#aaeth ,,congress #b;d ,session ,s4 #bjgf ,,an ,,act ,to amend the ,public ,health ,service ,act to authorize the expansion of activities related to ,alzheimer's disease1 cognitive decline1 and brain health under the ,alzheimer's ,disease and ,healthy ,aging ,program1 and for other purposes4 #a4 ,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 ,act4 #b4 ,promotion of public health knowledge and awareness of ,alzheimer's disease1 cognitive decline1 and brain health under the ,alzheimer's ,disease and ,healthy ,aging ,program ,part ,k of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;c et seq47 is amended-- 7#a7 in the part heading1 by adding ,,and ,,public ,,health ,,programs ,,for ,,dementia at the end2 and 7#b7 in subpart ,,ii-- 7,a7 by striking the subpart heading and inserting the following3 ,,ii ,programs ,with ,respect to ,alzheimer's ,disease and ,related ,dementias 2 and 7,b7 by striking section #cih;,a 7#db ,u4,s4,c4 #bhj;c-#d7 and inserting the following3 #cih;,a4 ,promotion of public health knowledge and awareness of ,alzheimer's disease and related dementias 7a7 ,alzheimer's ,disease and ,related ,dementias ,public ,health ,centers of ,excellence 7#a7 ,in general ,the ,secretary1 in coordination with the ,director of the ,centers for ,disease ,control and ,prevention and the heads of other agencies as appropriate1 shall award grants1 contracts1 or cooperative agreements to eligible entities1 such as institutions of higher education1 ,state1 tribal1 and local health departments1 ,indian tribes1 tribal organizations1 associations1 or other appropriate entities for the establishment or support of regional centers to address ,alzheimer's disease and related dementias by-- 7,a7 advancing the awareness of public health officials1 health care professionals1 and the public1 on the most current information and research related to ,alzheimer's disease and related dementias1 including cognitive decline1 brain health1 and associated health disparities2 7,b7 identifying and translating promising research findings1 such as findings from research and activities conducted or supported by the ,national ,institutes of ,health1 including ,alzheimer's ,disease ,research ,centers authorized by section #dde1 into evidence-based programmatic interventions for populations with ,alzheimer's disease and related dementias and caregivers for such populations2 and 7,c7 expanding activities1 including through public-private partnerships related to ,alzheimer's disease and related dementias and associated health disparities4 7#b7 ,requirements ,to be eligible to receive a grant1 contract1 or cooperative agreement under this subsection1 an entity shall submit to the ,secretary an application containing such agreements and information as the ,secretary may require1 including a description of how the entity will-- 7,a7 coordinate1 as applicable1 with existing ,federal1 ,state1 and tribal programs related to ,alzheimer's disease and related dementias2 7,b7 examine1 evaluate1 and promote evidence-based interventions for individuals with ,alzheimer's disease and related dementias1 including underserved populations with such conditions1 and those who provide care for such individuals2 and 7,c7 prioritize activities relating to-- 7i7 expanding efforts1 as appropriate1 to implement evidence-based practices to address ,alzheimer's disease and related dementias1 including through the training of ,state1 local1 and tribal public health officials and other health professionals on such practices2 7ii7 supporting early detection and diagnosis of ,alzheimer's disease and related dementias2 7iii7 reducing the risk of potentially avoidable hospitalizations of individuals with ,alzheimer's disease and related dementias2 7iv7 reducing the risk of cognitive decline and cognitive impairment associated with ,alzheimer's disease and related dementias2 7v7 enhancing support to meet the needs of caregivers of individuals with ,alzheimer's disease and related dementias2 7vi7 reducing health disparities related to the care and support of individuals with ,alzheimer's disease and related dementias2 7vii7 supporting care planning and management for individuals with ,alzheimer's disease and related dementias2 and 7viii7 supporting other relevant activities identified by the ,secretary or the ,director of the ,centers for ,disease ,control and ,prevention1 as appropriate4 7#c7 ,considerations ,in awarding grants1 contracts1 and cooperative agreements under this subsection1 the ,secretary shall consider1 among other factors1 whether the entity-- 7,a7 provides services to rural areas or other underserved populations2 7,b7 is able to build on an existing infrastructure of services and public health research2 and 7,c7 has experience with providing care or caregiver support1 or has experience conducting research related to ,alzheimer's disease and related dementias4 7#d7 ,distribution of awards ,in awarding grants1 contracts1 or cooperative agreements under this subsection1 the ,secretary1 to the extent practicable1 shall ensure equitable distribution of awards based on geographic area1 including consideration of rural areas1 and the burden of the disease within sub-populations4 7#e7 ,data reporting and program oversight ,with respect to a grant1 contract1 or cooperative agreement awarded under this subsection1 not later than #ij days after the end of the first year of the period of assistance1 and annually thereafter for the duration of the grant1 contract1 or agreement 7including the duration of any renewal period as provided for under paragraph 7#e771 the entity shall submit data1 as appropriate1 to the ,secretary regarding-- 7,a7 the programs and activities funded under the grant1 contract1 or agreement2 and 7,b7 outcomes related to such programs and activities4 7b7 ,improving data on ,state and national prevalence of ,alzheimer's disease and related dementias 7#a7 ,in general ,the ,secretary shall1 as appropriate1 improve the analysis and timely reporting of data on the incidence and prevalence of ,alzheimer's disease and related dementias4 ,such data may include1 as appropriate1 information on cognitive decline1 caregiving1 and health disparities experienced by individuals with cognitive decline and their caregivers4 ,the ,secretary may award grants1 contracts1 or cooperative agreements to eligible entities for activities under this paragraph4 7#b7 ,eligibility ,to be eligible to receive a grant1 contract1 or cooperative agreement under this subsection1 an entity shall be a public or nonprofit private entity1 including institutions of higher education1 ,state1 local1 and tribal health departments1 and ,indian tribes and tribal organizations1 and submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#c7 ,data sources ,the analysis1 timely public reporting1 and dissemination of data under this subsection may be carried out using data sources such as the following3 7,a7 ,the ,behavioral ,risk ,factor ,surveillance ,system4 7,b7 ,the ,national ,health and ,nutrition ,examination ,survey4 7,c7 ,the ,national ,health ,interview ,survey4 7c7 ,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 ,services4 4 #c4 ,supporting state public health programs related to alzheimer's disease and related dementias ,section #cih of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;c-#c7 is amended-- 7#a7 in the section heading1 by striking ,establishment of program and inserting ,cooperative agreements to ,states and public health departments for ,alzheimer's disease and related dementias2 7#b7 by striking subsection 7a7 and inserting the following3 7a7 ,in general ,the ,secretary1 in coordination with the ,director of the ,centers for ,disease ,control and ,prevention and the heads of other agencies1 as appropriate1 shall award cooperative agreements to health departments of ,states1 political subdivisions of ,states1 and ,indian tribes and tribal organizations1 to address ,alzheimer's disease and related dementias1 including by reducing cognitive decline1 helping meet the needs of caregivers1 and addressing unique aspects of ,alzheimer's disease and related dementias to support the development and implementation of evidence-based interventions with respect to-- 7#a7 educating and informing the public1 based on evidence-based public health research and data1 about ,alzheimer's disease and related dementias2 7#b7 supporting early detection and diagnosis2 7#c7 reducing the risk of potentially avoidable hospitalizations for individuals with ,alzheimer's disease and related dementias2 7#d7 reducing the risk of cognitive decline and cognitive impairment associated with ,alzheimer's disease and related dementias2 7#e7 improving support to meet the needs of caregivers of individuals with ,alzheimer's disease and related dementias2 7#f7 supporting care planning and management for individuals with ,alzheimer's disease and related dementias4 7#g7 supporting other relevant activities identified by the ,secretary or the ,director of the ,centers for ,disease ,control and ,prevention1 as appropriate 42 and 7#c7 by striking subsection 7b72 7#d7 by redesignating subsection 7c7 as subsection 7g72 7#e7 by inserting after subsection 7a71 the following3 7b7 ,preference ,in awarding cooperative agreements under this section1 the ,secretary shall give preference to applications that focus on addressing health disparities1 including populations and geographic areas that have the highest prevalence of ,alzheimer's disease and related dementias4 7c7 ,eligibility ,to be eligible to receive a cooperative agreement under this section1 an eligible entity 7pursuant to subsection 7a77 shall prepare and submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including a plan that describes-- 7#a7 how the applicant proposes to develop or expand1 programs to educate individuals through partnership engagement1 workforce development1 guidance and support for programmatic efforts1 and evaluation with respect to ,alzheimer's disease and related dementias1 and in the case of a cooperative agreement under this section1 how the applicant proposes to support other relevant activities identified by the ,secretary or ,director of the ,centers for ,disease ,control and ,prevention1 as appropriate4 7#b7 the manner in which the applicant will coordinate with ,federal1 tribal1 and ,state programs related to ,alzheimer's disease and related dementias1 and appropriate ,state1 tribal1 and local agencies1 as well as other relevant public and private organizations or agencies2 and 7#c7 the manner in which the applicant will evaluate the effectiveness of any program carried out under the cooperative agreement4 7d7 ,matching requirement ,each health department that is awarded a cooperative agreement under subsection 7a7 shall provide1 from non-,federal sources1 an amount equal to #cj percent of the amount provided under such agreement 7which may be provided in cash or in-kind7 to carry out the activities supported by the cooperative agreement4 7e7 ,waiver authority ,the ,secretary may waive all or part of the matching requirement described in subsection 7d7 for any fiscal year for a health department of a ,state1 political subdivision of a ,state1 or ,indian tribe and tribal organization 7including those located in a rural area or frontier area71 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 ,state1 political subdivision of a ,state1 or ,indian tribe and tribal organization4 2 7#f7 in subsection 7f7 7as so redesignated71 by striking grant and inserting cooperative agreement2 and 7#g7 by adding at the end the following3 7f7 ,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-- 7#a7 activities of centers of excellence with respect to ,alzheimer's disease and related dementias described in section #cih;,a2 and 7#b7 activities of public health departments with respect to ,alzheimer's disease and related dementias described in this section4 4 #d4 ,additional provisions ,section #cih;,b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;c-#e7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by inserting or cooperative agreement after grant each place that such appears2 7,b7 by striking section #cih7;a7 to a ,state unless the ,state and inserting sections #cih or #cih;,a to an entity unless the entity2 and 7,c7 by striking #aj and inserting #e2 7#b7 by striking subsection 7b72 7#c7 by redesignating subsections 7c7 and 7d7 as subsections 7b7 and 7c71 respectively2 7#d7 in subsection 7b7 7as so redesignated7-- 7,a7 in the matter preceding paragraph 7#a71 by striking section #cih7;a7 to a ,state unless the ,state and inserting sections #cih or #cih;,a to an entity unless the entity2 7,b7 in paragraph 7#a71 by striking expenditures required in subsection 7b72 and inserting expenditures22 7#e7 in subsection 7c7 7as so redesignated7-- 7,a7 in paragraph 7#a7-- 7i7 by striking each demonstration project for which a grant and inserting the activities for which an award2 and 7ii7 by striking section #cih7;a7 and inserting sections #cih or #cih;,a2 and 7,b7 in paragraph 7#b71 by striking #f months and inserting #a year2 7#f7 by inserting after subsection 7c7 7as so redesignated71 the following3 7d7 ,definition ,in this subpart1 the terms #8,indian tribe' and #8tribal organization' have the meanings given such terms in section #d of the ,indian ,health ,care ,improvement ,act4 2 and 7#g7 in subsection 7e71 by striking #e1jjj1jjj for each of the fiscal years #aihh through #aiij and all that follows through #bjjb and inserting #bj1jjj1jjj for each of fiscal years #bjbj through #bjbd4 ,passed the ,senate ,december #ab1 #bjah4,secretary