[House Report 118-515]
[From the U.S. Government Publishing Office]


118th Congress    }                                      {      Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                      {     118-515

======================================================================



 
    BOLD INFRASTRUCTURE FOR ALZHEIMER'S REAUTHORIZATION ACT OF 2024

                                _______
                                

  May 21, 2024.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mrs. Rodgers of Washington, from the Committee on Energy and Commerce, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 7218]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 7218) to amend title III of the Public Health 
Service Act to extend the program for promotion of public 
health knowledge and awareness of Alzheimer's disease and 
related dementias, and for other purposes, having considered 
the same, reports favorably thereon without amendment and 
recommends that the bill do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Committee Action.................................................     2
Committee Votes..................................................     3
Oversight Findings and Recommendations...........................     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     5
Statement of General Performance Goals and Objectives............     5
Duplication of Federal Programs..................................     5
Related Committee and Subcommittee Hearings......................     5
Committee Cost Estimate..........................................     6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     6
Advisory Committee Statement.....................................     6
Applicability to Legislative Branch..............................     6
Section-by-Section Analysis of the Legislation...................     6
Changes in Existing Law Made by the Bill, as Reported............     6

                          Purpose and Summary

    H.R. 7218 reauthorizes programs to support states, local 
public health departments, and other entities that educate and 
support early detection and diagnosis, support patients and 
caregivers needs, and promote public health knowledge and 
awareness of Alzheimer's disease and related dementias, among 
other activities, for fiscal years 2025 through 2029.

                  Background and Need for Legislation

    The ``BOLD (Building Our Largest Dementia) Infrastructure 
for Alzheimer's Act'' utilizes population-level approaches to 
prevent Alzheimer's and related dementias and improve outcomes 
by promoting cognitive health. The law provides funding to 
support public health strategies that promote brain health, 
address dementia, and support individuals living with 
Alzheimer's and related dementia and their caregivers. An 
estimated 6.7 million Americans aged 65 and older are living 
with Alzheimer's in 2023. By 2050, this number is projected to 
rise to 12.7 million. About 1 in 9 people aged 65 and older 
(10.7 percent) have Alzheimer's, and 1 in 3 seniors dies with 
Alzheimer's or another dementia.\1\
---------------------------------------------------------------------------
    \1\Alzheimer's Association, ``Alzheimer's Disease Facts and 
Figures'', 2024. https://www.alz.org/alzheimers-dementia/facts-figures.
---------------------------------------------------------------------------

                            Committee Action

    On February 14, 2024, the Subcommittee on Health held a 
hearing on H.R. 7218. The title of the hearing was 
``Legislative Proposals to Support Patients and Caregivers.'' 
The Subcommittee received testimony from:
           Andy Shih, PhD, Chief Science Officer, 
        Autism Speaks;
           Corey Feist, JD, MBA, Co-Founder and CEO, 
        Dr. Lorna Breen Heroes' Foundation;
           Joanne Pike, DrPH, President and CEO, 
        Alzheimer's Association;
           Gordon Tomaselli, MD, Former President, 
        American Heart Association; Marilyn and Stanley M. Katz 
        Dean, Emeritus and Professor of Medicine, Albert 
        Einstein College of Medicine; Adjunct Professor of 
        Medicine, Johns Hopkins University School of Medicine;
           Michelle Whitten, President, CEO, and Co-
        Founder, Global Down Syndrome Foundation;
           Randy Strozyk, President, American Ambulance 
        Association; and
           Christina Annunziata, MD, PhD, Senior Vice 
        President of Extramural Discovery Science, American 
        Cancer Society.
    On March 12, 2024, the Subcommittee on Health met in open 
markup session and forwarded H.R. 7218, without amendment, to 
the full Committee by a record vote of 25 yeas and 0 nays.
    On March 20, 2024, the full Committee on Energy and 
Commerce met in open markup session and ordered H.R. 7218, 
without amendment, favorably reported to the House by a record 
vote of 44 yeas and 0 nays.

                            Committee Votes

    Clause 3(b) of rule XIII requires the Committee to list the 
record votes on the motion to report legislation and amendments 
thereto. The following reflects the record votes taken during 
the Committee consideration:

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                 Oversight Findings and Recommendations

    Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of 
rule XIII, the Committee held a hearing and made findings that 
are reflected in this report.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to clause 3(c)(2) of rule XIII, the Committee 
finds that H.R. 7218 would result in no new or increased budget 
authority, entitlement authority, or tax expenditures or 
revenues.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII, at the time this 
report was filed, the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974 was not available.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

         Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to promote 
public health knowledge and awareness of Alzheimer's disease 
and related dementias.

                    Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 7218 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

              Related Committee and Subcommittee Hearings

    Pursuant to clause 3(c)(6) of rule XIII, the following 
related hearing was used to develop or consider H.R. 7218:
           On February 14, 2024, the Subcommittee on 
        Health held a hearing on H.R. 7218. The title of the 
        hearing was ``Legislative Proposals to Support Patients 
        and Caregivers.'' The Subcommittee received testimony 
        from:
                   Andy Shih, PhD, Chief Science 
                Officer, Autism Speaks;
                   Corey Feist, JD, MBA, Co-Founder 
                and CEO, Dr. Lorna Breen Heroes' Foundation;
                   Joanne Pike, DrPH, President and 
                CEO, Alzheimer's Association;
                   Gordon Tomaselli, MD, Former 
                President, American Heart Association; Marilyn 
                and Stanley M. Katz Dean, Emeritus and 
                Professor of Medicine, Albert Einstein College 
                of Medicine; Adjunct Professor of Medicine, 
                Johns Hopkins University School of Medicine;
                   Michelle Whitten, President, 
                CEO, and Co-Founder, Global Down Syndrome 
                Foundation; o Randy Strozyk, President, 
                American Ambulance Association; and
                   Christina Annunziata, MD, PhD, 
                Senior Vice President of Extramural Discovery 
                Science, American Cancer Society.

                        Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974. At the time this report was 
filed, the estimate was not available.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 7218 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 provides that the Act may be cited as the ``BOLD 
Infrastructure for Alzheimer's Reauthorization Act of 2024.''

Section 2. Extension of program for promotion of public health 
        knowledge and awareness of Alzheimer's disease and related 
        dementias

    Section 2 reauthorizes the ``BOLD Infrastructure Act'' for 
five years from fiscal year 2025 through fiscal year 2029.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part K--Health Care Services in the Home and Public Health Programs for 
Dementia

           *       *       *       *       *       *       *



 Subpart II--Programs With Respect to Alzheimer's Disease and Related 
Dementias

           *       *       *       *       *       *       *


SEC. 398B. GENERAL PROVISIONS.

  (a) Limitation on Administrative Expenses.--The Secretary may 
not make a grant or cooperative agreement under sections 398 or 
398A to an entity unless the entity agrees that not more than 5 
percent of the grant or cooperative agreement will be expended 
for administrative expenses with respect to the grant or 
cooperative agreement.
  (b) Requirement of Application.--The Secretary may not make a 
grant under sections 398 or 398A to an entity unless the entity 
has submitted to the Secretary an application for the grant. 
The application shall--
          (1) contain the description of intended expenditures;
          (2) with respect to carrying out the purpose for 
        which the grant is to be made, provide assurances of 
        compliance satisfactory to the Secretary; and
          (3) otherwise be in such form, be made in such 
        manner, and contain such information and agreements as 
        the Secretary determines to be necessary to carry out 
        this subpart.
  (c) Evaluations and Report by Secretary.--The Secretary 
shall--
          (1) provide for an evaluation of the activities for 
        which an award is made under sections 398 or 398A; and
          (2) not later than 1 year after the completion of 
        such evaluations, submit to the Congress a report 
        describing the findings made as a result of the 
        evaluations.
  (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.
  (e) Authorizations of Appropriations.--For the purpose of 
carrying out this subpart, there are authorized to be 
appropriated $20,000,000 for each of fiscal years 2020 through 
2024 and $33,000,000 for each of fiscal years 2025 through 
2029.

           *       *       *       *       *       *       *


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