II Calendar No. 182 118th CONGRESS 1st Session S. 133 IN THE SENATE OF THE UNITED STATES January 30, 2023 Ms. Collins (for herself, Mr. Warner , Mrs. Capito , Mr. Markey , Mr. Moran , Mr. Menendez , Ms. Murkowski , Ms. Stabenow , Mr. Lankford , Mr. Wicker , Mr. Crapo , Mr. Warnock , Mr. Scott of Florida , Mr. Boozman , Mr. Daines , Mr. Bennet , Mr. Rubio , Ms. Rosen , Mrs. Gillibrand , Mr. Cramer , Mrs. Hyde-Smith , Mr. Tillis , Ms. Smith , Mr. Hickenlooper , Mr. Van Hollen , Mrs. Fischer , and Mr. Budd ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions July 27, 2023 Reported by Mr. Sanders , with an amendment Strike out all after the enacting clause and insert the part printed in italic A BILL To extend the National Alzheimer's Project.

1. Short title This Act may be cited as the NAPA Reauthorization Act . 2. Extension of project Section 2 of the National Alzheimer's Project Act ( 42 U.S.C. 11225 ) is amended— (1) in subsection (c)— (A) in paragraph (2), by striking and coordination of and inserting on, and coordination of, ; (B) in paragraph (4)— (i) by redesignating subparagraphs (A) and (B) as subparagraphs (B) and (C), respectively; and (ii) by inserting before subparagraph (B), as so redesignated, the following: (A) promotion of healthy aging and reduction of risk factors for Alzheimer's; ; (C) in paragraph (5), by striking ; and and inserting a semicolon; (D) by redesignating paragraph (6) as paragraph (7); and (E) by inserting after paragraph (5) the following: (6) provide information on, and promote the adoption of, healthy behaviors that may reduce the risk of cognitive decline and promote and protect cognitive health; and ; (2) in subsection (d)(2)— (A) by inserting , across public and private sectors, after Nation's progress ; and (B) by inserting , including consideration of public-private collaborations, as appropriate before the period; (3) in subsection (e)— (A) in paragraph (2)— (i) in subparagraph (A), by adding at the end the following: (xi) A designee of the Department of Justice. (xii) A designee of the Federal Emergency Management Agency. (xiii) A designee of the Social Security Administration. (xiv) A designee of the Office of Management and Budget. (xv) 1 or more other designees of the Department of Health and Human Services, as determined by the Secretary of Health and Human Services. ; and (ii) in subparagraph (B)— (I) in clause (v)— (aa) by striking 2 researchers and inserting 3 researchers ; and (bb) by striking ; and and inserting , including at least one researcher with demonstrated experience in recruitment and retention of diverse cohorts of trial participants; ; (II) in clause (vi), by striking the period and inserting ; and ; and (III) by adding at the end the following: (vii) an individual with a diagnosis of Alzheimer's disease. ; (B) in paragraph (5)— (i) in subparagraph (A)— (I) by striking an initial evaluation and inserting annual evaluations ; and (II) by striking research, clinical and inserting research, risk reduction, public health, clinical ; (ii) in subparagraph (B), by striking initial ; (iii) in subparagraph (C)— (I) in the matter preceding clause (i), by striking initial ; and (II) in clause (ii), by inserting and reduce disparities before the semicolon; and (iv) in subparagraph (D), by striking annually thereafter, an evaluation and inserting annual evaluations ; and (C) in paragraph (6), by striking 2025 and inserting 2035 ; (4) in subsection (g)(3)(A)(ii), by inserting and reduce disparities before the semicolon; and (5) in subsection (h), by striking 2025 and inserting 2035 .

1. Short title This Act may be cited as the NAPA Reauthorization Act . 2. Extension of project Section 2 of the National Alzheimer's Project Act ( 42 U.S.C. 11225 ) is amended— (1) in subsection (c)— (A) in paragraph (2), by striking and coordination of and inserting on, and coordination of, ; (B) in paragraph (4)— (i) by redesignating subparagraphs (A) and (B) as subparagraphs (B) and (C), respectively; and (ii) by inserting before subparagraph (B), as so redesignated, the following: (A) promotion of healthy aging and reduction and mitigation of risk factors for Alzheimer's; ; (C) in paragraph (5)— (i) by inserting and other underserved populations, including individuals with developmental disabilities such as Down syndrome, after ethnic and racial populations ; and (ii) by striking ; and and inserting a semicolon; (D) by redesignating paragraph (6) as paragraph (7); and (E) by inserting after paragraph (5) the following: (6) provide information on, and promote the adoption of, healthy behaviors that may reduce the risk of cognitive decline and promote and protect cognitive health; and ; (2) in subsection (d)(2)— (A) by inserting , across public and private sectors, after Nation's progress ; and (B) by inserting , including consideration of public-private collaborations, as appropriate before the period; (3) in subsection (e)— (A) in paragraph (2)— (i) in subparagraph (A), by adding at the end the following: (xi) A designee of the Department of Justice. (xii) A designee of the Federal Emergency Management Agency. (xiii) A designee of the Social Security Administration. (xiv) 2 or more other designees, as determined by the Secretary of Health and Human Services, at least one of whom has expertise in risk factors associated with the development or the progression of Alzheimer's. ; and (ii) in subparagraph (B)— (I) in the matter preceding clause (i), by striking 12 and inserting 15 ; (II) in clause (v)— (aa) by striking 2 researchers and inserting 3 researchers ; and (bb) by striking ; and and inserting , including at least one researcher with demonstrated experience in recruitment and retention of diverse cohorts of trial participants; ; (III) in clause (vi), by striking the period and inserting a semicolon; and (IV) by adding at the end the following: (vii) 1 individual with a diagnosis of Alzheimer's disease; and (viii) 1 representative from a historically underserved population whose lifetime risk for developing Alzheimer's is markedly higher than that of other populations. ; (B) in paragraph (5)— (i) in subparagraph (A)— (I) by striking an initial evaluation and inserting annual evaluations ; and (II) by striking research, clinical and inserting research, risk reduction, public health, clinical ; (ii) in subparagraph (B), by striking initial ; (iii) in subparagraph (C)— (I) in the matter preceding clause (i), by striking initial ; and (II) in clause (ii), by inserting and reduce disparities before the semicolon; and (iv) in subparagraph (D), by striking annually thereafter, an evaluation and inserting annual evaluations ; and (C) in paragraph (6), by striking 2025 and inserting 2035 ; (4) in subsection (g)(3)(A)(ii), by inserting and reduce disparities before the semicolon; and (5) in subsection (h), by striking 2025 and inserting 2035 .

July 27, 2023 Reported with an amendment