Alzheimer's Disease Research, Training, and Education Amendments of 1992
PL 102-507 (S.1577), enacted 10/24/1992

PUBLIC LAW 102-507—OCT. 24,1992 
106 STAT. 3281 
Public Law 102-507 
102(1 Congress 
An Act 
To amend the Alzheimer's Disease and Related Dementias Services Research Act 
of 1986 to reauthorize the Act, 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 ''Alzheimer's Disease Research, 
Training, and Education Amendments of 1992". 
SEC. 2. SHORT TITLE OF ACT. 
(a) IN GENERAL.—Section 901 of the Alzheimer's Disease and 
Related Dementias Services Research Act of 1986 (42 U.S.C. 11201 
note) is amended by striking "Services Research Act of 1986" and 
inserting "Research Act of 1992". 
(b) CONFORMING AMENDMENT.^The Alzheimer's Disease and 
Related Dementias Research Act of 1992 (42 U.S.C. 11201 et seq.) 
is amended in the heading for title DC by striking "SERVICES*'. 
SEC. 3. REFERENCES. 
Except as otherwise specifically provided, whenever in this 
Act an amendment or repeal is expressed in terms of an amendment 
to, or a repeal of, a section or other provision, the reference shall 
be considered to be made to a section or other provision of the 
Alzheimer's Disease and Related Dementias Research Act of 1992 
(42 U.S.C. 11201 et seq.). 
SEC. 4. FINDINGS. 
Section 902 (42 U.S.C. 11201) is amended— 
(1) by redesignating paragraphs (7) through (12) as para-
graphs (9) through (14); 
(2) by striking paragraphs (4), (5), and (6); and 
(3) by inserting after paragraph (3) the following new para-
graphs: 
"(4) the cost of caring for individuals with Alzheimer's 
disease and related dementias is great, and conservative esti-
mates range between $38,000,000,000 and $42,000,000,000 per 
year solely for direct costs; 
"(5) progress in the neurosciences and behavioral sciences 
has demonstrated the interdependence and mutual reinforce-
ment of basic science, cUnical research, and services research 
for Alzheimer's disease and related dementias; 
"(6) programs initiated as part of the Decade of the Brain 
are likely to provide significant progress in understanding the 
fundamental mechanisms underlying the causes of, and treat-
ments for, Alzheimer's disease and related dementias; 
"(7) although substantial progress has been made in recent 
years in identifying possible leads to the causes of Alzheimer's 
disease and related dementias, and more progress can be 
expected in the near future, there is little Ukelihood of a break-
Oct. 24,1992 
[S. 1577] 
Alzheimer's 
Disease 
Research, 
Training, and 
Education 
Amendments of 
1992. 
Health smd 
health care. 
42 u s e 11201 
note. 
59-194 O—93 
18:QL3(Pt. 4) 
106 STAT. 3282 
PUBLIC LAW 102-507—OCT. 24, 1992 
through in the immediate future that would eUminate or sub-
st£intially reduce— 
"(A) the number of individuals with the disease and 
dementias; or 
"(B) the difficulties of CEiring for the individuals; 
"(8) the responsibility for care of individuals with Alz-
heimer's disease and related dementias falls primarily on their 
families, and the care is financially and emotionally dev-
astating;". 
SEC. 5. COUNCIL ON ALZHEIMER'S DISEASE. 
(2) 
ESTABLISHMENT.—Section 
911 (42 U.S.C. 
11211) 
is 
amended— 
(1) in subsection (a)— 
(A) in paragraph (2), by striking "Surgeon General 
of the United States" and inserting "Surgeon Greneral of 
the Public Health Service"; 
(B) in paragraph (6), by striking "smd Communicative 
Diseases" and inserting "Disorders"; 
(C) by striking paragraphs (10), (11), and (12); and 
(D) by adding at the end the following new paragraphs: 
"(10) the Administrator of the Agency for Health (5are 
Policy and Research; 
(11) the Administrator of the Health Resources and Serv-
ices Administration; 
"(12) the Director of the National Center for Nursing 
Research; 
"(13) the Chief Medical Director of the Department of Vet-
erans Affairs; 
"(14) the Director of the National Center for Health Statis-
tics; and 
"(15) such additional members as the Secretary of Health 
and Humein Services (hereinafter referred to as the 'Secretary*) 
considers appropriate."; 
(2) by striking subsection (b) and inserting the following 
new subsection: 
"(b) The Assistant Secretary for Health shall serve as the 
Chairman of the Council."; and 
(3) in subsection (d), by striking "twice" and inserting 
"once". 
(b) FUNCTIONS.—Section 912 (42 U.S.C. 11212) is amended— 
(1) in subsection (a)— 
(A) by adding "and" at the end of paragraph (3); 
(B) by striking "; and" at the end of paragraph (4) 
and inserting a period; and 
(C) by striking paragraph (5); and 
(2) by striking subsection (b) and inserting the following 
new subsection: 
Reports. 
"(b)(1) The Chairman of the Council shall submit to the commit-
tees listed in paragraph (2) an annual report containing information 
on— 
"(A) progress made by research, sponsored by the Federal 
Government, on Alzheimer's disease and related dementias; 
and 
"(B) new directions that the Council considers potentially 
important in research on Alzheimer's disease and related 
dementias. 
PUBLIC LAW 102-507—OCT. 24,1992 
106 STAT. 3283 
**(2) The Chairman of the Council shall submit the report 
described in paragraph (1) to— 
"(A) the Committee on Energy and Commerce of the House 
of Representatives; 
*XB) the Committee on Ways and Means of the House 
of Representatives; 
"(C) the Committee on Veterans' Affairs of the House of 
Representatives; 
"(D) the Committee on Appropriations of the House of 
Representatives; 
"(E) the Committee on Labor and Human Resources of 
the Senate; 
"(F) the Committee on Finance of the Senate; 
"(G) the Conunittee on Veterans' Affairs of the Senate; 
and 
"(H) the Committee on Appropriations of the Senate.". 
SEC. 6. ADVISORY PANEL ON ALZHEIMER'S DISEASE. 
(a) ESTABUSHMENT.—Section 921 (42 U.S.C. 
11221) 
is 
amended— 
(1) in subsection (a)(2), by striking "the Director of the 
National Center for Health Services Research and Health Care 
Technology Assessment" and inserting "the Administrator of 
the Agency for Health Care PoUcy and Research"; 
(2) in subsection (d), to read as follows: 
"(d)(1)(A) Except as provided in subparagraph (B), members 
of the Panel appointed imder subsection (a)(1) shall each serve 
for a term of 3 years. 
"(B) Of the members appointed under subsection (a)(1) that 
are serving on the Panel on the day before the date of the enactment 
of this subsection— 
"(i) five shall serve for a term that expires on such date; 
"(ii) five shall serve for a term that expires 1 year after 
such date; and 
"(iii) five shall serve for a term that expires 2 years after 
such date. 
"(2) A vacancy on the Panel shall be filled in the same manner 
as the original appointment was made, and not later than 90 
days after the date on which the vacancy first arises. A vacancy 
on the Panel shall not affect the powers of the Panel."; 
(3) in subsection (f), oy striking "twice" and inserting 
once ; 
(4) in subsection (h), by striking "of $100 per day" and 
inserting "at the daily equivalent of the maximum rate specified 
for GS-15 of the General Schedule under section 5332 of title 
5, United States Code,"; and 
(5) by adding at the end the following new subsection: 
"(i) Notwithstandmg section 14 of the Federal Advisory Commit- Termination 
tee Act (5 U.S.C. App.), on September 30, 1996, the Panel shall ^*e-
be aboHshed and all programs established under this part shall 
terminate.". 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 923 (42 U.S.C. 
11223) is amended to read as follows: 
'nSEC. 923. AUTHORIZATION OF APPROPRIATIONS. 
"There are authorized to be appropriated to carry out this 
part such sums as may be necessary for each of the fiscal years 
1992 through 1996.". 
106 STAT. 3284 
PUBLIC LAW 102-507—OCT. 24, 1992 
SEC. 7. RESEARCH RELATING TO SERVICES FOR INDIVIDUALS WITH 
ALZHEIMER'S DISEASE AND RELATED DEMENTIAS AND FAM-
ILIES OF THE INDIVIDUALS. 
(a) RESPONSIBILITIES OF THE NATIONAL INSTITUTE OF MENTAL 
HEALTH.— 
(1) GRANTS.—Section 931 (42 U.S.C. 11251) is amended— 
(A) by striking subsections (b)(2) and (c); 
(B) in subsection (a), by inserting "and specialized care" 
£ifter "services"; and 
(C) in subsection (b)(1)— 
(i) by striking "Within 6 months" and all that 
follows through "plan shall" and inserting "The Direc-
tor of the National Institute of Mental Health shall"; 
(ii) in subparagraph (A)— 
(I) by striking "provide for" and inserting 
"ensure that the research conducted under sub-
section (a) includes"; 
(II) by striking clause (iii) and inserting the 
following new clause: 
"(iii) the optimal range, types, and cost-effective-
ness of services £uid specialized care for individuals 
with Alzheimer's disease and related dementias and 
for their families, in community and residentied set-
tings (including home care, day care, and respite care), 
and in institutional settings, particularly with respect 
to— 
"(I) the design of the services and care; 
"(II) appropriate staffing for the provision of 
the services and care; 
"(III) the timing of the services and care dur-
ing the progression of the disease or dementias; 
and 
"(IV) the appropriate mix and coordination of 
the services and specialized care;"; 
(III) in clause (iv), by inserting "the evaluation 
of best practices for the development of before 
"appropriate"; and 
(IV) in clauses (v) and (vii), by striking "and 
nursing home services" and inserting "nursing 
home services, and other residential services and 
care"; and 
(iii) in subparagraph (B), by striking "research car-
ried out under the plan" and inserting "the research". 
(2) CONFORMING AMENDMENTS.—Section 931(b) (42 U.S.C. 
11251(b)) is amended— 
(A) by striking "(1)"; 
(B) by redesignating subparagraphs (A) and (B) as 
paragraphs (1) and (2), respectively; 
(C) in paragraph (1) (as redesignated by subparagraph 
(B) of this paragraph), by redesignating clauses (i) through 
(vii) as subparagraphs (A) through (G), respectively; and 
(D) in paragraph (IXC) (as so redesignated, and as 
amended by paragraph (lXCXii)(II) of this subsection), by 
redesignating subclauses (I) through (IV) as clauses (i) 
through (iv), respectively. 
(3) AUTHORIZATION OF APPROPRIATIONS.—Section 933 (42 
U.S.C. 11253) is amended to read as follows: 
PUBUC LAW 102-507—OCT. 24,1992 
106 STAT. 3285 
<
n
S
E
C 933. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to he appropriated to carry out this 
subpart such sums as may be necessary for each of the fiscal 
years 1992 through 1996.". 
(b) RESPONsroiLTTiES OF THE AGENCY FOR HEALTH CARE PoucY 
AND RESEARCH.— 
(1) RESEARCH PROGRAM AND PLAN.—Subpart 2 of part D 
(42 U.S.C. 11261 et seq.) is amended— 
(A) in the heading for iAie subpart, by striking 
'National Center" and all that follows and inserting the 
following: "Agency for Health Care Policy and Research"; 
and 
(B) by striking section 934 and inserting the following 
new section: 
•^EC 934. RESEARCH PROGRAM. 
42 USC 11261. 
"(a) GRANTS FOR RESEARCH.^The Administrator of the Agency 
for Health Care Policy and Research shall conduct, or make grante 
for the conduct of, research relevant to appropriate services for 
individuals with Alzheimer's disease and related dementias and 
for their families. 
"(b) RESEARCH SUBJECTS.—The Administrator of the Agency 
for Health Care Policy and Research shall ensure that research 
conducted under subsection (a) shall include research— 
**(1) concerning improving the organization, delivery, and 
financing of services for individuals with Alzheimer's disease 
and related dementias and for their families, including research 
on— 
"(A) the design, staffing, and operation of special care 
units for the individuals in institutional settings, as well 
as individuals in institutional settings, as well as individ-
uals in home care, day care, and respite care; and 
"(B) the exploration and enhancement of services such 
as home care, day care, and respite care, that provide 
alternatives to institutional care; 
"(2) concerning the costs incurred by individuals with Alz-
heimer's disease and related dementias and by their families 
in obtaining services, particularly services that are essential 
to the individuals and that are not generally required by other 
patients under long-term care progrsims; 
"(3) concerning the costs, cost-effectiveness, and effective-
ness of various interventions to provide services for individuals 
with Alzheimer's disease and related dementias and for their 
families; 
"(4) conducted in consultation with the Director of the 
National Institutes on Aging and the Commissioner of the 
Administration on Aging, concerning the role of physicians 
in caring for persons with Alzheimer's disease and related 
dementias and for their families, including the role of a physi-
cian in connecting such persons with appropriate health care 
and supportive services, including those supported through 
State and area agencies on aging designated under section 
305(a) (1) and (2XA) of the Older Americans Act of 1965 (42 
U.S.C. 3025(a)(1) and (2)(A)); and 
"(5) conducted in consultation with the Director of the 
National Institute! on Aging and the Commissioner of the 
Administration on Aging, concerning legal and ethical issues, 
106 STAT. 3286 
PUBUC LAW 102-507—OCT. 24.1992 
including issues associated with special care units, facing 
individuals with Alzheimer's disease and related dementias 
and facing their famiUes.". 
(2) AUTHORIZATION OF APPROPRIATIONS.—Section 936 
(42 
U.S.C. 11263) is amended to read as follows: 
*^EC. 936. AUTHORIZATION OF APPROPRIATIONS. 
"There are authorized to be appropriated to carry out this 
subpart such sums as may be necessary for each of the fiscal 
years 1992 through 1996.". 
SEC. 8. TRAINING AND EDUCATIONAL ACTIVITIES. 
(a) ACTIVITIES.—Section 962 (42 U.S.C. 11292) is amended to 
read as follows: 
'^EC. 962. EDUCATION OF THE PUBUC, INDIVIDUALS WITH ALZ-
HEIMER'S DISEASE AND THEIR FAMILIES, AND HEALTH 
AND LONG-TERM CARE PROVIDERS. 
*
*
(
a
) TRAINING MODELS GRANTS.— 
"<1) GRANTS.—^The Director of the National Institute on 
Aging majT award grants to eligible entities to assist the entities 
in developing and evaluating model training programs— 
W for-
"(i) health care professionals, including mental 
health professionals; 
"(ii) health care paraprofessionals; 
"(iii) personnel, including information and referral, 
case management, and in-home services personnel 
(including personnel receiving support under the Older 
Americans Act of 1965 (42 U.S.C. 3001 et seq.)), provid-
ing supportive services to the elderly and the families 
of the elderly; 
**(iv) family caregivers providing care and treat-
ment for individuals with Alzheimer's disease and 
related disorders; and 
"(v) personnel of local organizations (including 
community groups, business and labor groups, and reU-
gious, educational, and charitable organizations) that 
have traditionally not been involved in planning and 
developing long-term care services; and 
"(B) with attention to such variables as— 
"(i) curricula development for training and continu-
ing education programs; 
"(ii) care setting; and 
"(iii) intervention technique. 
"(2) ELIGIBLE ENTITY.—TO be eUgible to receive grants 
under this subsection, an entity shall be— 
"(A) an educational institution providing training and 
education in medicine, psychology, nursing, social work, 
gerontology, or health care administration; 
"(B) an educational institution providing preparatory 
training and education of personnel for nursing homes, 
hospitals, and home or community settings; or 
"(C) an Alzheimer's Disease Research Center described 
in section 445(a) of the PubUc Health Service Act. 
"(b) EDUCATIONAL GRANTS.—The Director of the National 
Institute on Aging is authorized to make grants to public and 
nonprofit private entities to assist such entities in establishing 
PUBLIC LAW 102-507—OCT. 24, 1992 
106 STAT. 3287 
programs, for educating health care providers and the famiUes 
of individuals with Alzheimer's disease or related disorders, 
regarding— 
"(1) caring for individuals with such diseases or disorders; 
and 
"(2) the availability in the community of public and private 
sources of assistance, including financial assistance, for caring 
for such individuals. 
"(c) AWARD OF GRANTS.—In awarding grants under this section, 
the Director of the National Institute on Aging shall— 
"(1) award the grants on the basis of merit; 
"(2) award the grants in a manner that will ensure access 
to the programs described in subsections (a) and (b) by rural, 
minority, and underserved populations throughout the country; 
and 
"(3) ensure that the grants are distributed among the prin-
cipal geographic regions of the United States. 
"(d) APPLICATION.—^To be eligible to receive a grant under this 
section, an entity shall submit an appUcation to the Director of 
the National Institute on Aging at such time, in such manner, 
and containing or accompanied by such information, as the Director 
may reasonably require, including, at a minimum, an assurance 
that the entity will coordinate programs provided under this section 
with the State agency designated under section 305(a)(1) of the 
Older Americans Act of 1965, in the State in which the entity 
will provide such programs. 
"(e) COORDINATION.—^The Director of the National Institute on 
Aging shall coordinate the award of greints under this section with 
the heads of other appropriate agencies, including the Conmiissioner 
of the Administration on Aging.". 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 964 of such 
Act (42 U.S.C. 11294) is amended— 
(1) by inserting "(a)" after "964."; 
(2) in subsection (a), as designated by paragraph (1) of 
this section, by striking "this part" and inserting "sections 
961 and 963"; and 
(3) by adding at the end the following new subsection: 
"(b) There are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 1992 through 1996, 
to carry out section 962.". 
SEC. 9. GRANTS FOR PROMOTING INDEPENDENCE AND PREVENTING 
SECONDARY DISABILITIES IN PERSONS WITH ALZHEIMER'S 
DISEASE. 
Section 445C of the Public Health Service Act (42 U.S.C. 285e-
5) is amended by adding at the end the following new subsection: 
"(d) the Director of the Institute may develop, or make grants 
to develop— 
(1) model techniques to— 
"(A) promote greater independence, including enhanced 
independence in performing activities of daily living and 
instrumental activities of daily living, for persons with 
Alzheimer's disease and related disorders; and 
"(B) prevent or reduce the severity of secondanr disabil-
ities, including confiisional episodes, falls, bladder and 
bowel incontinence, £uid adverse effects of prescription and 
over-the-counter medications, in such persons; and 
106 STAT. 3288 
PUBUC LAW 102-507—OCT. 24,1992 
"(2) model curricula for health care professionals, health 
care paraprofessionals, and family caregivers, for traimng and 
application in the use of such techniques.". 
Approved October 24,1992. 
.-.'itif. 
LEGISLATIVE HISTORY—S. 1577: 
SENATE REPORTS: No. 102-242 (Comm. on Labor and Human Resources). 
CONGRESSIONAL RECORD: 
Vol. 137 (1991): Nov. 26, considered and passed Senate. 
Vol. 138 (1992): Oct. 5, considered cmd passed House, amended. 
Oct 7, Senate concuned in House amendment