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SENATE DOCKET, NO. 2319 FILED ON: 1/17/2025
SENATE . . . . . . . . . . . . . . No. 468
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Adam Gomez
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to improve care and prepare for the new era of Alzheimer’s and dementia.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Adam GomezHampdenJason M. LewisFifth MiddlesexPaul W. MarkBerkshire, Hampden, Franklin and
Hampshire
2/1/2025John F. KeenanNorfolk and Plymouth2/1/2025James B. EldridgeMiddlesex and Worcester2/11/2025Angelo J. Puppolo, Jr.12th Hampden2/20/2025Jacob R. OliveiraHampden, Hampshire and Worcester2/20/2025Thomas M. Stanley9th Middlesex2/20/2025Sal N. DiDomenicoMiddlesex and Suffolk2/20/2025Paul K. Frost7th Worcester2/25/2025Bruce E. TarrFirst Essex and Middlesex2/27/2025Patricia D. JehlenSecond Middlesex2/27/2025Joanne M. ComerfordHampshire, Franklin and Worcester2/27/2025Brendan P. CrightonThird Essex3/5/2025Michael D. BradySecond Plymouth and Norfolk3/5/2025Michael O. MooreSecond Worcester3/5/2025Patrick M. O'ConnorFirst Plymouth and Norfolk3/5/2025 1 of 16
SENATE DOCKET, NO. 2319 FILED ON: 1/17/2025
SENATE . . . . . . . . . . . . . . No. 468
By Mr. Gomez, a petition (accompanied by bill, Senate, No. 468) of Adam Gomez, Jason M.
Lewis, Paul W. Mark, John F. Keenan and other members of the General Court for legislation to
improve care and prepare for the new era of Alzheimer’s and dementia by developing a public
awareness campaign on brain health. Elder Affairs.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act to improve care and prepare for the new era of Alzheimer’s and dementia.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 111 of the General Laws is hereby amended by inserting after
2section 244 the following section:
3 Section 245. Alzheimer’s Disease and Dementia Awareness and Data Collection
4 1. The Department of Public Health, in partnership with the Executive Office of Aging
5and Independence, the Massachusetts Advisory Council on Alzheimer’s Disease and All Other
6Dementias, and any additional community stakeholders as determined by the department, shall
7develop a public awareness campaign on brain health, Alzheimer’s disease and other dementias,
8and incorporate the campaign into its existing, relevant public health outreach programs on an
9ongoing basis. The public awareness campaign shall:
10 (a) educate health care providers on the importance of early detection and timely
11diagnosis of cognitive impairment, validated cognitive assessment tools, current and emerging 2 of 16
12treatment options, the value of a Medicare Annual Wellness visit for cognitive health, and the
13Medicare and Medicaid care planning billing codes for individuals with cognitive impairment;
14 (b) increase public understanding and awareness of early warning signs of Alzheimer's
15disease and other types of dementia, the value of early detection and diagnosis, and how to
16reduce the risk of cognitive decline, particularly among persons in diverse communities who are
17at greater risk of developing Alzheimer's disease and other types of dementia; and
18 (c) inform health care professionals and the general public of dementia care coordination
19services for those living with Alzheimer’s disease and other dementias and other resources and
20services available to individuals living with dementia and their families and caregivers.
21 The department shall strive to provide uniform, consistent guidance on Alzheimer’s and
22other dementia in nonclinical terms, with an emphasis on cultural relevancy and health literacy,
23specifically targeting diverse populations who are at higher risk for developing dementia in its
24public awareness and educational outreach programs.
25 2. Not later than January 1, 2027, and biannually thereafter, the department shall report
26to the Joint Committee on Public Health as well as to the Massachusetts Advisory Council on
27Alzheimer’s Disease and All Other Dementias regarding the department's work on the Healthy
28Brain Initiative Road Map. As used in this section, "Healthy Brain Initiative Road Map" means
29the National Centers for Disease Control and Prevention's collaborative approach to fully
30integrate cognitive health into public health practice and reduce the risk and impact of
31Alzheimer's disease and other dementias.
32 3. The Department of Public Health shall include the National Centers for Disease
33Control and Prevention's Healthy Aging Program’s module on Subjective Cognitive Decline or 3 of 16
34module on Caregiving in the annual Behavioral Risk Factor Surveillance System (BRFSS)
35survey on a rotating annual basis to collect prevalence data on Alzheimer’s and other dementias,
36track trends over time and analyze data to direct public health programs and resources.
37 4. The Massachusetts State Health Assessment and any related data reports or tools shall
38include data on the racial and ethnic disparities for Alzheimer’s disease and other dementias
39where available, as well as data pertaining to cognitive decline and caregiving collected as part
40of the annual BRFSS survey. All resulting reports shall provide data in an aggregate and de-
41identified format.
42 SECTION 2. Chapter 6A of the General Laws is hereby amended by inserting after
43section 16FF the following section:
44 Section 16GG. Massachusetts Director of Dementia Care and Coordination
45 1. There shall be a position titled Director of Dementia Care and Coordination within the
46Executive Office of Health and Human Services. The Secretary of Health and Human Services
47shall hire the director who shall report to the secretary or their designee. The director may call
48upon appropriate agencies of the state government for assistance as is needed. Duties and
49responsibilities of the director shall include, but not be limited to, the following:
50 (a) Coordinate the successful implementation of the Alzheimer’s Disease State Plan.
51 (b) Coordinate with relevant departments and the Chair of the Massachusetts Advisory
52Council on Alzheimer’s Disease and All Other Dementias to support the council’s work and
53annual updates to the Alzheimer’s state plan. 4 of 16
54 (c) Coordinate with the Department of Public Health on awareness efforts as directed
55through section 245 of Chapter 111 of the Massachusetts General Laws; Facilitate and support
56coordination of outreach programs and services between agencies, area agencies on aging, aging
57services access points and other community organizations for the purpose of fostering public
58awareness and education regarding Alzheimer's disease and other forms of dementia.
59 (d) Coordinate with relevant state agencies and community organizations to ensure
60coordination of services, access to services and a high quality of care for individuals with
61dementia and their family caregivers to meet the needs of the affected population and prevent
62duplication of services.
63 (f) Assess dementia-related training requirements for any professionals required to
64receive dementia training including healthcare, long term care, first responders and home and
65community based services professionals on a biannual basis, including hours required, frequency
66of training required and content of training, to determine whether existing training requirements
67meet the needs of the dementia community in Massachusetts; the assessment shall also include
68whether trainings incorporate the latest recommendations from leading national voluntary or
69governmental health organizations in Alzheimer’s care, support and research to ensure trainings
70are based on expert opinion and include evidence-based curriculum that result in a high quality
71of care for people living with dementia. Upon completion of the assessment, provide
72recommendations to the Department of Public Health, the Executive Office of Aging and
73Independence, the Massachusetts Advisory Council on Alzheimer’s Disease and All Other
74Dementias, the Board of Registration in Nursing and the Board of Registration in Medicine and
75any other appropriate departments or boards for additional training necessary to adequately
76support the dementia community in Massachusetts. 5 of 16
77 (g) Work with the Commissioner of the Department of Public Health, the Secretary of the
78Executive Office of Aging and Independence, the Board of Registration in Nursing, the Board of
79Registration in Medicine and any other appropriate departments or boards to ensure all
80professionals required to complete dementia training are in compliance.
81 (h) Work with the Commissioner of the Department of Public Health to ensure that
82hospitals are dementia capable and in compliance with Chapter 220 of the Acts of 2018.
83 (i) Identify and manage grants to assist Massachusetts in becoming dementia-capable.
84 (j) Ensure collection and reporting of data related to the impact of Alzheimer's disease in
85the commonwealth; work with the department's Behavioral Risk Factor Surveillance System
86Coordinator in identifying available funds to execute appropriate modules for critical data
87collection and research; coordinate with the Department of Public Health to improve public
88health outcomes utilizing relevant dementia data.
89 SECTION 3. Chapter 118E of the general laws is hereby amended by adding the
90following new section:
91 Section 83. Dementia Care Coordination Benefit for SCO & One Care Members
92 As used in this section the following words shall, unless the context clearly requires
93otherwise, have the following meanings:-
94 “Dementia Care Coordination”, a proactive care consultation service provided to
95individuals living with dementia and their caregiver.
96 (b) To ensure that members of Senior Care Options (SCO) plans and One Care plans
97receive cost effective, quality dementia care, to lower other health care costs and provide support 6 of 16
98to caregivers, MassHealth shall require that all Massachusetts SCO plans and One Care plans
99include Dementia Care Coordination (DCC) services as a benefit to SCO and One Care members
100that have been diagnosed with Alzheimer’s disease and other dementias and their caregivers.
101 DCC shall be initiated by a referral from the member’s care team. Upon referral, a patient
102with dementia and their caregiver or family member will receive a call from a trained care
103consultant, who shall provide care consultation services to the family, resulting in an
104individualized family care plan. A summary of the individualized family care plan shall be
105provided to the referring care team for inclusion in the health record.
106 Individualized care plans may provide guidance on dementia caregiving strategies,
107including symptom management strategies, communication techniques, legal and financial
108issues, safety recommendations, and recommendations for appropriate community support
109services.
110 (c) In order to meet the requirements of this Section, SCO and One Care plans may
111contract with community partners, or directly provide DCC services to their members.
112 SECTION 4. Chapter 6 of the Massachusetts General Laws is hereby amended by
113inserting the following section after Section 116K:
114 Section 116L. Municipal police training committee; training program for appropriate
115interactions with persons living with Alzheimer’s or other dementias.
116 The municipal police training committee shall identify or develop and implement a
117dementia training program for law enforcement officers, in consultation with the Executive
118Office of Aging and Independence, the Alzheimer’s Association Massachusetts Chapter, the 7 of 16
119Massachusetts Coalition of Police, Massachusetts Chiefs of Police Association, and the
120Massachusetts Police Association. The committee may also consult with other appropriate
121organizations and agencies having an interest and expertise in Alzheimer’s and other dementias,
122or those representing or working with first responders. The program must include instruction on
123the identification of people with Alzheimer’s and other dementias, risks such as wandering and
124elder abuse, and the best practices for interacting with them.
125 All law enforcement officers shall complete at least two (2) hours of initial training
126within the recruit basic training curriculum. The program shall cover the following:
127 Dementia and symptoms associated with dementia;
128 Communication issues, including how to communicate respectfully and effectively with
129the individual who has dementia in order to determine the most appropriate response and
130effective communication techniques to enhance collaboration with caregivers;
131 Techniques for understanding and approaching behavioral symptoms and identifying
132alternatives to physical restraints;
133 Identifying and reporting incidents of abuse, neglect, and exploitation to the Executive
134Office of Aging and Independence Adult Protective Services;
135 Protocols for contacting caregivers when a person with dementia is found wandering, or
136during emergency or crisis situations; and
137 Local caregiving resources that are available for people living with dementia. 8 of 16
138 All law enforcement officers shall complete at least one (1) hour of biannual in-service
139education covering the subjects described in subsections (a) through (f). The biannual in-service
140training shall qualify towards the minimum credit hours required for in-service education.
141 SECTION 5. Chapter 22C of the Massachusetts General Laws is hereby amended by
142inserting the following section after Section 20:
143 Section 20A. State Police training program for appropriate interactions with persons
144living with Alzheimer’s or other dementias.
145 The Department of State Police shall identify or develop and implement a dementia
146training program for state police officers, in consultation with the Executive Office of Aging and
147Independence, the Alzheimer’s Association Massachusetts Chapter, and the State Police
148Association of Massachusetts. The department may also consult with other appropriate
149organizations and agencies having an interest and expertise in Alzheimer’s and other dementias,
150or those representing or working with first responders. The program must include instruction on
151the identification of people with Alzheimer’s and other dementias, risks such as wandering and
152elder abuse, and the best practices for interacting with them.
153 All state police officers shall complete at least two (2) hours of initial training within the
154recruit basic training curriculum. The program shall cover the following:
155 Dementia and symptoms associated with dementia;
156 Communication issues, including how to communicate respectfully and effectively with
157the individual who has dementia in order to determine the most appropriate response and
158effective communication techniques to enhance collaboration with caregivers; 9 of 16
159 Techniques for understanding and approaching behavioral symptoms and identifying
160alternatives to physical restraints;
161 Identifying and reporting incidents of abuse, neglect, and exploitation to the Executive
162Office of Aging and Independence Adult Protective Services;
163 Protocols for contacting caregivers when a person with dementia is found wandering, or
164during emergency or crisis situations; and
165 Local caregiving resources that are available for people living with dementia.
166 2. All state police officers shall complete at least one (1) hour of biannual in-service
167education covering the subjects described in subsections (a) through (f). The biannual in-service
168training shall qualify towards the minimum credit hours required for in-service education.
169 SECTION 6. Chapter 6 of the Massachusetts General Laws is hereby amended by
170inserting the following section after Section 164:
171 Section 164A. Massachusetts fire training council; training program for appropriate
172interactions with persons living with Alzheimer’s or other dementias.
173 The Massachusetts fire training council will identify or develop and implement a
174dementia training program for firefighters, in consultation with the Massachusetts fire service
175commission, the Executive Office of Aging and Independence, the Alzheimer's Association
176Massachusetts Chapter, the Professional Firefighters of Massachusetts and the Massachusetts
177Fire Chiefs Association. The council may also consult with other appropriate organizations and
178agencies having an interest and expertise in Alzheimer’s and other dementias, or those
179representing or working with first responders. The program must include instruction on the 10 of 16
180identification of people with Alzheimer’s and other dementias, risks such as wandering and elder
181abuse, and the best practices for interacting with them.
182 All firefighters shall complete at least two (2) hours of initial training within the recruit
183basic training curriculum. The program shall cover the following:
184 Dementia and symptoms associated with dementia;
185 Communication issues, including how to communicate respectfully and effectively with
186the individual who has dementia in order to determine the most appropriate response and
187effective communication techniques to enhance collaboration with caregivers;
188 Techniques for understanding and approaching behavioral symptoms and identifying
189alternatives to physical restraints;
190 Identifying and reporting incidents of abuse, neglect, and exploitation to the Executive
191Office of Aging and Independence Adult Protective Services;
192 Protocols for contacting caregivers when a person with dementia is found wandering, or
193during emergency or crisis situations; and
194 Local caregiving resources that are available for people living with dementia.
195 All firefighters shall complete at least one (1) hour of biannual in-service education
196covering the subjects described in subsections (a) through (f). The biannual in-service training
197shall qualify towards the minimum credit hours required for in-service education.
198 SECTION 7. Chapter 111C of the Massachusetts General Laws is hereby amended by
199inserting the following section after Section 9A: 11 of 16
200 Section 9B. EMS training program for appropriate interactions with persons living with
201Alzheimer’s or other dementias.
202 The Department of Public Health will identify or develop and implement a dementia
203training program for EMS personnel, in consultation with the Executive Office of Aging and
204Independence, the Alzheimer's Association Massachusetts Chapter and the Massachusetts
205Ambulance Association. The department may also consult with other appropriate organizations
206and agencies having an interest and expertise in Alzheimer’s and other dementias, or those
207representing or working with first responders. The program must include instruction on the
208identification of people with Alzheimer’s and other dementias, risks such as wandering and elder
209abuse, and the best practices for interacting with them.
210 1. All EMS personnel shall complete at least two (2) hours of initial training within the
211recruit basic training curriculum. The program shall cover the following:
212 Dementia and symptoms associated with dementia;
213 Communication issues, including how to communicate respectfully and effectively with
214the individual who has dementia in order to determine the most appropriate response and
215effective communication techniques to enhance collaboration with caregivers;
216 Techniques for understanding and approaching behavioral symptoms and identify
217alternatives to physical restraints;
218 Identifying and reporting incidents of abuse, neglect, and exploitation to the Executive
219Office of Aging and Independence Adult Protective Services; 12 of 16
220 Protocols for contacting caregivers when a person with dementia is found wandering, or
221during emergency or crisis situations; and
222 Local caregiving resources that are available for people living with dementia.
223 2. All EMS personnel shall complete at least one (1) hour of biannual in-service
224education covering the subjects described in subsections (a) through (f). The biannual in-service
225training shall qualify towards the minimum credit hours required for in-service education.
226 SECTION 8. Chapter 111 of the General Laws is hereby amended in Section 25N (a) (2)
227by inserting after the words “obstetrics/gynecology”, the following words:
228 “, geriatrics, geriatric psychiatry,”
229 SECTION 9. Chapter 112 of the Massachusetts General Laws is hereby amended in
230Section 12G ½ by inserting the words “or other dementias” after each occurrence of the words
231“Alzheimer’s disease".
232 SECTION 10. Section 8 of Chapter 220 of the Acts of 2018 is hereby amended by
233striking out the words “not later than October 1, 2021” and inserting in place thereof the
234following: “not later than July 1, 2027 and every 5 years thereafter”.
235 Said section of Chapter 220 of the Acts of 2018 is further amended by striking out
236subsections (i) through (iii) and inserting in place thereof the following:
237 (i) Complete an operational plan for the recognition and management of patients with
238dementia or delirium in acute-care settings. Upon completion of the operational plan, the plan
239shall be submitted to the Department of Public Health for approval. The department shall
240evaluate the plan and approve or offer amendments to the plan within 90 days of receipt. Once a 13 of 16
241final plan is approved by the Department of Public Health, the plan shall be implemented by the
242hospital.
243 (ii) The operational plan shall include provisions on the following: (a) education and
244training of clinical and non-clinical staff; (b) providing a dementia and/or delirium appropriate
245environment; (c) recognition of dementia and/or delirium; (d) patient management and treatment,
246including how to manage symptoms, treatment protocols and side effect management; (e)
247transition planning to improve and provide safe admissions, transfers and discharges, including
248protocols to ensure that patients living with dementia are safe and have a staff member or
249caregiver present during discharge or transfer; (f) advance care planning information; (g)
250caregiver communication and coordination, including protocols to ensure that a contact to a
251caregiver has been attempted upon arrival and prior to discharge if patient agrees; and (h)
252address additional applicable recommendations made by the Alzheimer’s and related dementias
253acute care advisory committee established pursuant to chapter 228 of the acts of 2014 and any
254additional guidance issued by the Massachusetts Health & Hospital Association or the
255Department of Public Health;
256 (ii) Each hospital’s operational plan shall be updated at least every five years, with the
257option to update the plan more frequently as needed;
258 (iii) A copy of each hospital’s plan shall be provided to the Massachusetts Advisory
259Council on Alzheimer’s Disease and All Other Dementias upon approval;
260 (v) An electronic copy of each hospital’s operational plan shall be provided to each
261employee upon approval and a written copy of the plan shall be provided to any of its employees
262upon request; and 14 of 16
263 (vi) Each hospital shall keep a copy of the plan on file and make available for review by
264the public.
265 SECTION 11. Chapter 111 of the Massachusetts General Laws is hereby amended by
266inserting the following section after Section 53H:
267 Section 53I. Alzheimer’s and Dementia Patient and Caregiver Rights in Acute Care
268Settings; Safe Discharge for Alzheimer’s and Dementia Patients
269 The department shall require acute care hospitals to allow a family member or other
270caregiver for patients with Alzheimer’s or other dementias, or for patients exhibiting symptoms
271of dementia or cognitive impairment, to remain with the patient at all times that are medically
272appropriate, including, but not limited to, while in the emergency department and while admitted
273as an inpatient. Caregivers for patients living with Alzheimer’s or other dementias shall not be
274required to adhere to restricted hospital visiting hours, unless it has been deemed unsafe for the
275patient, family member or caregiver.
276 The department shall require acute care hospitals to create policies and protocols to
277ensure that a family member, a caregiver, or the personal legal representative responsible for a
278patient with Alzheimer’s or other dementia is contacted as soon as possible following admission
279to the emergency department or hospital if the patient presents to the hospital without a family
280member, a caregiver, or a personal legal representative; provided, however, that the hospital shall
281only contact a family member, a caregiver, or the personal legal representative if (i) the hospital
282has received consent from the patient if possible to do so; and (ii) to the extent consistent with
283federal and state law or regulation, and in the reasonable judgment of the hospital. If the patient
284is incapacitated or not able to provide consent, a health care provider may share the patient’s 15 of 16
285information with a family member, a caregiver, or the personal legal representative responsible
286for a patient with Alzheimer’s or other dementia as long as the health care provider determines,
287based on professional judgment, that it is in the best interest of the patient.
288 The department shall require acute care hospitals to create policies and protocols to
289ensure that a family member, a caregiver, or the personal legal representative responsible for a
290patient living with Alzheimer’s or other dementia is contacted prior to the patient’s discharge to
291ensure a safe discharge, including suitable transport from the hospital, and review the discharge
292plan; provided, however, that the hospital shall only contact a family member, a caregiver, or the
293personal legal representative if (i) the hospital has received consent from the patient if possible to
294do so; and (ii) to the extent consistent with federal and state law or regulation, and in the
295reasonable judgment of the hospital. If the patient is incapacitated or not able to provide consent,
296a health care provider may contact a family member, a caregiver, or the personal legal
297representative responsible for the patient with Alzheimer’s or other dementia as long as the
298health care provider determines, based on professional judgment, that it is in the best interest of
299the patient. If a family member, caregiver or personal legal representative is not able to be
300contacted or if the patient declines contact, the patient living with Alzheimer’s or other dementia
301shall meet with a hospital social worker or other professional who can assess for discharge safety
302and other supports needed prior to discharge.
303 Subsections (a) through (c) shall also apply to a patient who presents with symptoms of
304dementia or cognitive impairment based on the assessment of the physician overseeing their care
305in the hospital. 16 of 16
306 Subsections (a) through (d) shall be exempted during a declared public health state of
307emergency.
308 The department shall promulgate regulations consistent with the provisions of
309subsections (a) through (e). The department shall also ensure that subsections (a) through (d)
310comply with all state and federal privacy requirements, including those imposed by 45 C.F.R. §
311164.510(b).