[Congressional Record Volume 164, Number 196 (Wednesday, December 12, 2018)]
[Senate]
[Pages S7526-S7527]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
BUILDING OUR LARGEST DEMENTIA INFRASTRUCTURE FOR ALZHEIMER'S ACT
Mr. GARDNER. Mr. President, I ask unanimous consent that the Senate
proceed to the immediate consideration of Calendar No. 694, S. 2076.
The PRESIDING OFFICER. The clerk will report the bill by title.
The senior assistant legislative clerk read as follows:
A bill 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.
There being no objection, the Senate proceeded to consider the bill,
which had been reported from the Committee on Health, Education, Labor,
and Pensions, with an amendment to strike all after the enacting clause
and insert in lieu thereof the following:
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.''.
[[Page S7527]]
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--
``(1) a health department of a State, political subdivision
of a State, or Indian tribe and tribal organization, 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; or
``(2) a health department of a State, political subdivision
of a State, or Indian tribe and tribal organization located
in a rural area or frontier area.'';
(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''.
Mr. GARDNER. Mr. President, I ask unanimous consent that the Collins
amendment at the desk be considered and agreed to, that the committee-
reported substitute amendment, as amended, be agreed to, and the bill,
as amended, be considered read a third time.
The PRESIDING OFFICER. Without objection, it is so ordered.
The amendment (No. 4104) was agreed to as follows:
(Purpose: To clarify provisions relating to waivers)
Beginning on page 28, line 23, strike ``year for--'' and
all that follows through line 9 on page 29, and insert the
following: `` `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.';''.
The committee-reported amendment in the nature of a substitute, as
amended, was agreed to.
The bill was ordered to be engrossed for a third reading and was read
the third time.
Mr. GARDNER. Mr. President, I know of no further debate on the bill.
The PRESIDING OFFICER. Is there further debate on the bill?
Hearing none, the question is, Shall the bill pass?
The bill (S. 2076), as amended, was passed.
Mr. GARDNER. Mr. President, I ask unanimous consent the motion to
reconsider be considered made and laid upon the table.
The PRESIDING OFFICER. Without objection, it is so ordered.
(The bill (S. 2076), as amended, is printed in the Record of December
21, 2018, on page S. 8018.)
=========================== NOTE ===========================
On page S7527, December 12, 2018, in the third column, the
following appears: The PRESIDING OFFICER. Without objection, it is
so ordered.
The online Record has been corrected to read: The PRESIDING
OFFICER. Without Objection, it is so ordered. (The bill (S. 2076),
as amended, is printed in the Record of December 21, 2018, on page
S. 8018.)
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