HHS's October 22 announcement and national plan, CMS model guidance, and National Institute on Aging home-safety advice
The federal dementia strategy has a new structure and a practical concern for occupational therapy: how families manage care at home. HHS released its 2026 national plan update on October 22, giving caregiver support and community services a place alongside dementia risk reduction and research.
In brief
- Four goals replace the plan's six historical goals.
- Home and community services, respite, safety, and caregiver education remain explicit priorities.
- CMS's MAHA ELEVATE model tests selected interventions; its funding does not establish general Medicare coverage.
Daily care has its own place in the plan
The four goals cover risk reduction across the lifespan, research and treatment innovation, healthcare throughout the disease course, and services for people living with dementia and their families. HHS says it will assess progress in the 2027 update.
Goal 4 addresses the work that continues after an appointment ends. The plan describes dementia-specific respite programs added in 2026 and expects further expansion of the Administration for Community Living's Alzheimer's Disease Programs Initiative in 2027. Those efforts include state, community, and Tribal services, with attention to communities whose needs are going unmet. These are program priorities and investments; access still depends on the services available locally.
Check the funding before promising a service
The plan also points to CMS's MAHA ELEVATE model. CMS describes approximately $100 million for up to 30 three-year cooperative agreements testing evidence-based lifestyle or functional medicine approaches for Original Medicare beneficiaries. Three awards are reserved for interventions addressing dementia.
CMS says the proposals include services currently outside Original Medicare coverage and will collect cost and quality evidence to inform future decisions. An OT practice considering a partnership should establish the recipient's role, patient eligibility, and payment arrangements before offering model-funded care. The national strategy does not itself create a new OT billing entitlement or establish that a particular intervention prevents dementia.
Start with the routine a family is struggling to manage
For an OT team, a useful response is to review how its dementia referrals capture everyday difficulties and caregiver needs. A family struggling with meals or getting dressed can bring a specific routine to the assessment. The therapist can examine the task and surroundings with the person and caregiver, then record what support is needed and how it will be reviewed.
The National Institute on Aging advises checking the home room by room and revisiting safety as abilities change. Its examples include lighting and clear labels, as well as kitchen and bathroom hazards. Pairing individualized therapy with a current local respite and support directory gives families somewhere to turn when the next difficulty falls outside a therapy visit.