona Department of Health conducted a community needs assessments for caregivers.
AZ Arizona Department of Health Services With partners, Arizona Department of Health Services conducted a comprehensive needs assessment of people living dementia and caregivers in the state, assessed providers to identify gaps in existing services and supports for people living with dementia and caregivers, and developed a three-pronged approach to address these issues
CA California Department of Public Health Issued six competitive grants of $750,000 each to local health departments to implement actions of the Healthy Brain Initiative Road Maps - the local health departments funded are: Shasta, Placer, Sacramento, Santa Clara, Los Angeles and San Diego
CA California Department of Public Health California Department of Public Health included Alzheimer’s data in its annual county health status profiles report
CA City of San Diego County public health agency conducted needs assessments in 2015 and 2016
CA City of San Diego City of San Diego published a city-wide evaluation of their dementia-readiness
CA City of San Francisco City of San Francisco developed and reported an evaluation aimed at improving dementia care
CA City of San Francisco Northern California and Northern Nevada Chapter of the Alzheimer’s Association convened a summit for emergency department physicians on detection and diagnosis.
CA City of Santa Clara Assessed where more resources are needed to assist in the early detection and diagnosis of individuals with dementia by mapping where people with dementia were "entering" the system (e.g., hospitals, aging services).
CA San Diego County San Diego County Health & Human Services Department released report on Alzheimer’s disease in San Diego County
CO Colorado Department of Public Health and Environment Raised awareness about the public health significance of Alzheimer’s disease by analyzing data from the Behavioral Risk Factor Surveillance System survey modules on cognition and caregiving and disseminating findings.
DC District of Columbia Department of Health DC Department of Health conducted a comprehensive needs assessment of existing dementia services to identify service and workforce gaps
FL Florida Department of Health Incorporated Alzheimer’s disease into the State Health Improvement Plan, which guides how FDOH and its partners will improve the health of Floridians.
GA Department of Public Health Georgia Department of Public Health analyzed surveillance data to describe the prevalence of Alzheimer’s and related dementias among Georgia Medicare beneficiaries, including the overall burden, disparities, and impact on service utilization and related costs.
GA Department of Public Health State government established a position to coordinate work on Alzheimer’s disease and the implementation of the state Alzheimer’s disease plan.
ID Department of Health and Welfare Idaho Department of Health and Welfare, Division of Public Health, published its analysis of dementia mortality data from 2014
IL Illinois Department of Public Health Developed and deployed dementia-specific training for all direct care workers in residential settings, and in home- and community-based settings. IL DPH hosts training and monitors compliance across the state.
KS Kansas Department of Health and Environment Informed decision-makers about Alzheimer’s and other dementias by incorporating data on cognitive health into public health burden reports, including chronic disease and injury prevention.
MA City of Boston City of Boston includes dementia specific-recommendations to improve care and support throughout the city.
MD Maryland Department of Health Assured state’s council on Alzheimer’s disease and related dementias has public health expertise and involvement by serving as council co-chair with the Maryland Department of Aging.
MD Maryland Department of Health Facilitated the integration of cognition and cognitive health concerns into public health programming, including older driver safety and education of public health professionals.
MD Department of Health and Mental Hygiene Maryland Department of Health and Mental Hygiene provides small grants to local health improvement coalitions to help them provide individuals with educational programs and resources on cognitive health, aging, and financial and legal planning.
MN Minnesota Department of Health Developed a framework to identify high-risk communities with data analyses, help prioritize resources, and expand cognitive health partnerships throughout the health department.
MN Minnesota Department of Health Informed efforts to make communities more supportive of people living with dementia and their caregivers by integrating cognitive and caregiver surveillance data and related resources into county fact sheets; MDH prioritized counties that have a high proportion of at-risk older adults.
MN Chisago County Public Health Department Chisago County Public Health Department supported training of local law enforcement officers and first responders on how to effectively communicate with and serve people with dementia.
MN City of Northfield Conducted a community-wide assessment of community organizations, nursing homes, and health systems to identify needs and gaps in services/supports and to determine what existing resources could be used to fill gaps.
MN Department of Health Convened a public stakeholder meeting with state agency staff (including public health, human services, and aging services) and community organizations to examine what policies (and what Road Map action items) can positively affect families with Alzheimer's throughout the state.
MN Department of Health Minnesota Department of Health will include dementia alongside other chronic conditions and obesity in its annual report regarding projected health and long-term care spending. Beginning in Nov. 2016, the health commissioner may apply any savings between projected versus actual outlays to state-administered health care programs.
MN University of Minnesota School of Public Health University of Minnesota School of Public Health created a dedicated professorship focused on dementia education for public health students (anticipated to begin in 2016-2017 academic year). Curriculum development underway.
MO Missouri Department of Health and Social Services Expand DHSS efforts on Alzheimer’s and other dementias as public health issues by incorporating cognition and caregiving into the State Health Improvement Plan, Coordinated Chronic Disease Plan, and Healthy Aging Plan.
MS State Department of Health Mississippi State Department of Health (MSDH) incorporated cognitive health into the MSDH Coordinated Chronic Disease Plan and the Health Promotion State Plan
NC Department of Health and Human Services North Carolina’s Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), part of the state’s public health surveillance system, was used to analyze five years of data to obtain rates of emergency department visits with a dementia diagnosis
NJ Department of Health New Jersey Department of Health arranged for the Alzheimer’s Association to brief its commissioner’s deputies on the Alzheimer’s Road Map and Alzheimer’s as a public health issue.
NM Department of Health New Mexico Department of Health conducted a symposium on the public health aspects of Alzheimer’s at the New Mexico Public Health Association’s annual meeting.
NY State Department of Health New York State Department of Health informed public health professionals and others about the burden of Alzheimer’s disease and other dementias in the state and its impact on Medicaid service utilization and costs in a Medicaid Update newsletter.
OR Oregon Department of Human Services Adding Years to Life and Life to Years: A case study of public health's contribution to healthy aging in Oregon
OR Department of Human Services Oregon Public Health Division hosted a symposium for state and local public health officials on intersection of public health and Alzheimer’s.
PA State of Pennsylvania Pennsylvania bill (RH 969) resolves the Secretary of Health to designate Alzheimer's disease and related disorders a public health issue.
RI Rhode Island Department of Health Established a new program - Alzheimer's Disease and Related Disorders - within the Rhode Island Department of Health to better assess and track state progress on risk reduction of cognitive decline and meeting the needs of people with dementia.
TN Department of Health Tennessee Department of Health arranged for the Alzheimer’s Association to brief about 20 of its top leaders on the Alzheimer’s Road Map and Alzheimer’s as a public health issue.
UT Utah Department of Health Utah Department of Health is developing comprehensive dementia training for health care providers including core competencies and certification standards of successful training completion
UT Department of Health Utah Department of Health featured Alzheimer’s and related dementias and their impact on the state in its May 2016 Monthly Health Status Update for public health professionals and stakeholders.
VA Virginia Department of Health Virginia Department of Health added weblinks to the department's website on Alzheimer's, dementia, and brain health
VT University of Vermont College of Medicine University of Vermont College of Medicine engaged public health students to document the medical community’s views about assessing for dementia and preferences for training. Students subsequently developed an online course for the medical community.
WA Washington State Depatment of Health Washington State Department of Health educated state employees about dementia and cognitive health
WA Washington State Depatment of Health Washington State Department of Health participated on webinar about their whole agency approach to engage the entire agency on cognitive health, dementia, and caregiving