STATE PRIORITIES


To help achieve our state policy goals, the Alzheimer’s Association educates legislators and regulators about our issues, offers model legislation for consideration, provides technical assistance for policy makers, brings our advocates to the state houses to tell their personal stories and a wide variety of other programs.

State policy is vital to the work that the Association is doing to meet the needs of individuals living with Alzheimer’s and their families. State officials determine regulatory and statutory standards for dementia training, control spending on state respite care dollars (which affects access to those services), designate spending for state long-term care services, and control Medicaid spending, and in some cases, eligibility and scope of benefits - all of which can have a direct effect on families impacted by Alzheimer's disease.

To achieve these goals we work to:


Since 2007, nearly every state has developed a State Alzheimer's Disease Plan to address to growing economic and social impact of the disease. These comprehensive plans identify critical issues, recommend solutions, and create a roadmap to guide a state's development into a dementia-capable state. State legislatures and state agnecies must fully implement the recommendations included in their state's Alzheimer's disease plan and revisit and re-publish their plans every three to five years to ensure they are kept up to date and account for current needs and recent developments.


People with Alzheimer’s deserve quality care throughout the course of the disease — and they deserve to receive it from knowledgeable professionals across the care continuum. All individuals employed to provide care in residential, home, and adult day settings must be properly trained in dementia care. Yet training standards vary widely by state. For example, less than half of all states require dementia training for staff of nursing homes, and less than one-fifth of states require it for adult day staff. As the number of people living with Alzheimer’s and other dementias increases, states must have adequate dementia- training laws to equip workers across the care continuum with the ability to provide person and family-centered care, communicate effectively with persons with dementia, and address specific and unique aspects of care and safety for people with dementia.


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. Healthy People 2020 has set the goal of increasing the percentage of individuals with the disease or their caregivers who are aware of the diagnosis.


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.


Among individuals with Alzheimer’s, 75 percent will be admitted to a nursing home by the age of 80. As a result, Medicaid is critical for many people with Alzheimer’s. 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.


Total Medicaid Costs for Americans Age 65 and Older Living with Alzheimer's or Other Dementias by State


State 2018 (in millions of dollars) 2025 (in millions of dollars) Percentage Increase
Alaska 66 109 63.9%
Alabama 839 1107 31.9%
Arkansas 353 446 26.3%
Arizona 364 537 47.6%
California 3.776 5150 36.4%
Colorado 573 775 35.3%
Connecticut 926 1166 25.9%
District of Columbia 121 132 9.6%
Delaware 226 307 35.8%
Florida 2.502 3392 35.6%
Georgia 1.114 1565 40.4%
Hawaii 207 280 35.4%
Iowa 630 778 23.7%
Idaho 139 193 39.0%
Illinois 1.649 2182 31.1%
Indiana 981 1211 23.4%
Kansas 424 533 25.8%
Kentucky 721 932 29.3%
Louisiana 712 917 28.8%
Massachusetts 1.633 1996 22.2%
Maryland 1.096 1508 37.5%
Maine 197 269 36.9%
Michigan 1.368 1707 24.8%
Minnesota 824 1069 29.7%
Missouri 888 1117 25.8%
Mississippi 564 716 26.9%
Montana 150 199 33.4%
North Carolina 1.188 1600 34.7%
North Dakota 175 211 21.0%
Nebraska 347 404 16.3%
New Hampshire 236 329 39.2%
New Jersey 2.011 2568 27.7%
New Mexico 199 274 37.7%
Nevada 178 272 53.5%
New York 4.834 6206 28.4%
Ohio 2.360 2888 22.4%
Oklahoma 481 600 24.8%
Oregon 235 311 32.7%
Pennsylvania 3.404 3958 16.3%
Rhode Island 438 555 26.6%
South Carolina 573 804 40.2%
South Dakota 167 208 24.3%
Tennessee 989 1353 36.8%
Texas 2.805 3882 38.4%
Utah 160 231 44.9%
Virginia 900 1244 38.2%
Vermont 106 144 36.1%
Washington 497 678 36.4%
Wisconsin 723 909 25.7%
West Virginia 414 512 23.6%
Wyoming 76 109 42.7%

All cost figures are reported in 2018 dollars. State totals may not add to the U.S. total due to rounding. Excerpted from the Alzheimer’s Association’s 2018 Alzheimer’s Disease Facts and Figures report. See the full report for methodology (alz.org/facts).