[United States Statutes at Large, Volume 132, 115th Congress, 2nd Session]
[From the U.S. Government Publishing Office, www.gpo.gov]


Public Law 115-406
115th Congress

An Act


 
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. <>

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--

[[Page 5363]]

``(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--

[[Page 5364]]

``(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 5365]]

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.

[[Page 5366]]

``(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;'';

[[Page 5367]]

(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''.

Approved December 31, 2018.

LEGISLATIVE HISTORY--S. 2076:
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CONGRESSIONAL RECORD, Vol. 164 (2018):
Dec. 12, considered and passed Senate.
Dec. 19, considered and passed House.