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A1352 1R FISCAL ESTIMATE
LEGISLATIVE FISCAL ESTIMATE
[First Reprint]
ASSEMBLY, No. 1352
STATE OF NEW JERSEY
222nd LEGISLATURE
DATED: JUNE 16, 2026
SUMMARY
Synopsis:
�Dementia Dignity and Advance Care Planning Act.�
Type of Impact:
Annual State expenditure increase.
Agencies Affected:
Department of Health.
Office of
Legislative Services Estimate
Annual Fiscal Impact
State Expenditure Increase
$500,000 to
$750,000
�
The
Office of Legislative Services (OLS) determines that the bill will result in
additional annual expenditures between $500,000 and $750,000 for the Department
of Health to establish and maintain a secure electronic Dementia Advance
Directive Registry of executed Dementia-Specific Advance Directives.� This
estimate is based on recent annual expenditures by the State on similar
registries.
�
Some
additional one-time and ongoing costs will accrue to the department to develop
the optional training programs for health care professionals and long-term care
staff on Dementia-Specific Advance Directives and comfort feeding practices and
to collect and publish data annually on the use of such directives on its
website.�
BILL DESCRIPTION
���� The Dementia Dignity and Advance Care Planning Act
allows a competent adult diagnosed with Alzheimer�s disease or other
neurodegenerative dementia to execute a Dementia-Specific Advance Directive,
which is a written document an individual with decisional capacity can use to specify
the health care preferences that are to apply if the individual later enters the
advanced stages of dementia.
���� The Department of Health will establish and maintain
a secure electronic registry to store Dementia-Specific Advance Directives and
will develop optional training for health care professionals and long-term care
staff on Dementia-Specific Advance Directives and comfort feeding practices.�
The department will also collect and publish annually on its website
de-identified data on the number of Dementia-Specific Advance Directives filed,
honored, and revoked.
���� Under the bill, licensed hospitals, nursing homes,
assisted living facilities, hospices, and health care professionals will be
immune from civil and criminal liability and from discipline by the department
or professional licensing boards if acting in good faith reliance on a Dementia-Specific
Advance Directive.
FISCAL ANALYSIS
EXECUTIVE BRANCH
����� None received.
OFFICE OF LEGISLATIVE SERVICES
����� The OLS determines that the bill will result in
additional annual expenditures between $500,000 and $750,000 for the Department
of Health to establish and maintain a secure electronic Dementia Advance
Directive Registry of executed Dementia-Specific Advance Directives.� This
estimate is based on recent annual expenditures by the department from FY 2023
through FY 2025 on the Statewide Birth Defects Registry and the Autism Registry.
Annual Expenditures
FY 2023
FY 2024
FY 2025
Statewide Birth Defects Registry
$514,504
$493,505
$514,307
Autism Registry
$750,000
$750,000
$747,338
����� Some additional one-time and ongoing costs will accrue
to the department to develop the optional training programs for health care
professionals and long-term care staff on Dementia-Specific Advance Directives
and comfort feeding practices and to collect and publish data annually on the
use of such directives on its website.� The OLS lacks the informational basis
to estimate these costs since their magnitude would depend on whether the
department utilizes existing staff and available resources to fulfill these
obligations or if the department contracts with a third party to do so.� Any
additional costs beyond staff time would push the fiscal impact of this bill
toward the higher end of the provided range or perhaps beyond it.
����� Nevada is currently the only state that offers Dementia-Specific
Advance Directives, pursuant to a 2019 statute.� Recent data on the number of
United States residents with advance directives are scant; however, a 2017
Health
Affairs
article reported that 36.7 percent of adults had completed an
advance directive, while 38.2 percent of individuals with a chronic illness had
completed an advance directive.� �
����� The OLS notes that the bill�s provision granting
hospitals, long-term care facilities, hospices, and health care professionals
with immunity from civil and criminal liability and discipline by the
department or professional licensing boards for acting in good faith reliance
on a Dementia-Specific Advance Directive could cause State revenues to decrease
by an indeterminate amount, in the form of avoided payment of fines and
penalties imposed under current law.�
Section:
Human Services
Analyst:
Anne Cappabianca
Senior Fiscal Analyst
Approved:
Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the
Office of Legislative Services due to the failure of the Executive Branch to
respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980,
c.67 (C.52:13B-6 et seq.).