```

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2076 Engrossed in Senate (ES)]

<DOC>
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
115th CONGRESS
  2d Session
                                S. 2076

_______________________________________________________________________

                                 AN ACT

 
 To amend the Public Health Service Act to authorize the expansion of 
activities related to Alzheimer's disease, cognitive decline, and brain 
health under the Alzheimer's Disease and Healthy Aging Program, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

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''.

            Passed the Senate December 12, 2018.

            Attest:

                                                             Secretary.
115th CONGRESS

  2d Session

                                S. 2076

_______________________________________________________________________

                                 AN ACT

 To amend the Public Health Service Act to authorize the expansion of 
activities related to Alzheimer's disease, cognitive decline, and brain 
health under the Alzheimer's Disease and Healthy Aging Program, and for 
                            other purposes.
```