Bill Summary:

The purpose of H.R. 4256 is 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. The bill aims to address the increasing prevalence and impact of Alzheimer's disease, which is currently an under-recognized threat to public health. The bill emphasizes the need for early detection and diagnosis of Alzheimer's disease, as well as the importance of educating the public, health professionals, and caregivers about the disease. The bill also aims to promote public health initiatives to reduce the risk of cognitive decline, enhance caregiver support, and reduce health disparities related to Alzheimer's disease. The bill allocates funds for various activities, including the establishment of centers of excellence in public health practice, providing cooperative agreements to health departments, and promoting the analysis and reporting of data related to cognitive decline and caregiving.

Bill Details:

Title: Building Our Largest Dementia Infrastructure for Alzheimer’s Act or BOLD Infrastructure for Alzheimer’s Act

Bill Number: H.R. 4256

Introduced By: Mr. Guthrie, Mr. Tonko, Ms. Maxine Waters of California, and Mr. Smith of New Jersey

Date Introduced: November 6, 2017

Referred to: Committee on Energy and Commerce

Findings:

Alzheimer's is the most under-recognized threat to public health in the 21st century, according to former Surgeon General and Director of the Centers for Disease Control and Prevention, Dr. David Satcher.
Deaths from Alzheimer's disease increased 55% between 1999 and 2014 in the United States, based on data from the Centers for Disease Control and Prevention.
More than 5 million people in the United States are living with Alzheimer's disease and, without efforts to change the current trajectory, this number is projected to increase to as many as 16 million people by 2050. The associated costs are estimated to rise from $259 billion in 2017 to over $1.1 trillion in 2050.
Approximately 50% of individuals living with Alzheimer's disease and other dementias have not been diagnosed, and only 33% of individuals diagnosed with Alzheimer's disease are aware of the diagnosis.
Among individuals with Alzheimer's disease and other dementias, 25.3% experience preventable hospitalizations, costing the Medicare program nearly $2.6 billion in 2013.
African Americans are about 2 times more likely than White Americans to have Alzheimer's disease and other dementias, and Hispanics are about one and a half times more likely.
In 2016, family members and friends provided 18.2 billion hours of unpaid care to individuals with Alzheimer's disease and other dementias, at an estimated economic value of over $230 billion. This caregiving resulted in an estimated $10.9 billion in increased caregiver health costs.
The 'National Plan to Address Alzheimer's Disease: 2017 Update' includes a strategy to improve coordination and identify model initiatives to advance Alzheimer's disease awareness and readiness across the government, particularly at the State, Tribal, and local levels.

Key Provisions:

The bill establishes or supports centers of excellence in public health practice to advance the education of public health officials, health care professionals, and the public on Alzheimer's disease, cognitive decline, brain health, and associated health disparities. These centers aim to apply evidence-based systems change, communications, and programmatic interventions for populations with cognitive impairment, including Alzheimer's disease, and their caregivers, and to expand public-private partnerships engaged in activities related to cognitive impairment and associated health disparities.

The bill provides cooperative agreements to health departments to promote cognitive functioning, address cognitive impairment, meet the needs of caregivers, and address unique aspects of Alzheimer's disease. These cooperative agreements support the development and implementation of programs that educate individuals, apply established data and evidence-based best practices, support early detection and diagnosis, reduce the risk of hospitalizations, reduce the risk of cognitive decline, enhance caregiver support, reduce health disparities, and support care planning and management. The bill gives preference to applications that focus on addressing health disparities and ensures equitable distribution of awards based on geographic area and the burden of the disease on sub-populations.

The bill also provides cooperative agreements for the analysis and reporting of data on cognitive decline, caregiving, and health disparities. These cooperative agreements support the timely public reporting of data on the state and national levels and the monitoring of dementia objectives under the Healthy People 2020 report.

The bill authorizes appropriations for each fiscal year from 2018 to 2025 to carry out the various activities outlined in the bill.

Rep. Troy Balderson

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