,,ii ,cal5d> ,no4 #fid #aae? ,,congress 
#b;d ,session  ,s4 #bjgf  ,,9 ,,!       
,,s5ate ,,( ,,! ,,unit$ ,,/ates         
,novemb] #f1 #bjag,ms4 ,coll9s 7=       
h]self1 ,ms4 ,cortez ,ma/o1 ,mrs4       
,capito1 ,mr4 ,ka9e1 ,mr4 ,coons1 ,mr4  
,wick]1 ,mr4 ,m>key1 ,ms4 ,/ab5[1 ,mr4  
,k+1 ,ms4 ,w>r51 ,mr4 ,crapo1 ,mr4 ,"y1 
,mr4 ,ris*1 ,mr4 ,van ,holl51 ,mr4      
,moran1 ,mr4 ,blum5?al1 ,mr4 ,inh(e1    
,mr4 ,boozman1 ,mr4 ,r\nds1 ,mr4 ,s&]s1 
,mr4 ,b>rasso1 ,mrs4 ,%ahe51 ,mr4       
,g>dn]1 ,ms4 ,heitkamp1 ,mr4 ,casey1    
,mr4 ,k5n$y1 ,ms4 ,klobu*>1 ,mr4        
,nelson1 ,mr4 ,murphy1 ,mr4 ,cassidy1   
,mr4 ,tillis1 ,ms4 ,hassan1 ,ms4 ,smi?1 
,mrs4 ,fis*]1 ,ms4 ,murk[ski1 ,ms4      
,hirono1 ,mr4 ,donnelly1 ,mrs4          
,gillibr&1 ,mr4 ,b5net1 ,mr4 ,jones1    
,ms4 ,baldw91 ,mr4 ,m]kley1 ,mr4        
,:iteh\se1 ,mr4 ,pet]s1 ,mrs4           
,hyde-,smi?1 ,mr4 ,te/]1 ,mr4 ,m55dez1  
,mrs4 ,fe9/e91 ,mr4 ,sullivan1 ,mr4     
,wyd51 ,mr4 ,rob]ts1 ,mr4 ,he9ri*1 ,mr4 
,re$1 ,mr4 ,book]1 ,mr4 ,br[n1 & ,ms4   

,h>ris7 introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,novemb] #bi1 #bjah,report$ by ,mr4     
,alex&]1 ) an amendment,strike out all  
aft] ! enact+ clause & ins]t ! "p pr9t$ 
9 italic  ,a ,,bill  ,to am5d ! ,public 
,heal? ,s]vice ,act to au?orize !       
expansion ( activities relat$ to        
,alzheim]'s disease1 cognitive decl9e1 &
 bra9 heal? "u ! ,alzheim]'s ,disease & 
,heal?y ,ag+ ,program1 & = o!r purposes4
  #a4 ,%ort title ,?is ,act may be cit$ 
z ! ,build+ ,our ,l>ge/ ,dem5tia        
,infra/ructure = ,alzheim]'s ,act or !  
,,bold ,infra/ructure = ,alzheim]'s     
,act4  #b4 ,f9d+s ,congress f9ds z      
foll[s3  7#a7 ,accord+ to =m] ,surgeon  
,g5]al & ,director ( ! ,c5t]s = ,disease
 ,control & ,prev5tion1 ,dr4 ,david     
,sat*]1 ,alzheim]'s is ! mo/            
"u-recogniz$ ?reat to public heal? 9 !  
#ba/ c5tury44  7#b7 ,dea?s f ,alzheim]'s
 disease increas$ #ee p]c5t betwe5 #aiii
 & #bjad 9 ! ,unit$ ,/ates1 accord+ to  

data f ! ,c5t]s = ,disease ,control &   
,prev5tion4  7#c7 ,m ?an #e1jjj1jjj p 9 
! ,unit$ ,/ates are liv+ ) ,alzheim]'s  
disease &1 )\t significant ef=ts to     
*ange ! curr5t trajectory1 z _m z       
#af1jjj1jjj p 9 ! ,unit$ ,/ates w h     
,alzheim]'s disease by #bjej4 ,?is      
explosive gr[? w cause co/s associat$ ) 
,alzheim]'s disease to increase f an    
e/imat$ #bei1jjj1jjj1jjj 9 #bjag to m   
?an #a1ajj1jjj1jjj1jjj 9 #bjej 79 #bjag 
doll>s74  7#d7 ,among individuals liv+ )
 ,alzheim]'s disease & o!r dem5tias1    
evid5ce indicates z _m z #ej p]c5t h n  
be5 diagnos$4 ,among individuals        
diagnos$ ) ,alzheim]'s disease1 only #cc
 p]c5t are aw>e ( ! diagnosis4 ,e>ly    
detection & diagnosis ( ,alzheim]'s     
disease & o!r dem5tias all[ p to access 
available treatm5ts1 build a c>e team1  
p>ticipate 9 support s]vices1 & enroll 9
 cl9ical trials4 ,e>ly detection c help 
physicians bett] manage a pati5t's      
comorbid conditions & avoid prescrib+   
m$ications t may wors5 cognition or     

function4  7#e7 ,among individuals liv+ 
) ,alzheim]'s disease & o!r dem5tias1   
#be4c p]c5t exp]i5ce a prev5table       
hospitalization1 & su* prev5table       
hospitalizations co/ ! ,m$ic>e program  
ne>ly #b1fjj1jjj1jjj 9 #bjac4  7#f7     
,african ,am]icans are ab\t #b times m  
likely ?an ,:ite ,am]icans to h         
,alzheim]'s disease & o!r dem5tias4     
,hispanics are ab\t "o & "o-half times m
 likely ?an ,:ite ,am]icans to h        
,alzheim]'s disease & o!r dem5tias4     
7#g7 ,9 #bjaf1 #ae1ijj1jjj family memb]s
 & fri5ds provid$ #ah1bjj1jjj1jjj h\rs (
 unpaid c>e to individuals ) ,alzheim]'s
 disease & o!r dem5tias1 at an economic 
value ( ov] #bcj1jjj1jjj1jjj4 ,!        
physical & emotional impact ( c>egiv+ ( 
individuals ) ,alzheim]'s disease & o!r 
dem5tia result$ 9 an e/imat$            
#aj1ijj1jjj1jjj 9 increas$ c>egiv] heal?
 co/s 9 #bjaf4  7#h7 ,/rategy #d4;,b ( !
 ,national ,plan to ,address ,alzheim]'s
 ,disease3 #bjag ,update ( ! ,(fice ( ! 
,assi/ant ,secret>y = ,plann+ &         

,evaluation ( ! ,dep>tm5t ( ,heal? &    
,human ,s]vices is to "w ) ,/ate1       
,tribal1 & local gov]nm5ts to improve   
coord9ation & id5tify model initiatives 
to advance ,alzheim]'s disease aw>5ess &
 read9ess across ! ,gov]nm5t44  #c4     
,promotion ( public heal? k & aw>5ess ( 
,alzheim]'s disease1 cognitive decl9e1 &
 bra9 heal? "u ! ,alzheim]'s ,disease & 
,heal?y ,ag+ ,program ,"p ,p ( title    
,,iii ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #bhj;g et seq47 is am5d$ 
by add+ at ! end ! foll[+3  #cii,v-#g4  
,promotion ( public heal? k & aw>5ess ( 
,alzheim]'s disease1 cognitive decl9e1 &
 bra9 heal? "u ! ,alzheim]'s ,disease & 
,heal?y ,ag+ ,program  7a7 ,def9itions  
,9 ! section3 7#a7 ,alzheim]'s disease  
,! t]m ,alzheim]'s disease means        
,alzheim]'s disease & relat$ dem5tias4  
7#b7 ,indian tribe2 tribal organization 
,! t]ms ,indian tribe & tribal          
organization h ! mean+s giv5 su* t]ms 9 
section #d ( ! ,indian ,heal? ,c>e      
,improvem5t ,act4  7b7 ,expansion (     

activities "u ! ,alzheim]'s ,disease &  
,heal?y ,ag+ ,program ,9 addition to    
activities conduct$ by ! ,secret>y "u ! 
,alzheim]'s ,disease & ,heal?y ,ag+     
,program ( ! ,c5t]s = ,disease ,control 
& ,prev5tion1 ! ,secret>y1 act+ ?r\gh ! 
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 subject to appropriations
 "u subsection 7g71 %all aw>d coop]ative
 agreem5ts "u subsections 7c71 7d71 &   
7e74  7c7 ,c5t]s ( excell5ce 9 public   
heal? practice  7#a7 ,9 g5]al ,!        
,secret>y %all aw>d coop]ative agreem5ts
 to eligible entities = ! e/abli%m5t or 
support ( national or regional c5t]s (  
excell5ce 9 public heal? practice 9     
,alzheim]'s disease to--  7,a7 advance !
 education ( public heal? (ficials (    
,/ates1 ( political subdivisions (      
,/ates1 & ( ,indian tribes or tribal    
organizations1 heal? c>e pr(essionals1 &
 ! public on ,alzheim]'s disease1       
cognitive decl9e1 bra9 heal?1 &         
associat$ heal? disp>ities2  7,b7       
advance ! ef=ts ( public heal? (ficials 

ref]r$ to 9 subp>agraph 7,a7 9 apply+   
evid5ce-bas$ sy/ems *ange1              
communications1 & programmatic          
int]v5tions = populations ) cognitive   
impairm5t1 includ+ ,alzheim]'s disease1 
& c>egiv]s = su* populations2 &  7,c7   
exp& public-private p>tn]%ips engag$ 9  
activities relat$ to cognitive impairm5t
 & associat$ heal? disp>ities )         
demon/rat$ success or innovative        
programs 7z det]m9$ by ! ,secret>y74    
7#b7 ,requirem5ts ,to be eligible to    
receive a coop]ative agreem5t "u ?is    
subsection1 an entity %all submit to !  
,secret>y an application conta9+ su*    
agreem5ts & in=mation z ! ,secret>y may 
require1 includ+ an agreem5t t ! c5t] to
 be e/abli%$ or support$ "u ! coop]ative
 agreem5t w op]ate 9 accordance ) !     
foll[+3  7,a7 ,! c5t] w exam9e1         
evaluate1 increase1 & promote           
evid5ce-bas$ & effective ,alzheim]'s    
disease & c>egiv+-relat$ int]v5tions =  
heal? & social s]vices pr(essionals1    
und]s]v$ populations1 families1 & !     

public1 aft] consultation ) relevant    
,/ate & local public heal? (ficials1    
private-sector ,alzheim]'s disease      
rese>*]s1 & advocates = individuals )   
,alzheim]'s disease4  7,b7 ,! c5t] w    
prioritize its activities on ! foll[+3  
7i7 ,exp&+ ef=ts to educate ,/ate1      
local1 & tribal (ficials & public heal? 
pr(essionals 9 apply+ e/abli%$ data &   
evid5ce-bas$ be/ practices to address   
,alzheim]'s disease4  7ii7 ,support+    
public heal? (ficials ( ,/ates1 (       
political subdivisions ( ,/ates1 & (    
,indian tribes or tribal organizations 9
 implem5t+ ! mo/ curr5t v]sion ( !      
,heal?y ,bra9 ,initiative3 ,public      
,heal? ,road ,map ( ! ,c5t]s = ,disease 
,control & ,prev5tion4  7iii7 ,support+ 
e>ly detection & diagnosis ( ,alzheim]'s
 disease4  7iv7 ,r$uc+ ! risk (         
pot5tially avoidable hospitalizations ( 
individuals ) ,alzheim]'s disease4  7v7 
,r$uc+ ! risk ( cognitive decl9e &      
cognitive impairm5t1 includ+ ,alzheim]'s
 disease4  7vi7 ,enhanc+ support to meet

 ! ne$s ( c>egiv]s ( individuals )      
,alzheim]'s disease4  7vii7 ,r$uc+ heal?
 disp>ities relat$ to ! c>e & support ( 
individuals ) cognitive decl9e &        
,alzheim]'s disease4  7viii7 ,support+  
c>e plann+ & managem5t = individuals )  
,alzheim]'s disease4  7#c7              
,consid]ations ,9 aw>d+ coop]ative      
agreem5ts "u ?is subsection1 ! ,secret>y
 %all consid]1 among o!r factors1 :e!r !
 entity--  7,a7 has access to rural     
areas or o!r und]s]v$ populations2  7,b7
 is locat$ 9 an area :]e ! aggregate    
success rate = applications = ,national 
,in/itutes ( ,heal? fund+ has be5       
hi/orically l[2  7,c7 is able to build  
on an exi/+ infra/ructure ( s]vice &    
public heal? rese>*2  7,d7 has exp]i5ce 
) provid+ c>e1 c>egiv] support1 & rese>*
 relat$ to ,alzheim]'s disease2 &  7,e7 
is integrat$ into exi/+ local gov]nm5t &
 public heal? infra/ructures4  7#d7     
,di/ribution ( aw>ds ,9 aw>d+ coop]ative
 agreem5ts "u ?is subsection1 !         
,secret>y1 to ! ext5t practicable1 %all 

ensure equitable di/ribution ( aw>ds    
bas$ on geographic area1 includ+        
consid]ation ( rural areas1 & ! burd5 ( 
! disease on sub-populations4  7d7      
,coop]ative agreem5ts to public heal?   
dep>tm5ts  7#a7 ,9 g5]al ,! ,secret>y   
%all aw>d coop]ative agreem5ts to heal? 
dep>tm5ts ( ,/ates1 ( political         
subdivisions ( ,/ates1 & ( ,indian      
tribes & tribal organizations to promote
 cognitive function+1 address cognitive 
impairm5t = individuals liv+ 9 su*      
communities1 help meet ! ne$s (         
c>egiv]s1 & address unique aspects (    
,alzheim]'s disease1 z foll[s3  7,a7 ,! 
,secret>y %all aw>d core capacity       
coop]ative agreem5ts to su* heal?       
dep>tm5ts to support ! developm5t &     
implem5tation ( sy/ems *ange1           
communications1 & programmatic          
int]v5tions ) respect to ,alzheim]'s    
disease1 includ+ activities involv+--   
7i7 educat+ & in=m+ ! public bas$ on    
e/abli%$ public heal? rese>* & data2    
7ii7 support+ e>ly detection &          

diagnosis2  7iii7 r$uc+ ! risk (        
pot5tially avoidable hospitalizations2  
7iv7 r$uc+ ! risk ( cognitive decl9e &  
cognitive impairm5t2  7v7 enhanc+       
support to meet ! ne$s ( c>egiv]s2  7vi7
 support+ c>e plann+ & managem5t2 or    
7vii7 support+ ! actions set =? 9 ! mo/ 
curr5t v]sion ( ! ,heal?y ,bra9         
,initiative3 ,public ,heal? ,road ,map (
 ! ,c5t]s = ,disease ,control &         
,prev5tion4  7,b7 ,! ,secret>y %all aw>d
 n less ?an #e enhanc$ activity         
coop]ative agreem5ts to su* heal?       
dep>tm5ts to c>ry out activities relat$ 
to ,alzheim]'s disease1 includ+ ?r\gh   
public-private p>tn]%ips ) organizations
 or o!r ag5cies1 su* z l>ge employ]s1   
public h\s+ ag5cies1 l>ge heal? c>e     
sy/ems1 & p>ks & recreation dep>tm5ts1 t
 include--  7i7 exp&+ implem5tation (   
programs describ$ 9 p>agraph 7#b77;,a7  
to rea* l>g] segm5ts ( ! population2 &  
7ii7 implem5t+ ! reports describ$ 9     
subp>agraph 7,a77vii74  7#b7 ,o!r       
consid]ations  7,a7 ,pref]5ce ,9 aw>d+  

coop]ative agreem5ts "u p>agraph 7#a71 !
 ,secret>y %all give pref]5ce to        
applications t focus on address+ heal?  
disp>ities1 includ+ populations &       
geographic areas t are mo/ 9 ne$ (      
int]v5tion4  7,b7 ,cl>ification on      
enhanc$ activity coop]ative agreem5ts   
,if ! ,secret>y is unable to id5tify #e 
eligible heal? dep>tm5ts to receive a   
coop]ative agreem5t "u p>agraph         
7#a77;,b71 ! ,secret>y %all allocate any
 am\nts res]v$ = su* agreem5ts to       
additional coop]ative agreem5ts "u      
p>agraph 7#a77;,a74  7#c7 ,eligibility  
,to be eligible to receive a coop]ative 
agreem5t "u p>agraph 7#a71 a ,/ate1     
political subdivision ( a ,/ate1 ,indian
 tribe1 or tribal organization %all     
prep>e & submit to ! ,secret>y an       
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
require1 includ+ a plan t describes--   
7,a7 h[ ! applicant proposes to develop 
or exp&1 programs to educate individuals
 ?r\gh p>tn]%ip engagem5t1 work=ce      

developm5t1 guidance & support =        
programmatic ef=ts1 /rategic            
communication1 & evaluation ) respect to
 ,alzheim]'s disease1 & 9 ! case ( a    
coop]ative agreem5t "u p>agraph         
7#a77;,b71 h[ ! applicant proposes to   
implem5t ! mo/ curr5t v]sion ( ! ,heal?y
 ,bra9 ,initiative3 ,public ,heal? ,road
 ,map ( ! ,c5t]s = ,disease ,control &  
,prev5tion2  7,b7 ! mann] 9 :i* !       
applicant w coord9ate ) appropriate     
,/ate & local au?orities z well z1 9 !  
case ( a coop]ative agreem5t "u p>agraph
 7#a77;,b71 relevant public & private   
organizations or ag5cies2 &  7,c7 !     
mann] 9 :i* ! applicant w evaluate !    
effectiv5ess ( any program c>ri$ out "u 
! coop]ative agreem5t4  7#d7 ,use (     
funds ,a heal? dep>tm5t aw>d$ a         
coop]ative agreem5t "u p>agraph 7#a7    
%all use am\nts receiv$ "u su*          
coop]ative agreem5t to--  7,a7 develop1 
implem5t1 dissem9ate1 evaluate1 & if    
applicable1 exp& programs to educate    
individuals on matt]s relat$ to         

,alzheim]'s disease describ$ 9 p>agraph 
7#a77;,a72 &  7,b7 9 ! case ( a         
coop]ative agreem5t "u p>agraph         
7#a77;,b71 implem5t ! mo/ curr5t v]sion 
( ! ,heal?y ,bra9 ,initiative3 ,public  
,heal? ,road ,map ( ! ,c5t]s = ,disease 
,control & ,prev5tion & evaluate its    
implem5tation4  7#e7 ,mat*+ requirem5t  
7,a7 ,9 g5]al ,except z may be provid$ 9
 subp>agraph 7,b71 ea* heal? dep>tm5t t 
is aw>d$ a coop]ative agreem5t "u       
p>agraph 7#a7 %all provide1 f non-,f$]al
 s\rces1 an am\nt equal to #ae p]c5t ( !
 am\nt provid$ "u su* agreem5t 7:i* may 
be provid$ 9 ca% or 9-k9d7 to c>ry out !
 activities support$ by ! coop]ative    
agreem5t4  7,b7 ,waiv] au?ority ,!      
,secret>y may waive all or "p ( ! mat*+ 
requirem5t describ$ 9 subp>agraph 7,a7 =
 any fiscal ye> =--  7i7 a heal?        
dep>tm5t1 if ! ,secret>y det]m9es t     
apply+ su* mat*+ requirem5t to ! heal?  
dep>tm5t w\ld result 9 s]i\s h>d%ip or  
an inability to c>ry out ! purposes ( ! 
coop]ative agreem5t aw>d$ to su* heal?  

dep>tm5t2 or  7ii7 a rural or fronti]   
region4  7e7 ,coop]ative agreem5ts =    
analysis & report+ ( data reg>d+        
cognitive decl9e & c>egiv+  7#a7 ,9     
g5]al ,! ,secret>y may aw>d coop]ative  
agreem5ts to eligible entities = !      
foll[+ activities3  7,a7 ,! analysis &  
timely public report+ ( data on ! ,/ate 
& national levels reg>d+ cognitive      
decl9e1 includ+ ,alzheim]'s disease1    
c>egiv+1 & heal? disp>ities exp]i5c$ by 
individuals ) cognitive decl9e & _!     
c>egiv]s4  7,b7 ,! monitor+ ( objectives
 on dem5tia1 includ+ ,alzheim]'s        
disease1 & c>egiv+ 9 ! program ( !      
,secret>y reg>d+ heal?-/atus goals =    
#bjbj 7commonly ref]r$ to z ! ,heal?y ,p
 #bjbj report71 & ! developm5t &        
monitor+ ( su* objectives 9 future      
,heal?y ,p reports ( ! ,dep>tm5t (      
,heal? & ,human ,s]vices4  7#b7         
,eligibility ,to be eligible to receive 
a coop]ative agreem5t "u ?is subsection1
 an entity %all be a public or nonpr(it 
private entity1 includ+ in/itutions (   

high] education1 & submit to ! ,secret>y
 an application at su* "t1 9 su* mann]1 
& conta9+ su* in=mation z ! ,secret>y   
may require4  7#c7 ,surveillance ,!     
analysis1 timely public report+1 &      
dissem9ation ( data reg>d+ cognitive    
decl9e1 cognitive impairm5t1 c>egiv+1 & 
heal? disp>ities on ! ,/ate & national  
levels "u a coop]ative agreem5t "u ?is  
subsection may be c>ri$ out by eligible 
entities us+ data s\rces su* z ! foll[+3
  7,a7 ,! ,behavioral ,risk ,factor     
,surveillance ,sy/em4  7,b7 ,! ,national
 ,heal? & ,nutrition ,exam9ation        
,survey4  7,c7 ,! ,national ,heal?      
,int]view ,survey4  7f7 ,data collection
 ,! ,secret>y %all collect data on      
cognitive decl9e1 cognitive impairm5t1  
c>egiv+1 & heal? disp>ities on ! ,/ate &
 national levels1 us+ ! surveillance    
sy/ems describ$ 9 subp>agraphs 7,a7     
?r\gh 7,c7 ( subsection 7e77#c74  7g7   
,nonduplication ( ef=t ,! ,secret>y %all
 ensure t activities "u any coop]ative  
agreem5t aw>d$ "u ?is section d n       

unnecess>ily duplicate ef=ts ( o!r      
ag5cies & (fices )9 ! ,dep>tm5t ( ,heal?
 & ,human ,s]vices relat$ to--  7#a7    
activities ( c5t]s ( excell5ce 9 public 
heal? practice ) respect to ,alzheim]'s 
disease describ$ 9 subsection 7c72  7#b7
 activities ( public heal? dep>tm5ts )  
respect to ,alzheim]'s disease describ$ 
9 subsection 7d72 or  7#c7 ! analysis & 
public report+ ( surveillance data on   
cognitive decl9e1 c>egiv+1 & heal?      
disp>ities ( individuals ) ,alzheim]'s  
disease "u subsection 7e74  7h7         
,au?orization ( appropriations ,= ea* ( 
fiscal ye>s #bjah ?r\gh #bjbe1 !re are  
au?oriz$ to be appropriat$ #ab1jjj1jjj =
 purposes ( c>ry+ out subsection 7c71   
#bj1jjj1jjj = purposes ( c>ry+ out      
subsection 7d71 & #e1jjj1jjj = purposes 
( c>ry+ out subsections 7e7 & 7f74      
,funds appropriat$ "u ?is subsection    
%all rema9 available until exp5d$4  4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,build+ ,our ,l>ge/ ,dem5tia          
,infra/ructure = ,alzheim]'s ,act or !  

,,bold ,infra/ructure = ,alzheim]'s     
,act4  #b4 ,promotion ( public heal? k &
 aw>5ess ( ,alzheim]'s disease1         
cognitive decl9e1 & bra9 heal? "u !     
,alzheim]'s ,disease & ,heal?y ,ag+     
,program ,"p ,k ( title ,,iii ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bhj;c et seq47 is am5d$--    
7#a7 9 ! "p head+1 by add+ ,,& ,,public 
,,heal? ,,programs ,,= ,,dem5tia at !   
end2 &  7#b7 9 subp>t ,,ii--  7,a7 by   
/rik+ ! subp>t head+ & ins]t+ ! foll[+3 
,,ii ,programs ,) ,respect to           
,alzheim]'s ,disease & ,relat$ ,dem5tias
  2 &  7,b7 by /rik+ section #cih;,a    
7#db ,u4,s4,c4 #bhj;c-#d7 & ins]t+ !    
foll[+3  #cih;,a4 ,promotion ( public   
heal? k & aw>5ess ( ,alzheim]'s disease 
& relat$ dem5tias  7a7 ,alzheim]'s      
,disease & ,relat$ ,dem5tias ,public    
,heal? ,c5t]s ( ,excell5ce  7#a7 ,9     
g5]al ,! ,secret>y1 9 coord9ation ) !   
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion & ! heads ( o!r ag5cies z 
appropriate1 %all aw>d grants1          

contracts1 or coop]ative agreem5ts to   
eligible entities1 su* z in/itutions (  
high] education1 ,/ate1 tribal1 & local 
heal? dep>tm5ts1 ,indian tribes1 tribal 
organizations1 associations1 or o!r     
appropriate entities = ! e/abli%m5t or  
support ( regional c5t]s to address     
,alzheim]'s disease & relat$ dem5tias   
by--  7,a7 advanc+ ! aw>5ess ( public   
heal? (ficials1 heal? c>e pr(essionals1 
& ! public1 on ! mo/ curr5t in=mation & 
rese>* relat$ to ,alzheim]'s disease &  
relat$ dem5tias1 includ+ cognitive      
decl9e1 bra9 heal?1 & associat$ heal?   
disp>ities2  7,b7 id5tify+ & translat+  
promis+ rese>* f9d+s1 su* z f9d+s f     
rese>* & activities conduct$ or support$
 by ! ,national ,in/itutes ( ,heal?1    
includ+ ,alzheim]'s ,disease ,rese>*    
,c5t]s au?oriz$ by section #dde1 into   
evid5ce-bas$ programmatic int]v5tions = 
populations ) ,alzheim]'s disease &     
relat$ dem5tias & c>egiv]s = su*        
populations2 &  7,c7 exp&+ activities1  
includ+ ?r\gh public-private p>tn]%ips  

relat$ to ,alzheim]'s disease & relat$  
dem5tias & associat$ heal? disp>ities4  
7#b7 ,requirem5ts ,to be eligible to    
receive a grant1 contract1 or coop]ative
 agreem5t "u ?is subsection1 an entity  
%all submit to ! ,secret>y an           
application conta9+ su* agreem5ts &     
in=mation z ! ,secret>y may require1    
includ+ a description ( h[ ! entity w-- 
7,a7 coord9ate1 z applicable1 ) exi/+   
,f$]al1 ,/ate1 & tribal programs relat$ 
to ,alzheim]'s disease & relat$         
dem5tias2  7,b7 exam9e1 evaluate1 &     
promote evid5ce-bas$ int]v5tions =      
individuals ) ,alzheim]'s disease &     
relat$ dem5tias1 includ+ und]s]v$       
populations ) su* conditions1 & ^? :o   
provide c>e = su* individuals2 &  7,c7  
prioritize activities relat+ to-- 7i7   
exp&+ ef=ts1 z appropriate1 to implem5t 
evid5ce-bas$ practices to address       
,alzheim]'s disease & relat$ dem5tias1  
includ+ ?r\gh ! tra9+ ( ,/ate1 local1 & 
tribal public heal? (ficials & o!r heal?
 pr(essionals on su* practices2  7ii7   

support+ e>ly detection & diagnosis (   
,alzheim]'s disease & relat$ dem5tias2  
7iii7 r$uc+ ! risk ( pot5tially         
avoidable hospitalizations ( individuals
 ) ,alzheim]'s disease & relat$         
dem5tias2  7iv7 r$uc+ ! risk ( cognitive
 decl9e & cognitive impairm5t associat$ 
) ,alzheim]'s disease & relat$ dem5tias2
  7v7 enhanc+ support to meet ! ne$s (  
c>egiv]s ( individuals ) ,alzheim]'s    
disease & relat$ dem5tias2  7vi7 r$uc+  
heal? disp>ities relat$ to ! c>e &      
support ( individuals ) ,alzheim]'s     
disease & relat$ dem5tias2  7vii7       
support+ c>e plann+ & managem5t =       
individuals ) ,alzheim]'s disease &     
relat$ dem5tias2 &  7viii7 support+ o!r 
relevant activities id5tifi$ by !       
,secret>y or ! ,director ( ! ,c5t]s =   
,disease ,control & ,prev5tion1 z       
appropriate4  7#c7 ,consid]ations ,9    
aw>d+ grants1 contracts1 & coop]ative   
agreem5ts "u ?is subsection1 ! ,secret>y
 %all consid]1 among o!r factors1 :e!r !
 entity--  7,a7 provides s]vices to     

rural areas or o!r und]s]v$ populations2
  7,b7 is able to build on an exi/+     
infra/ructure ( s]vices & public heal?  
rese>*2 &  7,c7 has exp]i5ce ) provid+  
c>e or c>egiv] support1 or has exp]i5ce 
conduct+ rese>* relat$ to ,alzheim]'s   
disease & relat$ dem5tias4  7#d7        
,di/ribution ( aw>ds ,9 aw>d+ grants1   
contracts1 or coop]ative agreem5ts "u   
?is subsection1 ! ,secret>y1 to ! ext5t 
practicable1 %all ensure equitable      
di/ribution ( aw>ds bas$ on geographic  
area1 includ+ consid]ation ( rural      
areas1 & ! burd5 ( ! disease )9         
sub-populations4  7#e7 ,data report+ &  
program ov]sight ,) respect to a grant1 
contract1 or coop]ative agreem5t aw>d$  
"u ?is subsection1 n lat] ?an #ij days  
aft] ! end ( ! fir/ ye> ( ! p]iod (     
assi/ance1 & annually !reaft] = !       
duration ( ! grant1 contract1 or        
agreem5t 7includ+ ! duration ( any      
r5ewal p]iod z provid$ = "u p>agraph    
7#e771 ! entity %all submit data1 z     
appropriate1 to ! ,secret>y reg>d+--    

7,a7 ! programs & activities fund$ "u ! 
grant1 contract1 or agreem5t2 &  7,b7   
outcomes relat$ to su* programs &       
activities4  7b7 ,improv+ data on ,/ate 
& national preval5ce ( ,alzheim]'s      
disease & relat$ dem5tias  7#a7 ,9 g5]al
 ,! ,secret>y %all1 z appropriate1      
improve ! analysis & timely report+ (   
data on ! incid5ce & preval5ce (        
,alzheim]'s disease & relat$ dem5tias4  
,su* data may include1 z appropriate1   
in=mation on cognitive decl9e1 c>egiv+1 
& heal? disp>ities exp]i5c$ by          
individuals ) cognitive decl9e & _!     
c>egiv]s4 ,! ,secret>y may aw>d grants1 
contracts1 or coop]ative agreem5ts to   
eligible entities = activities "u ?is   
p>agraph4  7#b7 ,eligibility ,to be     
eligible to receive a grant1 contract1  
or coop]ative agreem5t "u ?is           
subsection1 an entity %all be a public  
or nonpr(it private entity1 includ+     
in/itutions ( high] education1 ,/ate1   
local1 & tribal heal? dep>tm5ts1 &      
,indian tribes & tribal organizations1 &

 submit to ! ,secret>y an application at
 su* "t1 9 su* mann]1 & conta9+ su*     
in=mation z ! ,secret>y may require4    
7#c7 ,data s\rces ,! analysis1 timely   
public report+1 & dissem9ation ( data "u
 ?is subsection may be c>ri$ out us+    
data s\rces su* z ! foll[+3  7,a7 ,!    
,behavioral ,risk ,factor ,surveillance 
,sy/em4  7,b7 ,! ,national ,heal? &     
,nutrition ,exam9ation ,survey4  7,c7 ,!
 ,national ,heal? ,int]view ,survey4    
7c7 ,improv$ coord9ation ,! ,secret>y   
%all ensure t activities & programs     
relat$ to dem5tia "u ?is section d n    
unnecess>ily duplicate activities &     
programs ( o!r ag5cies & (fices )9 !    
,dep>tm5t ( ,heal? & ,human ,s]vices4  4
  #c4 ,support+ /ate public heal?       
programs relat$ to alzheim]'s disease & 
relat$ dem5tias ,section #cih ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bhj;c-#c7 is am5d$-- 7#a7 9 !
 section head+1 by /rik+ ,e/abli%m5t (  
program & ins]t+ ,coop]ative agreem5ts  
to ,/ates & public heal? dep>tm5ts =    

,alzheim]'s disease & relat$ dem5tias2  
7#b7 by /rik+ subsection 7a7 & ins]t+ ! 
foll[+3  7a7 ,9 g5]al ,! ,secret>y1 9   
coord9ation ) ! ,director ( ! ,c5t]s =  
,disease ,control & ,prev5tion & ! heads
 ( o!r ag5cies1 z appropriate1 %all aw>d
 coop]ative agreem5ts to heal? dep>tm5ts
 ( ,/ates1 political subdivisions (     
,/ates1 & ,indian tribes & tribal       
organizations1 to address ,alzheim]'s   
disease & relat$ dem5tias1 includ+ by   
r$uc+ cognitive decl9e1 help+ meet !    
ne$s ( c>egiv]s1 & address+ unique      
aspects ( ,alzheim]'s disease & relat$  
dem5tias to support ! developm5t &      
implem5tation ( evid5ce-bas$ int]v5tions
 ) respect to--  7#a7 educat+ & in=m+ ! 
public1 bas$ on evid5ce-bas$ public     
heal? rese>* & data1 ab\t ,alzheim]'s   
disease & relat$ dem5tias2  7#b7        
support+ e>ly detection & diagnosis2    
7#c7 r$uc+ ! risk ( pot5tially avoidable
 hospitalizations = individuals )       
,alzheim]'s disease & relat$ dem5tias2  
7#d7 r$uc+ ! risk ( cognitive decl9e &  

cognitive impairm5t associat$ )         
,alzheim]'s disease & relat$ dem5tias2  
7#e7 improv+ support to meet ! ne$s (   
c>egiv]s ( individuals ) ,alzheim]'s    
disease & relat$ dem5tias2  7#f7        
support+ c>e plann+ & managem5t =       
individuals ) ,alzheim]'s disease &     
relat$ dem5tias4  7#g7 support+ o!r     
relevant activities id5tifi$ by !       
,secret>y or ! ,director ( ! ,c5t]s =   
,disease ,control & ,prev5tion1 z       
appropriate  42 &  7#c7 by /rik+        
subsection 7b72  7#d7 by r$esignat+     
subsection 7c7 z subsection 7g72  7#e7  
by ins]t+ aft] subsection 7a71 ! foll[+3
  7b7 ,pref]5ce ,9 aw>d+ coop]ative     
agreem5ts "u ?is section1 ! ,secret>y   
%all give pref]5ce to applications t    
focus on address+ heal? disp>ities1     
includ+ populations & geographic areas t
 h ! highe/ preval5ce ( ,alzheim]'s     
disease & relat$ dem5tias4  7c7         
,eligibility ,to be eligible to receive 
a coop]ative agreem5t "u ?is section1 an
 eligible entity 7pursuant to subsection

 7a77 %all prep>e & submit to !         
,secret>y an application at su* "t1 9   
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+ a plan t 
describes--  7#a7 h[ ! applicant        
proposes to develop or exp&1 programs to
 educate individuals ?r\gh p>tn]%ip     
engagem5t1 work=ce developm5t1 guidance 
& support = programmatic ef=ts1 &       
evaluation ) respect to ,alzheim]'s     
disease & relat$ dem5tias1 & 9 ! case ( 
a coop]ative agreem5t "u ?is section1 h[
 ! applicant proposes to support o!r    
relevant activities id5tifi$ by !       
,secret>y or ,director ( ! ,c5t]s =     
,disease ,control & ,prev5tion1 z       
appropriate4  7#b7 ! mann] 9 :i* !      
applicant w coord9ate ) ,f$]al1 tribal1 
& ,/ate programs relat$ to ,alzheim]'s  
disease & relat$ dem5tias1 & appropriate
 ,/ate1 tribal1 & local ag5cies1 z well 
z o!r relevant public & private         
organizations or ag5cies2 &  7#c7 !     
mann] 9 :i* ! applicant w evaluate !    
effectiv5ess ( any program c>ri$ out "u 

! coop]ative agreem5t4  7d7 ,mat*+      
requirem5t ,ea* heal? dep>tm5t t is     
aw>d$ a coop]ative agreem5t "u          
subsection 7a7 %all provide1 f          
non-,f$]al s\rces1 an am\nt equal to #cj
 p]c5t ( ! am\nt provid$ "u su* agreem5t
 7:i* may be provid$ 9 ca% or 9-k9d7 to 
c>ry out ! activities support$ by !     
coop]ative agreem5t4  7e7 ,waiv]        
au?ority ,! ,secret>y may waive all or  
"p ( ! mat*+ requirem5t describ$ 9      
subsection 7d7 = any fiscal ye> =--     
7#a7 a heal? dep>tm5t ( a ,/ate1        
political subdivision ( a ,/ate1 or     
,indian tribe & tribal organization1 if 
! ,secret>y det]m9es t apply+ su* mat*+ 
requirem5t w\ld result 9 s]i\s h>d%ip or
 an inability to c>ry out ! purposes ( !
 coop]ative agreem5t aw>d$ to su* heal? 
dep>tm5t ( a ,/ate1 political           
subdivision ( a ,/ate1 or ,indian tribe 
& tribal organization2 or  7#b7 a heal? 
dep>tm5t ( a ,/ate1 political           
subdivision ( a ,/ate1 or ,indian tribe 
& tribal organization locat$ 9 a rural  

area or fronti] area4  2  7#f7 9        
subsection 7f7 7z s r$esignat$71 by     
/rik+ grant & ins]t+ coop]ative         
agreem5t2 &  7#g7 by add+ at ! end !    
foll[+3  7f7 ,non-duplication ( ef=t ,! 
,secret>y %all ensure t activities "u   
any coop]ative agreem5t aw>d$ "u ?is    
subp>t d n unnecess>ily duplicate ef=ts 
( o!r ag5cies & (fices )9 ! ,dep>tm5t ( 
,heal? & ,human ,s]vices relat$ to--    
7#a7 activities ( c5t]s ( excell5ce )   
respect to ,alzheim]'s disease & relat$ 
dem5tias describ$ 9 section #cih;,a2 &  
7#b7 activities ( public heal? dep>tm5ts
 ) respect to ,alzheim]'s disease &     
relat$ dem5tias describ$ 9 ?is section4 
4  #d4 ,additional provisions ,section  
#cih;,b ( ! ,public ,heal? ,s]vice ,act 
7#db ,u4,s4,c4 #bhj;c-#e7 is am5d$--    
7#a7 9 subsection 7a7--  7,a7 by ins]t+ 
or coop]ative agreem5t aft] grant ea*   
place t su* appe>s2  7,b7 by /rik+      
section #cih7;a7 to a ,/ate unless !    
,/ate & ins]t+ sections #cih or #cih;,a 
to an entity unless ! entity2 &  7,c7 by

 /rik+ #aj & ins]t+ #e2  7#b7 by /rik+  
subsection 7b72  7#c7 by r$esignat+     
subsections 7c7 & 7d7 z subsections 7b7 
& 7c71 respectively2  7#d7 9 subsection 
7b7 7z s r$esignat$7--  7,a7 9 ! matt]  
prec$+ p>agraph 7#a71 by /rik+ section  
#cih7;a7 to a ,/ate unless ! ,/ate &    
ins]t+ sections #cih or #cih;,a to an   
entity unless ! entity2  7,b7 9 p>agraph
 7#a71 by /rik+ exp5ditures requir$ 9   
subsection 7b72 & ins]t+ exp5ditures22  
7#e7 9 subsection 7c7 7z s r$esignat$7--
 7,a7 9 p>agraph 7#a7--  7i7 by /rik+   
ea* demon/ration project = :i* a grant &
 ins]t+ ! activities = :i* an aw>d2 &   
7ii7 by /rik+ section #cih7;a7 & ins]t+ 
sections #cih or #cih;,a2 &  7,b7 9     
p>agraph 7#b71 by /rik+ #f mon?s &      
ins]t+ #a ye>2  7#f7 by ins]t+ aft]     
subsection 7c7 7z s r$esignat$71 !      
foll[+3  7d7 ,def9ition ,9 ?is subp>t1 !
 t]ms #8,indian tribe' & #8tribal       
organization' h ! mean+s giv5 su* t]ms 9
 section #d ( ! ,indian ,heal? ,c>e     
,improvem5t ,act4  2 &  7#g7 9          

subsection 7e71 by /rik+ #e1jjj1jjj =   
ea* ( ! fiscal ye>s #aihh ?r\gh #aiij & 
all t foll[s ?r\gh #bjjb & ins]t+       
#bj1jjj1jjj = ea* ( fiscal ye>s #bjbj   
?r\gh #bjbd4  ,novemb] #bi1             
#bjah,report$ ) an am5dm5t