Proposal Presented for the Master Plan for Aging (#29)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Improve Alzheimer’s Disease and dementia care by requiring applicable training for nursing home and assisted living staff. This proposal also includes a series of measures to improve available training in dementia care.
Justification
Cognitive impairment is often misunderstood by health care professionals serving older adults and people with disabilities. Alzheimer's and Dementia training would increase awareness amongst the healthcare workforce and improve the ability of providers to deliver more comprehensive care and informed detection for those struggling with cognitive impairment. In turn, those facing cognitive impairment will be able to receive the interventions necessary at an earlier point in time, improving quality life for themselves and their caregivers.
Full Proposal
To improve detection, diagnosis, treatment, and management for individuals with cognitive impairment and support prevention and excess disability associated with cognitive decline through the life course a brain health and dementia-capable workforce must be developed:
- Require that all nursing home and assisted living staff receive specific training in dementia care practices, such as the opportunities recommended by the Alzheimer’s Association that apply to all settings and opportunities that are competency based and training tracked by DOH.
- Ensure that training credentials are stackable to prevent barriers to entering the workforce.
- Leverage and add to the federal Building Our Largest Dementia (BOLD) infrastructure funding currently with the NYS DOH Alzheimer’s Disease Program and the existing structure of the NYS Centers of Excellence for Alzheimer’s Disease (CEAD) and Alzheimer’s Disease Community Assistance Program (AlzCap).
- Implement, expand, and disseminate the use of evidence-based practice inclusive of assessment and evaluation, approaches to connect persons living with dementia and their care partners to community supports and services.
- Include and promote opportunities for formal accredited training or certification for clinicians and direct care workforce to improve brain health across the life course.
- Elevate the importance of a dementia-capable workforce at the federal level, aligned with existing federal initiatives and momentum. New York’s advocacy promotes the State's leadership in cognitive health care.
- Develop population health strategies to encourage health care systems and organizations to implement early detection strategies into care processes, particularly those serving underserved regions of NYS.
- Use evidence-informed training embedded in health systems integrated with community-based organizations across the state.
- Continue to support funding that is directed towards brain health initiatives and dementia-capable workforce development.
- Promote care models that provide an interdisciplinary approach to the early detection, diagnosis, and care of cognitive decline, and the management of chronic diseases that impact brain health.
- Integrate and adopt training regarding early detection and diagnosis.
- Focus on whole-person care by promoting the benefits and importance of early detection and diagnosis so families can manage the disease process.
- Encourage a comprehensive approach combining psychosocial and medical approaches, including use of medications as appropriate, preparing for next stages in the disease course, and ensuring the existence of an Age-Friendly workforce.
- Address the impacts of cognitive impairment and ensure attention to the challenges in capturing what matters most to the patient/person through the disease course.
- Include examination of best ways to reimburse for integrated care that supports high-quality brain health.
Notes: Portions of this proposal have been adopted.
MPA Council Commentary
Components 3, 7, 9, 10, 11, 12, and 13 of this proposal are currently being implemented at DOH. The Office of Aging and Long-Term Care’s Alzheimer’s Disease program continues to engage in its goals of enhancing access to early screening and diagnosis of dementia, expanding the expertise of the healthcare workforce, and providing access to community-based services for individuals with dementia and their care partners. Area Agencies on Aging (AAAs) continue to provide a range of services that support caregivers, provide training, and aid in early detection of cognitive decline. DOH has acquired BOLD funding and is leveraging it for Alzheimer’s Disease programming. DOH is also engaged in the work of making healthcare across the state Age-Friendly. Component 1, the stackable training credentials and reimbursement for integrated care, is categorized as long-term due to administrative complexity. Continued metrics for evaluation include but are not limited to the number of patients diagnosed with a dementia, number of healthcare professionals trained, and the number of community supports and services accessed by care partners.