[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 3092 Introduced in Senate (IS)]







110th CONGRESS
  2d Session
                                S. 3092

 To amend the Public Health Service Act to ensure sufficient resources 
and increase efforts for research at the National Institutes of Health 
relating to Alzheimer's disease, to authorize an education and outreach 
program to promote public awareness and risk reduction with respect to 
Alzheimer's disease (with particular emphasis on education and outreach 
           in Hispanic populations), and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 5, 2008

 Mr. Menendez (for himself and Ms. Mikulski) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to ensure sufficient resources 
and increase efforts for research at the National Institutes of Health 
relating to Alzheimer's disease, to authorize an education and outreach 
program to promote public awareness and risk reduction with respect to 
Alzheimer's disease (with particular emphasis on education and outreach 
           in Hispanic populations), 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 ``Cure and Understanding through 
Research for Alzheimer's Act of 2008'', or the ``CURA Act of 2008''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The incidence and prevalence of Alzheimer's disease 
        increase with age. Alzheimer's disease is currently the 7th 
        leading cause of death of all ages in the United States (number 
        5 for people over 65 years of age), with 5,200,000 Americans 
        living with Alzheimer's. Currently, 1 in 8 Americans over age 
        65 has Alzheimer's. Every 71 seconds, someone develops 
        Alzheimer's disease, and by 2050, someone will develop this 
        disease every 33 seconds. By 2050, the number of individuals 
        age 65 and over with Alzheimer's will range from 11,000,000 to 
        16,000,000 people. It is projected that by 2050, more than 60 
        percent of people with Alzheimer's disease will be age 85 or 
        older.
            (2) The prevalence of Alzheimer's disease and dementia seem 
        to be higher among people with fewer years of education. People 
        with less than 12 years of education have a 15 percent greater 
        risk of developing dementia than people with 12 to 15 years of 
        education and a 35 percent greater risk of developing dementia 
        than people with more than 15 years of education.
            (3) Hispanics are the fastest growing population in the 
        United States and by 2050 will have a life expectancy of 87 
        years, longer than any other ethnic or racial group. The 
        Hispanic community in the United States is projected to 
        experience a six-fold increase in Alzheimer's disease (from 
        fewer than 200,000 to as many as 1,300,000) by 2050.
            (4) Hispanics may be at a greater risk of developing 
        dementia than other ethnic or racial groups. Hispanics have a 
        64 percent higher incidence of diabetes than non-Hispanic white 
        Americans, and this is of particular concern in light of new 
        findings that diabetes is the one vascular risk factor that, in 
        the absence of stroke, is related to an increased risk of 
        Alzheimer's disease.
            (5) Research on disparities in Alzheimer's risk factors 
        between Hispanic and other ethnic and racial groups is only 
        beginning to sort out complex differences. For example, even in 
        the absence of the APOE-e4 allele, the one known genetic risk 
        factor for late onset Alzheimer's, Caribbean Hispanics have a 
        cumulative risk for Alzheimer's twice that of non-Hispanic 
        whites.
            (6) The shortage of bilingual health professionals, 
        combined with the large population of monolingual Spanish-
        speaking seniors, makes adequate testing and diagnosis of 
        Alzheimer's among elderly Hispanics difficult and may lead to 
        cultural biases in cognitive testing. Moreover, inadequate 
        translation of diagnostic tools can lead to improper diagnoses, 
        and there may be poor understanding of recommended treatment 
        and self-care even among those who are properly diagnosed.
            (7) Hispanics are far more likely to be uninsured than any 
        other ethnic group. The Census Bureau reports that 34.1 percent 
        of Hispanics in the United States are uninsured, compared to 
        10.8 percent for non-Hispanic whites and 15.3 percent for all 
        United States residents.
            (8) Lack of access to healthcare and a strong cultural 
        commitment to caring for one's elders within the family are 
        among the factors that make Hispanics with dementia less likely 
        than non-Hispanics to see a physician and use related services 
        provided by formal health professionals. Delays in diagnosis 
        and lack of early and consistent treatment can lead to higher 
        levels of impairment and increased stress on family caregivers.
            (9) Hispanic elders are second most likely, after Asian-
        Americans, to live with their families rather than in long term 
        care facilities. More research is needed to better understand 
        the effects of differing care settings on family caregivers and 
        Alzheimer's patients.
            (10) Alzheimer's disease costs the United States 
        $148,000,000,000 a year in direct and indirect costs to 
        business, Medicare, and Medicaid (not including private 
        insurance).

SEC. 3. NIH RESEARCH AND EDUCATION ON ALZHEIMER'S DISEASE.

    (a) Research Activities.--In conducting research relating to 
Alzheimer's disease, the Director of the National Institutes of Health 
shall ensure sufficient resources for activities relating to 
Alzheimer's disease and Hispanic communities, including by--
            (1) increasing efforts in epidemiological work in Hispanic 
        subgroups;
            (2) allocating resources to the National Institute on Aging 
        Alzheimer's disease research centers, and other academic 
        centers involved in Alzheimer's disease research, to increase 
        participation of Hispanics and other underrepresented ethnic 
        groups in research and clinical trials in sufficient numbers to 
        draw valid conclusions; and
            (3) conducting social, behavioral, and health services 
        research--
                    (A) to understand more fully the underlying reasons 
                that Hispanic individuals delay diagnosis and 
                underutilize services;
                    (B) to identify culturally and linguistically 
                appropriate approaches for addressing such delays and 
                underutilization; and
                    (C) to identify what is culturally competent care.
    (b) Education Activities.--The Director of the National Institutes 
of Health shall expand and intensify the efforts of the Institutes--
            (1) to educate communities about the importance of research 
        relating to Alzheimer's disease; and
            (2) to respond effectively to cultural concerns about 
        participation in such research, especially with respect to 
        sensitive matters like the collection of brain tissue and 
        genetic information.

SEC. 4. INCREASED FUNDING FOR ALZHEIMER'S DISEASE DEMONSTRATION GRANTS.

    Section 398B(e) of the Public Health Service Act (42 U.S.C. 280c-
5(e)) is amended--
            (1) by striking ``and such'' and inserting ``such''; and
            (2) by inserting before the period the following: ``, 
        $25,000,000 for fiscal year 2009, and such sums as may be 
        necessary for each of fiscal years 2010 through 2013''.

SEC. 5. CDC OUTREACH AND EDUCATION.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 317S the following:

``SEC. 317T. EDUCATION AND OUTREACH ON ALZHEIMER'S DISEASE.

    ``(a) Purposes.--The purposes of this section are the following:
            ``(1) To reduce the risk of Alzheimer's disease through the 
        reduction of vascular risk factors.
            ``(2) To encourage the early recognition and diagnosis of 
        dementia.
            ``(3) To train public health personnel to recognize, 
        assess, diagnose, and treat Alzheimer's disease in ways that 
        are culturally appropriate and supportive of families.
    ``(b) Education and Outreach.--To achieve the purposes of this 
section, the Secretary, acting through the Centers for Disease Control 
and Prevention, shall conduct an aggressive, evidence-based education 
and outreach program to promote public awareness and risk reduction 
with respect to Alzheimer's disease. In conducting the outreach 
program, the Secretary shall consult with State health departments and 
other appropriate entities, including the Alzheimer's Association.
    ``(c) Emphasis.--In carrying out this section, the Secretary shall 
give particular emphasis to education and outreach in Hispanic 
populations.''.
                                 <all>