Building Our Largest Dementia Infrastructure for Alzheimer’s Act

SECTION 1. SHORT TITLE.
    This Act may be cited as the ``Building Our Largest Dementia 
Infrastructure for Alzheimer's Act'' or the ``BOLD Infrastructure for 
Alzheimer's Act''.
SEC. 2. PROMOTION OF PUBLIC HEALTH KNOWLEDGE AND AWARENESS OF 
ALZHEIMER'S DISEASE, COGNITIVE DECLINE, AND BRAIN HEALTH UNDER THE 
ALZHEIMER'S DISEASE AND HEALTHY AGING PROGRAM.
    Part K of title III of the Public Health Service Act (42 U.S.C. 
280c et seq.) is amended--
        (1) in the part heading, by adding ``and public health programs 
    for dementia'' at the end; and
        (2) in subpart II--
            (A) by striking the subpart heading and inserting the 
        following:

``Subpart II--Programs With Respect to Alzheimer's Disease and Related 
                            Dementias''; and

            (B) by striking section 398A (42 U.S.C. 280c-4) and 
        inserting the following:
``SEC. 398A. PROMOTION OF PUBLIC HEALTH KNOWLEDGE AND AWARENESS OF 
ALZHEIMER'S DISEASE AND RELATED DEMENTIAS.
    ``(a) Alzheimer's Disease and Related Dementias Public Health 
Centers of Excellence.--
        ``(1) In general.--The Secretary, in coordination with the 
    Director of the Centers for Disease Control and Prevention and the 
    heads of other agencies as appropriate, shall award grants, 
    contracts, or cooperative agreements to eligible entities, such as 
    institutions of higher education, State, tribal, and local health 
    departments, Indian tribes, tribal organizations, associations, or 
    other appropriate entities for the establishment or support of 
    regional centers to address Alzheimer's disease and related 
    dementias by--
            ``(A) advancing the awareness of public health officials, 
        health care professionals, and the public, on the most current 
        information and research related to Alzheimer's disease and 
        related dementias, including cognitive decline, brain health, 
        and associated health disparities;
            ``(B) identifying and translating promising research 
        findings, such as findings from research and activities 
        conducted or supported by the National Institutes of Health, 
        including Alzheimer's Disease Research Centers authorized by 
        section 445, into evidence-based programmatic interventions for 
        populations with Alzheimer's disease and related dementias and 
        caregivers for such populations; and
            ``(C) expanding activities, including through public-
        private partnerships related to Alzheimer's disease and related 
        dementias and associated health disparities.
        ``(2) Requirements.--To be eligible to receive a grant, 
    contract, or cooperative agreement under this subsection, an entity 
    shall submit to the Secretary an application containing such 
    agreements and information as the Secretary may require, including 
    a description of how the entity will--
            ``(A) coordinate, as applicable, with existing Federal, 
        State, and tribal programs related to Alzheimer's disease and 
        related dementias;
            ``(B) examine, evaluate, and promote evidence-based 
        interventions for individuals with Alzheimer's disease and 
        related dementias, including underserved populations with such 
        conditions, and those who provide care for such individuals; 
        and
            ``(C) prioritize activities relating to--
                ``(i) expanding efforts, as appropriate, to implement 
            evidence-based practices to address Alzheimer's disease and 
            related dementias, including through the training of State, 
            local, and tribal public health officials and other health 
            professionals on such practices;
                ``(ii) supporting early detection and diagnosis of 
            Alzheimer's disease and related dementias;
                ``(iii) reducing the risk of potentially avoidable 
            hospitalizations of individuals with Alzheimer's disease 
            and related dementias;
                ``(iv) reducing the risk of cognitive decline and 
            cognitive impairment associated with Alzheimer's disease 
            and related dementias;
                ``(v) enhancing support to meet the needs of caregivers 
            of individuals with Alzheimer's disease and related 
            dementias;
                ``(vi) reducing health disparities related to the care 
            and support of individuals with Alzheimer's disease and 
            related dementias;
                ``(vii) supporting care planning and management for 
            individuals with Alzheimer's disease and related dementias; 
            and
                ``(viii) supporting other relevant activities 
            identified by the Secretary or the Director of the Centers 
            for Disease Control and Prevention, as appropriate.
        ``(3) Considerations.--In awarding grants, contracts, and 
    cooperative agreements under this subsection, the Secretary shall 
    consider, among other factors, whether the entity--
            ``(A) provides services to rural areas or other underserved 
        populations;
            ``(B) is able to build on an existing infrastructure of 
        services and public health research; and
            ``(C) has experience with providing care or caregiver 
        support, or has experience conducting research related to 
        Alzheimer's disease and related dementias.
        ``(4) Distribution of awards.--In awarding grants, contracts, 
    or cooperative agreements under this subsection, the Secretary, to 
    the extent practicable, shall ensure equitable distribution of 
    awards based on geographic area, including consideration of rural 
    areas, and the burden of the disease within sub-populations.
        ``(5) Data reporting and program oversight.--With respect to a 
    grant, contract, or cooperative agreement awarded under this 
    subsection, not later than 90 days after the end of the first year 
    of the period of assistance, and annually thereafter for the 
    duration of the grant, contract, or agreement (including the 
    duration of any renewal period as provided for under paragraph 
    (5)), the entity shall submit data, as appropriate, to the 
    Secretary regarding--
            ``(A) the programs and activities funded under the grant, 
        contract, or agreement; and
            ``(B) outcomes related to such programs and activities.
    ``(b) Improving Data on State and National Prevalence of 
Alzheimer's Disease and Related Dementias.--
        ``(1) In general.--The Secretary shall, as appropriate, improve 
    the analysis and timely reporting of data on the incidence and 
    prevalence of Alzheimer's disease and related dementias. Such data 
    may include, as appropriate, information on cognitive decline, 
    caregiving, and health disparities experienced by individuals with 
    cognitive decline and their caregivers. The Secretary may award 
    grants, contracts, or cooperative agreements to eligible entities 
    for activities under this paragraph.
        ``(2) Eligibility.--To be eligible to receive a grant, 
    contract, or cooperative agreement under this subsection, an entity 
    shall be a public or nonprofit private entity, including 
    institutions of higher education, State, local, and tribal health 
    departments, and Indian tribes and tribal organizations, and submit 
    to the Secretary an application at such time, in such manner, and 
    containing such information as the Secretary may require.
        ``(3) Data sources.--The analysis, timely public reporting, and 
    dissemination of data under this subsection may be carried out 
    using data sources such as the following:
            ``(A) The Behavioral Risk Factor Surveillance System.
            ``(B) The National Health and Nutrition Examination Survey.
            ``(C) The National Health Interview Survey.
    ``(c) Improved Coordination.--The Secretary shall ensure that 
activities and programs related to dementia under this section do not 
unnecessarily duplicate activities and programs of other agencies and 
offices within the Department of Health and Human Services.''.
SEC. 3. SUPPORTING STATE PUBLIC HEALTH PROGRAMS RELATED TO ALZHEIMER'S 
DISEASE AND RELATED DEMENTIAS.
    Section 398 of the Public Health Service Act (42 U.S.C. 280c-3) is 
amended--
        (1) in the section heading, by striking ``establishment of 
    program'' and inserting ``cooperative agreements to states and 
    public health departments for alzheimer's disease and related 
    dementias'';
        (2) by striking subsection (a) and inserting the following:
    ``(a) In General.--The Secretary, in coordination with the Director 
of the Centers for Disease Control and Prevention and the heads of 
other agencies, as appropriate, shall award cooperative agreements to 
health departments of States, political subdivisions of States, and 
Indian tribes and tribal organizations, to address Alzheimer's disease 
and related dementias, including by reducing cognitive decline, helping 
meet the needs of caregivers, and addressing unique aspects of 
Alzheimer's disease and related dementias to support the development 
and implementation of evidence-based interventions with respect to--
        ``(1) educating and informing the public, based on evidence-
    based public health research and data, about Alzheimer's disease 
    and related dementias;
        ``(2) supporting early detection and diagnosis;
        ``(3) reducing the risk of potentially avoidable 
    hospitalizations for individuals with Alzheimer's disease and 
    related dementias;
        ``(4) reducing the risk of cognitive decline and cognitive 
    impairment associated with Alzheimer's disease and related 
    dementias;
        ``(5) improving support to meet the needs of caregivers of 
    individuals with Alzheimer's disease and related dementias;
        ``(6) supporting care planning and management for individuals 
    with Alzheimer's disease and related dementias.
        ``(7) supporting other relevant activities identified by the 
    Secretary or the Director of the Centers for Disease Control and 
    Prevention, as appropriate''.; and
        (3) by striking subsection (b);
        (4) by redesignating subsection (c) as subsection (g);
        (5) by inserting after subsection (a), the following:
    ``(b) Preference.--In awarding cooperative agreements under this 
section, the Secretary shall give preference to applications that focus 
on addressing health disparities, including populations and geographic 
areas that have the highest prevalence of Alzheimer's disease and 
related dementias.
    ``(c) Eligibility.--To be eligible to receive a cooperative 
agreement under this section, an eligible entity (pursuant to 
subsection (a)) shall prepare and submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may require, including a plan that 
describes--
        ``(1) how the applicant proposes to develop or expand, programs 
    to educate individuals through partnership engagement, workforce 
    development, guidance and support for programmatic efforts, and 
    evaluation with respect to Alzheimer's disease and related 
    dementias, and in the case of a cooperative agreement under this 
    section, how the applicant proposes to support other relevant 
    activities identified by the Secretary or Director of the Centers 
    for Disease Control and Prevention, as appropriate.
        ``(2) the manner in which the applicant will coordinate with 
    Federal, tribal, and State programs related to Alzheimer's disease 
    and related dementias, and appropriate State, tribal, and local 
    agencies, as well as other relevant public and private 
    organizations or agencies; and
        ``(3) the manner in which the applicant will evaluate the 
    effectiveness of any program carried out under the cooperative 
    agreement.
    ``(d) Matching Requirement.--Each health department that is awarded 
a cooperative agreement under subsection (a) shall provide, from non-
Federal sources, an amount equal to 30 percent of the amount provided 
under such agreement (which may be provided in cash or in-kind) to 
carry out the activities supported by the cooperative agreement.
    ``(e) Waiver Authority.--The Secretary may waive all or part of the 
matching requirement described in subsection (d) for any fiscal year 
for a health department of a State, political subdivision of a State, 
or Indian tribe and tribal organization (including those located in a 
rural area or frontier area), if the Secretary determines that applying 
such matching requirement would result in serious hardship or an 
inability to carry out the purposes of the cooperative agreement 
awarded to such health department of a State, political subdivision of 
a State, or Indian tribe and tribal organization.'';
        (6) in subsection (f) (as so redesignated), by striking 
    ``grant'' and inserting ``cooperative agreement''; and
        (7) by adding at the end the following:
    ``(f) Non-duplication of Effort.--The Secretary shall ensure that 
activities under any cooperative agreement awarded under this subpart 
do not unnecessarily duplicate efforts of other agencies and offices 
within the Department of Health and Human Services related to--
        ``(1) activities of centers of excellence with respect to 
    Alzheimer's disease and related dementias described in section 
    398A; and
        ``(2) activities of public health departments with respect to 
    Alzheimer's disease and related dementias described in this 
    section.''.
SEC. 4. ADDITIONAL PROVISIONS.
    Section 398B of the Public Health Service Act (42 U.S.C. 280c-5) is 
amended--
        (1) in subsection (a)--
            (A) by inserting ``or cooperative agreement'' after 
        ``grant'' each place that such appears;
            (B) by striking ``section 398(a) to a State unless the 
        State'' and inserting ``sections 398 or 398A to an entity 
        unless the entity''; and
            (C) by striking ``10'' and inserting ``5'';
        (2) by striking subsection (b);
        (3) by redesignating subsections (c) and (d) as subsections (b) 
    and (c), respectively;
        (4) in subsection (b) (as so redesignated)--
            (A) in the matter preceding paragraph (1), by striking 
        ``section 398(a) to a State unless the State'' and inserting 
        ``sections 398 or 398A to an entity unless the entity'';
            (B) in paragraph (1), by striking ``expenditures required 
        in subsection (b);'' and inserting ``expenditures;'';
        (5) in subsection (c) (as so redesignated)--
            (A) in paragraph (1)--
                (i) by striking ``each demonstration project for which 
            a grant'' and inserting ``the activities for which an 
            award''; and
                (ii) by striking ``section 398(a)'' and inserting 
            ``sections 398 or 398A''; and
            (B) in paragraph (2), by striking ``6 months'' and 
        inserting ``1 year'';
        (6) by inserting after subsection (c) (as so redesignated), the 
    following:
    ``(d) Definition.--In this subpart, the terms `Indian tribe' and 
`tribal organization' have the meanings given such terms in section 4 
of the Indian Health Care Improvement Act.''; and
        (7) in subsection (e), by striking ``$5,000,000 for each of the 
    fiscal years 1988 through 1990'' and all that follows through 
    ``2002'' and inserting ``$20,000,000 for each of fiscal years 2020 
    through 2024''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.

Summary: Building Our Largest Dementia Infrastructure for Alzheimer's Act or the BOLD Infrastructure for Alzheimer's Act This bill amends the Public Health Service Actnbsp. To award cooperative agreements: (1) for the establishment or support of national or regional centers of excellence in public health practice in Alzheimer's disease. (2) to state public health departments, Native American tribes, and other entities to promote cognitive functioning, address cognitive impairment and unique aspects of Alzheimer's disease, and help meet the needs of caregivers. (3) for analysis and public reporting of data on the state and national levels regarding cognitive decline, caregiving, and health disparities, and monitoring of objectives on dementia and caregiving in the Department of Health and Human Services'nbsp, Healthy People 2020 report.