[Congressional Record Volume 164, Number 200 (Wednesday, December 19, 2018)]
[House]
[Pages H10282-H10286]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    BUILDING OUR LARGEST DEMENTIA INFRASTRUCTURE FOR ALZHEIMER'S ACT

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (S. 2076) 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.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                S. 2076

       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.--

[[Page H10283]]

       ``(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''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from New York (Mr. Tonko) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of S. 2076, the BOLD Infrastructure 
for Alzheimer's Act.
  I would like to thank Representative Brett Guthrie from Kentucky for 
his work to bring this bill to the House floor and for his terrific 
partnership as a member and real leader on our Energy and Commerce 
Committee.
  Now, the BOLD Act is another bipartisan bill. It will enhance our 
Nation's public health infrastructure. It will improve lives for 
patients.
  More than 5 million Americans have Alzheimer's. It is the most 
expensive disease in our country. It costs our health system hundreds 
of billions of dollars each and every year, and those numbers are only 
going up.
  This legislation before us now will help us address those trends by 
establishing centers of excellence to improve coordination of care with 
local

[[Page H10284]]

public health departments for patients in our communities. These 
centers will increase data collection, analysis, and timely reporting 
to better inform researchers and policymakers across the country.
  For patients and their families, early intervention and coordination 
of care provided at these centers can make the burden of Alzheimer's 
just a little bit lighter.
  I have heard about the importance of the bill from Marya in Medford, 
who, in 2012, became one of the 180,000 Oregonians who serve as unpaid 
Alzheimer's caregivers for a loved one. In her case, that loved one was 
her father.
  When her father was diagnosed, she was faced with not only a daunting 
system and difficult choices to make without information, but also an 
unexpected cost of care of $342,000, on average.
  According to Marya, if passed, the BOLD Act would ensure States such 
as Oregon have the resources necessary to support earlier detection and 
diagnosis of Alzheimer's and help healthcare givers like her to grapple 
with this devastating disease.
  Mr. Speaker, on behalf of patients and their families across our 
Nation, I urge my colleagues to join me in passing this important 
legislation as well.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TONKO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in strong support of the BOLD Infrastructure for 
Alzheimer's Act, legislation that I have introduced with my good friend 
and fellow Energy and Commerce Committee member, Congressman Brett 
Guthrie.
  I thank both Chairman Walden and incoming Chair Pallone for their 
support of this particular legislation, and I greatly appreciate the 
partnership with Congressman Guthrie and his staff for helping to get 
this important legislation over the finish line today.
  Alzheimer's is a brutal, devastating disease. Anyone whose life has 
been touched by Alzheimer's or related dementias knows the heart-
wrenching toll that these diseases can and most often do take on an 
individual, on a family, and on a community.
  Since first coming to Congress, I have been laser-focused on how we 
can reduce the devastating burden that Alzheimer's disease has on our 
families and our Nation. We have had great success, many successes in 
recent years with legislation such as the National Alzheimer's Project 
Act and the Alzheimer's Accountability Act helping to coordinate our 
medical research agenda and strengthen our case for the unprecedented 
investments that Congress has appropriated to effectively treat and 
find a cure for Alzheimer's.
  With the HOPE for Alzheimer's Act, we were able to get CMS to provide 
coverage for comprehensive care planning services to Medicare 
beneficiaries and their caregivers following a diagnosis of Alzheimer's 
disease. These care planning visits are a critical tool for families 
struggling for answers and help to lessen the burden of this disease.
  Now we are taking another huge step forward with the passage of the 
BOLD Infrastructure for Alzheimer's Act, legislation that will invest 
in public health-oriented strategies for tackling Alzheimer's disease 
and related dementias.
  We know that in 2018, Alzheimer's and related dementias will cost our 
country $277 billion. By smartly investing in a public health 
infrastructure for this disease, we can reduce this cost burden on the 
local, State, and Federal Government, and improve care for those who 
have received an Alzheimer's diagnosis.
  The BOLD Act will enhance our public health infrastructure in three 
main ways:
  First, it will create Alzheimer's disease and related dementias 
public health centers of excellence. They will be dedicated to 
promoting effective Alzheimer's disease and caregiving interventions, 
as well as educating the public on Alzheimer's disease, cognitive 
decline, and brain health. These centers will implement the CDC's 
healthy aging public health road map and will take key steps to support 
health and social services professionals, as well as families and 
communities.
  Second, the legislation will allow for State and local cooperative 
agreements with HHS that will be awarded to State health departments, 
subdivisions of States, or Tribal entities to develop and carry out 
Alzheimer's interventions. These awards will help States build a 
foundation and also help those States that are already investing in a 
public health approach to Alzheimer's to amplify their initiatives 
through public-private partnerships.
  Finally, the BOLD Act will create data analysis and reporting 
cooperative agreements with HHS that will ensure that data on 
Alzheimer's, cognitive decline, caregiving, and health disparities are 
analyzed and disseminated to the public in a timely manner.

  We need this legislation more than ever. The burden of Alzheimer's 
disease does not take a day off, and Congress cannot afford to either.
  In closing, I again thank Chairman Walden, Ranking Member Pallone, 
House leadership, our Senate sponsors, and everyone who had a hand in 
this success today. Without such dedicated bipartisan Alzheimer's 
champions throughout Congress, we would not be making this strong step 
forward. It is mighty progress.
  Mr. Speaker, I strongly urge my colleagues to support this 
legislation, and I reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I want to commend the gentleman from New 
York for his leadership on this issue as well.
  Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. 
Burgess), so that he can speak on the legislation.
  Mr. BURGESS. Mr. Speaker, I thank the chairman for the recognition, 
and I rise to speak in support of S. 2076, the BOLD Infrastructure for 
Alzheimer's Act.
  This bill was introduced on the Senate side by Senator Susan Collins 
and Senator Catherine Cortez Masto, and it promotes public awareness of 
Alzheimer's disease and related dementias.
  But I also need to thank the champions on the House side of this 
legislation, Representatives Brett Guthrie and Paul Tonko, both 
valuable members of the Health Subcommittee.
  Alzheimer's is a devastating disease that affects families across our 
Nation. Every 65 seconds, another person in the United States develops 
Alzheimer's. Alzheimer's is the sixth leading cause of death in the 
United States, with one in three seniors dying of Alzheimer's or a 
related dementia.
  Over the past several years, Congress has doubled down on its 
commitment to researching Alzheimer's disease and the related dementias 
by substantially increasing our appropriations for the initiatives 
housed at the National Institutes of Health.
  This legislation will require the Secretary of the Department of 
Health and Human Services to work with the Centers for Disease Control 
and Prevention to award grants, contracts, or cooperative agreements to 
establish or support regional centers to address Alzheimer's disease 
and related dementias. The purpose of these centers of excellence is to 
increase awareness among public health officials, healthcare 
professionals, and the public as it relates to Alzheimer's disease and 
the related dementias.
  By empowering our healthcare workforce, and our patients with more 
information, there will be increasing awareness of the disease, the 
impact it has on individuals' lives, and the possibility of treatments 
or interventions.
  The effects of this disease are daunting for both the individual and 
for their families. This bill is a step toward building an 
infrastructure to support the ever-growing population of individuals 
with Alzheimer's and their related dementias.
  I support S. 2076, and I urge my fellow Members to do the same.
  Mr. TONKO. Mr. Speaker, I continue to reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from 
Kentucky (Mr. Guthrie), another leader on healthcare in the Energy and 
Commerce Committee.
  Mr. GUTHRIE. Mr. Speaker, I rise today in support of my legislation, 
the BOLD Infrastructure for Alzheimer's Act.
  It has been great to work with my good friend from New York (Mr. 
Tonko). We came here together as classmates in the 2008 election. We 
worked together because we wanted to create a public health 
infrastructure to help those with Alzheimer's and other

[[Page H10285]]

dementias receive the care they so desperately need.
  Over 5 million Americans are living with Alzheimer's and other 
dementias, making it the most costly disease in America. In the Second 
District, I have met countless Kentuckians who have been affected by 
this disease in some way.
  I, too, have shared similar experiences with a great-uncle, when I 
was a child, having early onset Alzheimer's and seeing my family having 
to try to understand and deal with it. When I was a child, it wasn't 
understood as well as it is even now.
  I watched my wife's grandfather go through it and saw my mother-in-
law being the primary caretaker and saw how it consumes the family.
  So what it does to the person with the disease, what it does to the 
family caring for the disease is of utmost importance in trying to move 
towards a cure. But, also, it is fiscally responsible what we are doing 
today because, by 2050, it is estimated it will cost the Federal 
Government over $1 trillion if we do not have some advances in caring 
for and delaying this onset.
  I used to say that is for my children and my grandchildren and my 
great-grandchildren, but, actually, in 30 years, I will be in my 
eighties, so it will be affecting my children. So we need to move 
forward, and it is fiscally responsible to do so.
  The BOLD Infrastructure for Alzheimer's Act would direct the CDC to 
establish a network to support the prevention, treatment, and care of 
Alzheimer's disease. In doing so, we hope to take care of those who 
have Alzheimer's and other dementias now and, hopefully, find a cure 
for these debilitating diseases in the near future.
  This important bill has passed the Senate. I urge my colleagues to 
support it today, and I look forward to seeing the President sign this 
bill into law.
  Before I close, I do want to thank all the staff for their hard work. 
This legislation wouldn't be done without them.
  Sophie Trainor in my office has worked tirelessly on this and other 
bills at the end of this session, and I appreciate her assistance and 
help.
  Mr. TONKO. Mr. Speaker, I continue to reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I yield 1 minute to the gentleman from 
Florida (Mr. Bilirakis) to speak on the legislation.

                              {time}  1545

  Mr. BILIRAKIS. Mr. Speaker, I thank the chairman for yielding me the 
time.
  Mr. Speaker, I rise today in support of S. 2076. I thank my good 
friend, Brett Guthrie from the great State of Kentucky, and also Mr. 
Tonko for sponsoring the House bill. This is so very important. The 
Building Our Largest Dementia Infrastructure for Alzheimer's Act, or 
the BOLD Infrastructure for Alzheimer's Act, is so very important. This 
bill will create Alzheimer's disease centers of excellence, which are 
badly needed.
  Through these centers and public health departments, we can 
strengthen our efforts at increasing early detection and diagnosis. It 
will also allow for the voluntary collection of data so researchers can 
analyze cognitive decline, caregiving, and health disparities in a 
timely manner. I know that is going to help so much in finding a cure 
for this disease.
  I am a cosponsor of the House version of the bill.
  In the Tampa area, we have the Byrd Alzheimer's Center and Research 
Institute, which is one of the largest freestanding Alzheimer's 
research centers in the United States.
  The SPEAKER pro tempore (Mr. Guthrie). The time of the gentleman has 
expired.
  Mr. WALDEN. Mr. Speaker, I yield an additional 30 seconds to the 
gentleman from Florida.
  Mr. BILIRAKIS. Mr. Speaker, this bill will help them in their efforts 
of Alzheimer's awareness and research. Please support this bill. We 
need it badly for our constituents. I appreciate all the help from all 
the volunteers and the advocates.
  Again, I urge strong support for this bill.
  Mr. TONKO. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from California (Ms. Maxine Waters). Representative Waters 
is from California's 43rd Congressional District and has invested a lot 
of time and work on the Alzheimer's issue, especially in her role as 
co-chair of the Congressional Task Force on Alzheimer's Disease.
  Ms. MAXINE WATERS of California. Mr. Speaker, I would like to thank 
Congressman Tonko for the leadership that he has provided and the 
opportunity to rise to urge all of my colleagues to support S. 2076, 
the BOLD Infrastructure for Alzheimer's Act.
  I congratulate Senator Susan Collins for shepherding this bill 
through the Senate. I join together with my colleagues, Representatives 
Brett Guthrie, Paul Tonko, and Chris Smith, to introduce the House 
version of this bill in order to promote early detection and diagnosis, 
support caregivers, and reduce health disparities related to the care 
and treatment of Alzheimer's patients.
  As the House Democratic co-chair of the bipartisan, bicameral 
Congressional Task Force on Alzheimer's Disease, I know how devastating 
this disease can be for patients, families, and caregivers. Alzheimer's 
affects more than 5 million Americans, and it is the sixth leading 
cause of death in the United States. There is no effective treatment, 
no means of prevention, and no method for slowing the progression of 
the disease.
  Alzheimer's is very costly to society. In 2017, the direct cost of 
care for Alzheimer's and other dementias was approximately $259 
billion, with 67 percent of those costs paid by Medicare or Medicaid. 
At the current rate, the direct costs of care for these tragic 
conditions will reach more than $1 trillion by 2050.
  Most Alzheimer's patients require constant care and attention, 
especially when they are in the final stages of the disease. More than 
15 million Americans provide unpaid care to family and friends living 
with Alzheimer's and other dementias. The Alzheimer's Association 
calculated that caregivers provided more than 18 billion hours of 
unpaid care for people with dementia in 2016, at an estimated value of 
more than $230 billion.
  Alzheimer's has a devastating impact on caregivers. Compared with 
caregivers for people without dementia, twice as many caregivers for 
people with dementia indicate substantial emotional, financial, and 
physical stress.
  The BOLD Infrastructure for Alzheimer's Act establishes Alzheimer's 
centers of excellence around the country to expand and promote 
innovative and effective Alzheimer's interventions. These interventions 
will support early detection, reduce the risk of hospitalizations and 
cognitive decline, support caregivers, and reduce health disparities. 
The BOLD Act will also improve data collection on the incidence and 
prevalence of Alzheimer's and related dementias.
  So, Mr. Speaker, I am pleased to be here with my colleagues today, 
and I would certainly urge all of my colleagues to support this 
important legislation.
  Mr. WALDEN. Mr. Speaker, may I inquire as to how much time remains on 
each side.
  The SPEAKER pro tempore. The gentleman from Oregon has 12\1/2\ 
minutes remaining. The gentleman from New York has 12 minutes 
remaining.
  Mr. WALDEN. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Georgia (Mr. Carter), who is a pharmacist on our 
committee and a great leader on health issues on the Energy and 
Commerce Committee.
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, I rise today in support of S. 2076, the BOLD 
Infrastructure for Alzheimer's Act, because of what it does to address 
this terrible disease. According to the Alzheimer's Association, nearly 
5.7 million Americans are currently living with Alzheimer's. It is 
currently the sixth leading cause of death in our country.
  This debilitating disease continues to grow amongst our population, 
but we still struggle to understand and find a cure. But there is hope. 
This legislation would award agreements to establish national and 
regional centers of excellence focused on Alzheimer's disease, as well 
as support State public health departments, tribes, and others working 
to fight this.

[[Page H10286]]

  This disease impacts not only those who have it but also the millions 
of caregivers responsible for the well-being of those who have 
Alzheimer's. These are often family members or close friends who have 
to make sacrifices in their own lives to care for others
  This legislation will make great strides in better understanding the 
cognitive decline associated with the disease, the impact on 
caregivers, and how we can continue to fight for a cure.
  I am a proud cosponsor of H.R. 4256, the companion bill in the House 
that was introduced by my good friend and colleague, Mr. Guthrie of 
Kentucky.
  I also want to thank those across the country who have continued to 
be tireless advocates on this issue, including Ms. Donna Camacho who 
has been a leader on this issue in my district. I can't overstate my 
appreciation for all of the hard work and dedication that so many 
people have poured into passing this legislation.
  Today, with this passage, we can help bring about hope in the future 
for those who are victims of this disease, like my legislative 
director's grandmother, Lisa Verlsteffen, a courageous woman who lived 
a long and happy life, but who eventually succumbed to the effects of 
Alzheimer's after a long and hard fight.
  While today's work isn't the final solution, it brings us one step 
closer in the fight to eradicate this disease. I urge my colleagues to 
support this legislation and vote ``yes'' on its passage.
  Mr. TONKO. Mr. Speaker, I yield myself the balance of my time to 
close.
  Mr. Speaker, I strongly urge passage of this legislation. The BOLD 
Act is another bit of foundation that we have done to move forward and 
conquer Alzheimer's and related dementias.
  Those of us who function in government understand full well that our 
Federal, State, and local budgets have been impacted severely by 
Alzheimer's disease, but, most importantly, families have been burdened 
by this disease. So it is so important for us to move forward with this 
legislation that provides, again, hope to those families and 
individuals living with Alzheimer's disease.
  Mr. Speaker, I ask for support of the legislation, and I yield back 
the balance of my time.
  Mr. WALDEN. Mr. Speaker, I, too, join my friend and colleague from 
New York and our friends across the building in the Senate in support 
of the BOLD Act, S. 2076.
  Mr. Speaker, I urge our colleagues to support it, and I yield back 
the balance of my time.
  The SPEAKER pro tempore (Mr. Carter of Georgia). The question is on 
the motion offered by the gentleman from Oregon (Mr. Walden) that the 
House suspend the rules and pass the bill, S. 2076.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. WALDEN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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