Establishes uniform training requirements for health care staff concerning persons with dementia.

S4500

SENATE, No. 4500

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED JUNE 22, 2026

Sponsored by:

Senator� RAJ MUKHERJI

District 32 (Hudson)

SYNOPSIS

���� Establishes uniform training requirements for health
care staff concerning persons with dementia.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act

concerning Alzheimer�s disease and dementia
care, amending various parts of statutory law, and supplementing Title 26 of
the Revised Statutes.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1. (New section) a. There is
established a training requirement for the care of persons with Alzheimer�s
disease and related disorders or other forms of dementia, to be overseen by the
Commissioner of Health.� Notwithstanding any law, rule, or regulation to the
contrary, compliance with the training requirements of this section by direct
care staff shall be a condition of State licensure for any program, facility,
or residence licensed, administered, or operated by the Departments of Health,
Human Services, Community Affairs, or Veterans� Affairs.�

���� Notwithstanding any law, rule,
or regulation to the contrary, the training requirements of this section shall
apply to all direct care staff, including any licensed health care
professional, employed or contracted by or providing services to:

���� (1) an assisted living
residence;

���� (2) a comprehensive personal
care home;

���� (3) a non-residential assisted
living program;

���� (4) a residential health care
facility;

���� (5) a continuing care
retirement community;

���� (6) a dementia care home;

���� (7) an adult family care
facility;

���� (8) a long-term care facility;
or

���� (9) an acute care facility,
including a general hospital.

���� b. All direct care staff
subject to subsection a. of this section shall demonstrate successful
completion of a minimum number of hours of live training and instruction every
two years as follows:

���� (1) four hours for any staff
member who does not hold a State professional license, certificate, or permit;

���� (2) eight hours for any staff
member who does hold a State professional license, certificate, or permit; and

���� (3) 12 hours for any staff
member who has supervisory or managerial authority over other staff members.

���� Successful completion shall be
demonstrated by correctly answering a minimum of five post-training examination
questions in the area of dementia care.

���� c. The training required
pursuant to this section shall consist of instruction in, at minimum, the
following topics:

���� (1) The nature of dementia,
including the cause, course and symptoms of the impairment, and the effects
that brain changes have on the person�s moods, abilities, and functioning;

���� (2) The effects on the patient
or client of staff verbal and nonverbal communication with the patient or client,
and means of modifying these communications and approaches to facilitate
effective interaction between patients, clients, and staff;

���� (3) The feeding and fluid
intake problems associated with dementia and the specialized techniques for
addressing those problems;

���� (4) The effect of the
environment on patients or clients with dementia, the appropriate environmental
stimuli to use with those patients or clients to reduce stress and maximize
normal functioning, and how to incorporate strategies that preserve function
and prevent excess disability;

���� (5) Possible causes of
dementia-related symptomatic behavior changes, specifically focusing on
understanding behavior as an attempt to communicate unmet needs, and how to
address such unmet needs including an understanding of how pain impacts
behavior;

���� (6) Ways to help the person
with dementia continue meaningful involvement in his or her day, the importance
of structure and routine, and the incorporation of the person�s life story and
past interests, routines, tastes, values, and background; and

���� (7) The stress involved for
the patient or client, family members, and staff in caring for a patient or
client with dementia, techniques for coping with this stress, and ways to
address the person with dementia�s core needs of having self−esteem
boosted, being useful, giving and receiving love, and caring for self and
others.

���� d. The Commissioner of Health,
in consultation with the Alzheimer�s and Dementia Care Long-Term Advisory
Commission, shall develop, administer, and ensure compliance with the training
required pursuant to this section.� The Commissioner shall, in accordance with
the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et
seq.), adopt rules and regulations as necessary to implement this section.

���� 2. Section 21 of P.L.2015,
c.125 (C.26:2H-152) is amended to read as follows:

���� 21. The commissioner shall
establish standards to ensure that each dementia care home is constructed and
operated in such a manner as will protect the health, safety, and welfare of
its residents and at the same time preserve and promote a homelike atmosphere
appropriate to these facilities, including, but not limited to, standards to
provide for the following:

���� a.���� Safety from fire;

���� b.��� Safety from structural,
mechanical, plumbing, and electrical deficiencies;

���� c.���� Adequate light and
ventilation;

���� d.��� Physical security;

���� e.���� Protection from
harassment, fraud, and eviction without due cause;

���� f.���� Clean and reasonably
comfortable surroundings;

���� g.��� Adequate personal and
financial services rendered in the facility;

���� h.��� Disclosure of owner
identification information;

���� i.���� Maintenance of orderly
and sufficient financial and occupancy records;

���� j.���� Referral of residents,
by the operator, to social service and health care providers for needed
services;

���� k.��� Assurance that no
constitutional, civil, or legal right will be denied solely by reason of
residence in a dementia care home;

���� l.���� Reasonable access for
employees of public and private agencies, and reasonable access for other
citizens upon receiving the consent of the resident to be visited by them;

���� m.�� Opportunity for each
resident to live with as much independence, autonomy, and interaction with the
surrounding community as the resident is capable of doing; and

���� n.��� Assurance that the needs
of residents of a dementia care home will be met, which shall include, at a
minimum, the following:

���� (1)�� staffing levels, which
shall ensure that the ratio of direct care staff to residents in the facility
is equal to or higher than that which existed on the date of enactment of
P.L.2015, c.125 (C.55:13B-5.1 et al.);

���� (2)�� staff qualifications and
training
in accordance with section 1 of P.L.��� , c.���� (C.������� )
(pending before the Legislature as this bill)
;

���� (3)�� special dietary needs of
residents;

���� (4)�� special supervision
requirements relating to the individual needs of residents;

���� (5)�� building safety
requirements appropriate to the needs of residents, including the requirement
to maintain the operation 24 hours a day, seven days a week, of window, door,
and any other locks or security system designed to prevent the elopement of a
resident;

���� (6)�� special health
monitoring of residents by qualified, licensed health care professionals,
including a requirement that a medical assessment by a physician be performed
on a resident with special needs as described in this subsection, as determined
necessary by the commissioner, prior to admission and on a quarterly basis
thereafter, to ensure that the facility is appropriate to the needs of the
resident; and

���� (7)�� criteria for discharging
residents which shall be set forth in the admission agreement, which shall be
provided to the resident or

the resident�s representative prior
to or upon admission.� The commissioner may revoke the license of any provider
who violates the criteria for discharging residents.

(cf: P.L.2015, c.125, s.21)

���� 3. Section 1 of P.L.1987,
c.440 (C.26:2M-7) is amended to read as follows:

���� a. The Commissioner of the
Department of Health shall establish a training program for health care
providers in licensed long-term health care facilities in the specialized care
of patients with Alzheimer�s Disease.� The training program shall include methods
to deal with the specific problems encountered in the care of Alzheimer�s
Disease patients, including communicating with patients and necessary safety
measures.

���� b. The training program shall
be made available, on a voluntary basis, to licensed long-term health care
facilities which provide treatment and care to Alzheimer�s Disease patients.�
Upon request, the commissioner shall provide the training program at the
long-term health care facility.

����
c. The training program
shall include, at minimum, the training hours, proficiency examination, and all
training topics set forth in subsections b. and c. of section 1 of P.L.��� ,
c.���� (C.������� ) (pending before the Legislature as this bill).� Successful
completion of the training program established pursuant to this section shall
be deemed to satisfy the requirements of section 1 of P.L.��� , c.���� (C. )
(pending before the Legislature as this bill) for a two-year cycle.

(cf: P.L.1987, c.440, s.1)

���� 4. Section 1 of P.L.2003,
c.269 (C.26:2M-7.2) is amended to read as follows:

���� 1. a. The Commissioner of
Health shall establish a mandatory training program for long-term care facility
staff, as described in subsection b. of this section, in the specialized care
of patients who are diagnosed by a physician as having Alzheimer�s disease or a
related disorder.� The training program shall include the causes and
progression of Alzheimer�s disease and related disorders and methods to deal
with the specific problems encountered in the care of patients with Alzheimer�s
disease and related disorders, including, but not limited to: communicating
with patients with Alzheimer�s disease and related disorders; psychological,
social and physical needs of patients with Alzheimer�s disease and related
disorders; and safety measures which need to be taken for a patient with
Alzheimer�s disease and related disorders.

���� b.��� A long-term care
facility shall annually provide training, under the training program
established pursuant to subsection a. of this section, to a certified nurse
aide, licensed practical nurse, registered professional nurse, and other health
care professionals, as appropriate, who provide direct care to a patient in the
facility who is diagnosed as having Alzheimer�s disease or a related disorder.

����
c. The training program
shall include, at minimum, the training hours, proficiency examination, and all
training topics set forth in subsections b. and c. of section 1 of P.L.��� ,
c.���� (C.������� ) (pending before the Legislature as this bill).� Successful
completion of the training program established pursuant to this section shall
be deemed to satisfy the requirements of section 1 of P.L.��� , c.���� (C. ) (pending
before the Legislature as this bill) for a two-year cycle.

(cf: P.L.2012, c.17, s.284)

���� 5. Section 5 of P.L.1988,
c.114 (C.26:2M-13) is amended to read as follows:

���� The department shall develop a
training program which includes information on the symptoms and progress of the
disease and appropriate techniques for dealing with the psychosocial, health
and physical needs of the participants.� The training program shall be
developed and provided as on-going, on-site training for adult day care centers
funded under this act and shall be available to other community based providers
who serve this client population.�
The training program shall include, at
minimum, the training hours, proficiency examination, and all training topics
set forth in subsections b. and c. of section 1 of P.L.��� , c.���� (C.�������
) (pending before the Legislature as this bill).� Successful completion of the
training program established pursuant to this section shall be deemed to
satisfy the requirements of section 1 of P.L.��� , c.���� (C. )
(pending before the Legislature as this bill) for a two-year cycle.

(cf: P.L.1988, c.114, s.5)

���� 6. Section 2 of P.L.2023, c.41
(C.26:2M-21) is amended to read as follows:

���� 2. a. The responsibilities of
the Alzheimer�s and Dementia Care Long-Term Advisory Commission established
pursuant to this act shall include, but not be limited to:

���� (1) studying the incidence,
prevalence, and impact of Alzheimer�s disease and related disorders or other
forms of dementia in the State and in each region of the State and make
projections about the future Statewide and regional incidence, prevalence, and
impact of these conditions;

���� (2) gathering, analyzing, and
disseminating to health care professionals, policymakers, and members of the
public, as appropriate, data and information about: (a) the needs of persons
with Alzheimer�s disease and related disorders or other forms of dementia, as
well as the needs of their family members and caregivers; (b) the quality and
consistency of care that is provided to persons with Alzheimer�s disease and
related disorders or other forms of dementia in the State, including those
members of the medically underserved community, the low income community, and
the lesbian, gay, bisexual, transgender, questioning, queer, and intersex
(LGBTQI) communities; (c) the affordability of care for Alzheimer�s disease and
related disorders or other forms of dementia in the State and the actual and
projected Statewide costs and individual costs associated with Alzheimer�s
disease and related disorders or other forms of dementia in New Jersey,
including, but not limited to, the costs of health care, mental health care,
long-term care, and personal care, and ancillary or incidental costs such as
those associated with the lost work productivity of, or the treatment of
stress-related physical conditions or depression and other mental health
conditions in, family caregivers; (d) the cost savings attained by the State
through the provision of unpaid caregiving and personal care services by family
caregivers; (e) the capacity of the State�s health care and long-term care
facilities to house and provide specialized services to patients with
Alzheimer�s disease and related disorders or other forms of dementia; (f) the
status of Alzheimer�s disease and related disorders or other forms of dementia
care in other states, as compared to New Jersey; and (g) with the approval of
the Commissioner of the Department of Human Services and subject to the
availability of funds as designated by the department, any other issue deemed
by the commission to be relevant to effectuate the purposes of this act;

���� (3) assessing the availability
and affordability of existing programs, services, facilities, and agencies in
the State that are used to meet the needs of persons with Alzheimer�s disease
and related disorders or other forms of dementia and the needs of their
families and caregivers; evaluating the capacity of those existing policies,
programs, services, facilities, and agencies to adapt to, and adequately
address, the changing needs of dementia patients and their families and
caregivers in the face of a continually increasing demand for services; and
identifying and recommending improvements to existing policies, programs,
services, facilities, or agencies or the institution of new policies, programs,
services, facilities, or agencies to address unmet and expanding needs in this
area;

���� (4) studying, and making
recommendations to the Department of Human Services on, the appropriate roles
of State government, local governments, and health care facilities and
professionals in providing or ensuring the provision of appropriate services
and other assistance to persons with Alzheimer�s disease and related disorders
or other forms of dementia, including persons in the early stages of disease,
and in providing or ensuring the provision of sufficient supportive and
assistive services, including training and respite services, to unpaid family
caregivers; and identifying ways in which State and local governments and
health care systems could increase their awareness of, and improve their
ability to more effectively address, issues affecting persons with Alzheimer�s
disease and related disorders or other forms of dementia and their families;

���� (5) reviewing and analyzing
the capacity of law enforcement officers and emergency medical responders in
the State to compassionately and effectively interact with, diffuse conflicts
involving, and provide emergency services to, persons with Alzheimer�s disease
and related disorders or other forms of dementia;

���� (6) identifying and
recommending best practices and training requirements for: (a) health care and
mental health care professionals, particularly geriatric specialists and
primary care practitioners, who are or will be practicing on the front lines of
caring for patients with Alzheimer�s disease and related disorders or other
forms of dementia, in order to ensure that such professionals are properly
trained and are capable of accurately and timely diagnosing Alzheimer�s disease
and related disorders or other forms of dementia, understanding the progression
of the disease, and recognizing and responding to the evolving needs of
patients; (b) personal care professionals who provide services to patients with
Alzheimer�s disease and related disorders or other forms of dementia, in order
to ensure that such professionals are capable of providing compassionate and
high-quality personal care services and adapting to the evolving needs of their
patients; and (c) law enforcement officers, emergency medical responders, and
other public safety officers, in order to ensure that those officers understand
the complexities of dealing with persons with Alzheimer�s disease and related
disorders or other forms of dementia and are better prepared to compassionately
diffuse or resolve conflicts and respond to emergencies involving such persons;

���� (7) evaluating the sufficiency
of the State�s Alzheimer�s disease and related disorders or other forms of
dementia care workforce, identifying current and future workforce needs,
anticipating future workforce shortages, developing innovative strategies to
encourage and increase the recruitment and retention of health care, mental
health care, direct support, and personal care professionals who are trained to
provide care for Alzheimer�s disease and related disorders or other forms of
dementia, and taking any other action necessary to encourage and facilitate the
development and maintenance of a robust and specialized professional Statewide
workforce that is capable of delivering high-quality care for patients with
Alzheimer�s disease and related disorders or other forms of dementia to a
rapidly growing population in the State; and

���� (8) studying and making
recommendations on any other issue related to Alzheimer�s disease and related
disorders or other forms of dementia.

���� b.��� One year after the
commission�s organizational meeting, annually thereafter for a period of no
less than five years, and thereafter upon request of the Legislature or as
determined by the commission, the commission shall prepare and submit a written
report to the Governor and, pursuant to section 2 of P.L.1991, c.164
(C.52:14-19.1), to the Legislature.� The written report shall contain, at a
minimum:

���� (1) the commission�s annual
findings on the issues described in subsection a. of this section;

���� (2) a description as to
whether, how, and why the commission�s findings have changed over time,
including an indication as to the implementation status of the commission�s
prior recommendations, a description of actions that have been undertaken by
any person or public or private entity in the State over the prior reporting
period to implement those prior recommendations, and a description of the
perceived or documented effects resulting from implementation of those prior
recommendations;

���� (3) a copy of, or reference
to, the statistical, demographic, testimonial, or other data or information
that was used by the commission to: (a) support its current findings under
paragraph (1) of this subsection; or (b) inform its analysis of the impact of
the commission�s prior recommendations under paragraph (2) of this subsection.�
The data provided pursuant to this paragraph shall be presented in aggregate
form and shall not contain the personal identifying information of any patient,
caregiver, or other person; and

���� (4) the commission�s
recommendations for actions that can be undertaken, or strategies that can be
implemented, to: (a) improve the quality, consistency, or affordability of care
for Alzheimer�s disease and related disorders or other forms of dementia in the
State and ensure the accessibility of care to all who need it; (b) reduce,
eliminate, or mitigate the societal and individual impact of, and the
Statewide, local, and individual costs or financial burdens associated with,
Alzheimer�s disease and related disorders or other forms of dementia; (c)
ensure that the State�s professional workforce is adequately trained, is
capable of providing affordable, high-quality care for patients with
Alzheimer�s disease and related disorders or other forms of dementia throughout
the State, and is sufficient in numbers and flexible enough to adapt to a
rapidly increasing demand for services in the State; (d) ensure that unpaid
caregivers in the State are recognized for their dedicated service and
significant contributions to society and are provided with sufficient
supportive and respite services, as well as financial assistance where possible
and appropriate, as may be necessary for them to capably perform their
caregiving tasks while avoiding unnecessary physical, mental, or financial
strain; or (e) otherwise address the issues or mitigate the problems identified
by the commission in its annual findings.

����
c. In addition to the
annual reports prepared pursuant to subsection b. of this section, one year
after the effective date of P.L. , c.����
(C.������� ) (pending before the Legislature as this bill), and annually
thereafter, the commission shall prepare and submit a written report to the
Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the
Legislature, concerning the implementation and effectiveness of the direct care
staff training requirements pursuant to section 1 of P.L.��� , c.����
(C.������� ) (pending before the Legislature as this bill).� The written report
shall contain, at minimum:

����
(1) an assessment of the
quality and availability of training providers and training opportunities
Statewide;

����
(2) an assessment of the
contents of the mandatory curriculum, the minimum hour requirements, and the
methods of instruction;

����
(3) an assessment of the
effectiveness of the training requirements as applied to the actual care of
persons with Alzheimer�s disease and related disorders or other forms of
dementia; and

����
(4) recommendations
concerning changes or updates, as necessary, to the training requirements.

(cf: P.L.2023, c.41, s.2)

���� 7. This act shall take effect
on the first day of the third month next following enactment, except that the Commissioner
of Health may take such anticipatory action as may be necessary for the timely
implementation of this act.

STATEMENT

���� This bill establishes a
uniform training requirement for direct service health care staff who deal with
or are likely to come into contact with persons with dementia, which will be
developed and administered by the Commissioner of Health in consultation with
the Alzheimer�s and Dementia Care Long-Term Advisory Commission.

���� The training requirement will
apply as a condition of State licensure for any program, facility, or residence
licensed, administered, or operated by the Departments of Health, Human
Services, Community Affairs, or Veterans� Affairs.� As such, the training
requirement will apply to all direct care staff, including any licensed health
care professional, employed or contracted by or providing services to:

���� (1) an assisted living
residence;

���� (2) a comprehensive personal
care home;

���� (3) a non-residential assisted
living program;

���� (4) a residential health care
facility;

���� (5) a continuing care
retirement community;

���� (6) a dementia care home;

���� (7) an adult family care
facility;

���� (8) a long-term care facility;
or

���� (9) an acute care facility,
including a general hospital.

���� The bill provides that all
direct care staff subject to the training requirement must demonstrate
successful completion of a minimum number of hours of live training and
instruction every two years as follows: four hours for any staff who do not
hold a State professional license, certificate, or permit; eight hours for any
staff who do hold a State professional license, certificate, or permit; and 12
hours for any staff who hold supervisory or managerial authority.� Successful
completion will be demonstrated by correctly answering a minimum of five
post-training examination questions in the area of dementia care.

���� The training required under
the bill will consist of instruction in, at minimum, the following topics:

���� (1) The nature of dementia,
including the cause, course and symptoms of the impairment, and the effects
that brain changes have on the person�s moods, abilities and functioning;

���� (2) The effects on the patient
or client of staff verbal and nonverbal communication with the patient or
client, and means of modifying these communications and approaches to
facilitate effective interaction between patients, clients, and staff;

���� (3) The feeding and fluid
intake problems associated with dementia and the specialized techniques for
addressing those problems;

���� (4) The effect of the
environment on patients or clients with dementia, the appropriate environmental
stimuli to use with those patients or clients to reduce stress and maximize
normal functioning, and how to incorporate strategies that preserve function
and prevent excess disability;

���� (5) Possible causes of
dementia-related symptomatic behavior changes, specifically focusing on
understanding behavior as an attempt to communicate unmet needs, and how to
address such unmet needs including an understanding of how pain impacts
behavior;

���� (6) Ways to help the person
with dementia continue meaningful involvement in his or her day, the importance
of structure and routine, and the incorporation of the person�s life story and
past interests, routines, tastes, values, and background; and

���� (7) The stress involved for
the patient or client, family members, and staff in caring for a patient or
client with dementia, techniques for coping with this stress, and ways to
address the person with dementia�s core needs of having self−esteem boosted,
being useful, giving and receiving love, and caring for self and others.

���� Finally, the bill requires the
Alzheimer�s and Dementia Care Long-Term Advisory Commission to report annually
to the Governor and the Legislature concerning the implementation of the
training requirement, with recommendations for improvement or updates to the
curriculum.