When Bobby and Sandy Marshall made the trip from Poplar Bluff to Jefferson City, they were not there for sightseeing. They were there to tell lawmakers that for families living with dementia in rural Missouri, help might as well be on another planet.
Bobby, diagnosed with early‑onset dementia in 2015, described to legislators what it takes just to see a neurologist: long drives, complex medication routines managed from afar and the constant stress of coordinating services that are nowhere near home. Their story put a very real face on a push in the Capitol to centralize help for families across the state.
As reported by St. Louis Public Radio, the Marshalls moved to southeast Missouri in 2023 and quickly discovered how thin local memory‑care support really is. They urged lawmakers to act while they still can. Bobby told the committee, “There is absolutely nothing in the rural areas of this state to help people with dementia,” the outlet reports.
On the table is House bill HB511, sponsored by Rep. Travis Wilson. The proposal would create a full‑time dementia services coordinator inside the Department of Health and Senior Services. According to the bill text (see HB511), that coordinator would be responsible for organizing information resources for families, overseeing grant strategies tied to federal dementia programs and helping shape statewide policy to improve access to care.
Numbers show the urgency
Advocates backing the bill point to numbers that are hard to ignore. The Alzheimer's Impact Movement estimates about 122,300 Missourians are living with Alzheimer's, with 2,690 deaths in 2024 alone and Medicaid costs for caring for those patients projected at roughly $1.29 billion in 2025 (Alzheimer's Impact Movement).
Those state figures match a national pattern of rising Alzheimer's deaths and ballooning care costs, outlined in the Alzheimer's Association's Facts and Figures report (Alzheimer's Association).
Regional solutions are emerging
Some neighbors are already putting serious money into diagnosis and access. Kansas lawmakers committed $5 million to build a Kansas Brain Health Assessment Network at the University of Kansas Medical Center. The idea is to bring specialist‑level dementia diagnostics into primary‑care clinics across the state and cut down the months‑long waits that rural patients often face, according to reporting by KCTV5.
Geriatric workforce gap
Experts warn that even the best plans will stall without enough clinicians trained to carry them out. The Alzheimer's Association's Facts and Figures report shows states will need major increases in geriatricians and other dementia specialists to keep up with future demand. Missouri advocates say the state needs roughly a 77% increase in geriatricians to meet projected needs, and supporters argue that a statewide coordinator could help close that gap by boosting telehealth options, workforce training and clear referral pathways (Alzheimer's Impact Movement).
Rep. Wilson told KBIA he wants the coordinator housed in the Department of Health and Senior Services and then sent through the appropriations process so funding can be nailed down. He argues that earlier detection and smoother navigation of services will ultimately lower overall costs.
Families like the Marshalls say that for them, the stakes are much more immediate. A single point of contact, they told lawmakers, could be the difference between staying at home or ending up in emergency care. Their message to legislators was simple: do not wait.
