An Act To Promote Workforce Education on Alzheimer's Disease and Dementia
Maine Legislature, Session 129, LD 1072
Committee: Health Coverage, Insurance and Financial Services
Sponsors: CRAVEN, GRATWICK, CLOUTIER, DOORE, HICKMAN, MADIGAN, MEYER, PERRY, SHEATS, STOVER
Amends: 22 MRSA §1711-C, 22 MRSA §3473-A, 32 MRSA §2213, 32 MRSA §2594-E, 32 MRSA §2600-D, 32 MRSA §3270-E, 32 MRSA §3300-G

Legislative Document
No. 1072
H.P. 795
House of Representatives, March 5, 2019
An Act To Promote Workforce Education on Alzheimer's Disease 
and Dementia
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative CRAVEN of Lewiston.
Cosponsored by Senator GRATWICK of Penobscot and
Representatives: CLOUTIER of Lewiston, DOORE of Augusta, HICKMAN of Winthrop, 
MADIGAN of Waterville, MEYER of Eliot, PERRY of Calais, SHEATS of Auburn, STOVER 
of Boothbay.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1711-C, sub-§6, ¶T, as amended by PL 2017, c. 203, §3, is 
further amended to read:
T.  To a lay caregiver designated by an individual pursuant to section 1711-G; and
Sec. 2.  22 MRSA §1711-C, sub-§6, ¶U, as enacted by PL 2017, c. 203, §4, is 
amended to read:
U.  To a panel coordinator of the maternal, fetal and infant mortality review panel 
pursuant to section 261, subsection 4, paragraph B-1 for the purposes of reviewing 
health care information of a deceased person and a mother of a child who died within 
one year of birth, including fetal deaths after 28 weeks of gestation.  For purposes of 
this paragraph, "panel coordinator" has the same meaning as in section 261, 
subsection 1, paragraph E and "deceased person" has the same meaning as in section 
261, subsection 1, paragraph B.; and
Sec. 3.  22 MRSA §1711-C, sub-§6, ¶V is enacted to read:
V.  To an authorized representative or family or household member of an individual 
unless expressly prohibited by the individual when the health care practitioner is 
providing a diagnosis of Alzheimer's disease or dementia.
Sec. 4.  22 MRSA §§1725-A and 1725-B are enacted to read:
§1725-A.  Alzheimer's disease and dementia service plans
In addition to disclosing the diagnosis to the patient, a health care practitioner who 
diagnoses Alzheimer's disease or dementia shall disclose the diagnosis to a family or 
household member or to an authorized representative as defined in section 1711-C, 
subsection 1, paragraph A pursuant to section 1711-C, subsection 6, paragraph V and 
shall provide information to the family or household member or authorized representative 
about care planning services, including assistance understanding the diagnosis, and 
medical and nonmedical options for treatment, services and supports and information 
about obtaining treatment, services and supports.
§1725-B.  Alzheimer's disease and dementia hospital plans
No later than January 1, 2023, a hospital shall develop and implement an operational 
plan for the recognition and management of patients with Alzheimer's disease or 
dementia within that hospital.  The plan must be developed in consultation with 
organizations with expertise in the field of Alzheimer's disease and dementia.   The plan 
must be kept on file in the hospital and made available to any person on request.
Sec. 5.  22 MRSA §3473-A is enacted to read:
§3473-A.  Alzheimer's disease and dementia training
The department shall provide at least 4 hours of Alzheimer's disease and dementia 
education and training to all employees or contract employees whose primary 
responsibility is in adult protective services pursuant to this chapter at the beginning of 
their employment.  The education and training must include:
1.  Symptoms.  Identification of psychiatric and behavioral symptoms of Alzheimer's 
disease and dementia;
2.  Communication.  Information regarding communication issues, including how to 
communicate effectively and in a respectful manner;
3.  Strategies.  Strategies and techniques for understanding and approaching 
behavioral symptoms;
4.  Safety.  Information on how to address specific aspects of safety, including 
wandering;
5.  Abuse and neglect.  Identification of types of neglect, abuse or exploitation of 
persons with Alzheimer's disease and dementia; 
6.  Law enforcement.  When it is necessary to alert law enforcement of neglect, 
abuse or exploitation by a family member, caretaker or facility;
7.  Self-neglect.  Identification of self-neglect by persons with Alzheimer's disease 
and dementia who live independently; and
8.  Resources.  Resources to connect persons with Alzheimer's disease and dementia 
to local resources, including professionals with expertise in care of persons with 
Alzheimer's disease and dementia.
Sec. 6.  32 MRSA §2213 is enacted to read:
§2213.  Patients with cognitive impairments; continuing education
By January 1, 2023, the board shall include, as part of required continuing education 
for an individual licensed under this chapter, a 2-hour course on Alzheimer's disease and 
dementia including diagnosis, behavioral symptoms, respectful and effective 
communication, safety, signs of abuse and neglect and identifying signs of self-neglect by 
persons living alone.  The course is not required for an individual licensed under this 
chapter who does not serve adult populations as part of the individual's regular 
employment.  The board shall adopt rules to implement this section.  Rules adopted 
pursuant to this section are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.
Sec. 7.  32 MRSA §2594-E, sub-§6 is enacted to read:
6.  Patients with cognitive impairments; continuing education.  By January 1, 
2023, the board shall adopt rules jointly with the Board of Licensure in Medicine to 
require, as part of continuing education requirements established pursuant to subsection 
5, paragraph I, the completion of a 2-hour course on Alzheimer's disease and dementia 
including diagnosis, behavioral symptoms, respectful and effective communication, 
safety, signs of abuse and neglect and identifying signs of self-neglect by persons living 
alone.  Rules adopted pursuant to this subsection are routine technical rules as defined in 
Title 5, chapter 375, subchapter 2-A.
Sec. 8.  32 MRSA §2600-D is enacted to read:
§2600-D.  Patients with cognitive impairments; continuing education 
By January 1, 2023, the board shall include, as part of required continuing education 
for an individual licensed under this chapter, a 2-hour course on Alzheimer's disease and 
dementia including diagnosis, behavioral symptoms, respectful and effective 
communication, safety, signs of abuse and neglect and identifying signs of self-neglect by 
persons living alone.  The course is not required for an individual licensed under this 
chapter who does not serve adult populations as part of the individual's regular 
employment.  The board shall adopt rules to implement this section.  Rules adopted 
pursuant to this section are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.
Sec. 9.  32 MRSA §3270-E, sub-§6 is enacted to read:
6.  Patients with cognitive impairments; continuing education.  By January 1, 
2023, the board shall adopt rules jointly with the Board of Osteopathic Licensure to 
require, as part of continuing education requirements established pursuant to subsection 
5, paragraph I, the completion of a 2-hour course on Alzheimer's disease and dementia 
including diagnosis, behavioral symptoms, respectful and effective communication, 
safety, signs of abuse and neglect and identifying signs of self-neglect by persons living 
alone.  Rules adopted pursuant to this subsection are routine technical rules as defined in 
Title 5, chapter 375, subchapter 2-A.
Sec. 10.  32 MRSA §3300-G is enacted to read:
§3300-G.  Patients with cognitive impairments; continuing education
By January 1, 2023, the board shall include, as part of required continuing education 
for an individual licensed under this chapter, a 2-hour course on Alzheimer's disease and 
dementia including diagnosis, behavioral symptoms, respectful and effective 
communication, safety, signs of abuse and neglect and identifying signs of self-neglect by 
persons living alone.  The course is not required for an individual licensed under this 
chapter who does not serve adult populations as part of the individual's regular 
employment.  The board shall adopt rules to implement this section.  Rules adopted 
pursuant to this section are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.
Sec. 11.  Hospital plans.  A hospital developing and implementing a plan pursuant 
to the Maine Revised Statutes, Title 22, section 1725-B shall consult with the Department 
of Health and Human Services and statewide organizations with expertise in the field of 
Alzheimer's disease and dementia and include relevant components from the federal 
Department of Health and Human Services, Centers for Disease Control and Prevention, 
Healthy Brain Initiative's publication, "State and Local Public Health Partnerships to 
Address Dementia, The 2018-2023 Road Map," and any later federal plans and the 
Department of Health and Human Services' State Plan for Alzheimer's Disease and 
Related Dementias in Maine.
SUMMARY
This bill requires health care practitioners to disclose a diagnosis of Alzheimer's 
disease or dementia to an authorized representative or a family or household member 
except for a person that is expressly prohibited by the individual diagnosed.  The health 
care practitioner making the diagnosis must also provide information regarding care 
planning services, including assistance understanding the diagnosis, and medical and 
nonmedical options for treatment, services and supports and information on how to 
access those options.
The bill requires that by January 1, 2023 every hospital must have a policy regarding 
the recognition and management of patients with Alzheimer's disease and dementia 
within that hospital and have the policy on file.  The hospital must consult with the 
Department of Health and Human Services and statewide organizations with expertise in 
the field of Alzheimer's disease and dementia and include relevant portions of the federal 
Department of Health and Human Services, Centers for Disease Control and Prevention 
"Healthy Brain Initiative" publication and any succeeding plans and the state plan 
regarding Alzheimer's disease and related dementias in Maine developed by the 
Department of Health and Human Services. 
The bill also requires continuing education requirements to be adopted by the Board 
of Licensure in Medicine, the Board of Osteopathic Licensure and the State Board of 
Nursing that relate to diagnosis, behavioral symptoms, respectful and effective 
communication, safety, signs of abuse and neglect and identifying signs of self-neglect by 
persons living alone with Alzheimer's or dementia.  It also requires physician assistants to 
receive the same continuing education.
The bill also requires the Department of Health and Human Services to provide 4 
hours of education and training to all employees of adult protective services at the 
beginning of employment.