Requires the Director of the Institute to: (1) undertake an Alzheimer's Disease Prevention Initiative, including accelerating the discovery of new risk and protective factors, rapidly identifying therapies and preventive interventions, and implementing effective prevention and treatment strategies; (2) conduct and support cooperative clinical research regarding Alzheimer's; and (3) conduct, or make grants to conduct, research concerning early detection and diagnosis, the relationship between Alzheimer's and vascular disease, and interventions designed to help caregivers.
Authorizes the Director to establish a National Alzheimer's Coordinating Center to facilitate collaboration among Alzheimer's Disease Centers and Alzheimer's Disease Research Centers.
Authorizes appropriations for FY 2004 through FY 2008.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 566 Introduced in Senate (IS)]
108th CONGRESS
1st Session
S. 566
To amend the Public Health Service Act to provide for Alzheimer's
disease research and demonstration grants.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 6, 2003
Ms. Mikulski (for herself, Mr. Bond, Mr. Kennedy, Mrs. Lincoln, Mr.
Breaux, and Mr. Dodd) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to provide for Alzheimer's
disease research and demonstration grants.
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 ``Alzheimer's Disease Research,
Prevention, and Care Act of 2003''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Alzheimer's disease is a disorder that destroys cells
in the brain. The disease is the leading cause of dementia, a
condition that involves gradual memory loss, decline in the
ability to perform routine tasks, disorientation, difficulty in
learning, loss of language skills, impairment of judgment, and
personality changes. As the disease progresses, people with
Alzheimer's disease become unable to care for themselves. The
loss of brain cells eventually leads to the failure of other
systems in the body.
(2) In the United States, 4,000,000 people have Alzheimer's
disease and 19,000,000 people say that they have a family
member with the disease. By 2050, 14,000,000 people in the
United States will have Alzheimer's disease unless science
finds a way to prevent or cure the disease.
(3) One in 10 people over the age of 65, and nearly half of
those over the age of 85 have Alzheimer's disease. Younger
people also get the disease.
(4) The Alzheimer's disease process may begin in the brain
as many as 20 years before the symptoms of Alzheimer's disease
appear. A person will live an average of 8 years and as many as
20 once the symptoms of Alzheimer's disease appear.
(5) The average lifetime cost of Alzheimer's disease, per
person, is $174,000.
(6) In 2000, medicare alone spent $31,900,000,000 for the
care of individuals with Alzheimer's disease and this amount is
projected to increase to $49,300,000,000 in 2010.
(7) Forty-nine percent of medicare beneficiaries who have
Alzheimer's disease also receive medicaid. Of the total
population dually eligible for medicare and medicaid, 22
percent have Alzheimer's disease.
(8) Seven in 10 people with Alzheimer's disease live at
home. While almost 75 percent of home care is provided by
family and friends, the average annual cost of paid care for
people with Alzheimer's disease at home is $19,000.
(9) Nearly 60 percent of all nursing home residents have
Alzheimer's disease or another dementia. The average annual
cost of Alzheimer's disease nursing home care is nearly
$64,000. Medicaid pays nearly half of the total nursing home
bill and helps 2 out of 3 residents pay for their care.
Medicaid expenditures for nursing home care for people with
Alzheimer's disease are estimated to increase from
$18,200,000,000 in 2000 to $33,000,000,000 in 2010.
(10) In fiscal year 2002, the Federal Government spent an
estimated $598,900,000 on Alzheimer's disease research. If our
Nation achieves its research goals (preventing the onset of
Alzheimer's disease in those at risk and treating and delaying
progression of the disease in those who have symptoms), the
projected number of cases of Alzheimer's disease can be reduced
by more than one-third by the middle of the century. The number
of baby boomers with moderate to severe Alzheimer's disease can
be reduced by 60 percent.
(11) A study commissioned by the United Hospital Fund
estimated that the annual value of this informal care system is
$257,000,000,000. Family caregiving comes at enormous physical,
emotional, and financial sacrifice, putting the whole system at
risk.
(12) One in 8 Alzheimer's disease caregivers becomes ill or
injured as a direct result of caregiving. One in 3 uses
medication for problems related to caregiving. Older caregivers
are 3 times more likely to become clinically depressed than
others in their age group.
(13) Elderly spouses strained by caregiving are 63 percent
more likely to die during a given 4-year period than other
spouses their age.
(14) Three of 4 caregivers are women. One in 3 has children
or grandchildren under the age of 18 living at home. Caregiving
leaves them less time for other family members and they are
much more likely to report family conflicts because of their
caregiving role.
(15) Most Alzheimer's disease caregivers work outside the
home before beginning their caregiving careers, but caregiving
forces them to miss work, cut back to part-time, take less
demanding jobs, choose early retirement, or give up work
altogether. As a result, in 2002, Alzheimer's disease cost
American business an estimated $36,500,000,000 in lost
productivity, as well as an additional $24,600,000,000 in
business contributions to the total cost of care.
SEC. 3. PRIORITY TO ALZHEIMER'S DISEASE RESEARCH.
Section 443 of the Public Health Service Act (42 U.S.C. 285e) is
amended--
(1) by striking ``The general'' and inserting ``(a) In
General.--The general''; and
(2) by adding at the end the following:
``(b) Priorities.--The Director of the Institute shall, in
expending amounts appropriated under this subpart, give priority to
conducting and supporting Alzheimer's disease research.''.
SEC. 4. ALZHEIMER'S DISEASE PREVENTION INITIATIVE.
Section 444 of the Public Health Service Act (42 U.S.C. 285e-1) is
amended--
(1) in subsection (d), by inserting ``and training'' after
``conduct research''; and
(2) by adding at the end the following:
``(e) The Director of the National Institutes of Health shall, in
collaboration with the Director of the Institute, the directors of
other relevant institutes, and with volunteer organizations and other
stakeholders, undertake an Alzheimer's Disease Prevention Initiative
to--
``(1) accelerate the discovery of new risk and protective
factors for Alzheimer's disease;
``(2) rapidly identify candidate diagnostics, therapies, or
preventive interventions or agents for clinical investigation
and trials relating to Alzheimer's disease;
``(3) support or undertake such investigations and trials;
and
``(4) implement effective prevention and treatment
strategies, including strategies to improve patient care and
alleviate caregiver burdens relating to Alzheimer's disease.''.
SEC. 5. ALZHEIMER'S DISEASE CLINICAL RESEARCH.
(a) Clinical Research.--Section 445F of the Public Health Service
Act (42 U.S.C. 285e-8) is amended to read as follows:
``SEC. 445F. ALZHEIMER'S DISEASE CLINICAL RESEARCH.
``(a) In General.--The Director of the Institute, pursuant to
subsections (d) and (e) of section 444, shall conduct and support
cooperative clinical research regarding Alzheimer's disease. Such
research shall include--
``(1) investigating therapies, interventions, and agents to
detect, treat, slow the progression of, or prevent Alzheimer's
disease;
``(2) enhancing the national infrastructure for the conduct
of clinical trials;
``(3) developing and testing novel approaches to the design
and analysis of such trials;
``(4) facilitating the enrollment of patients for such
trials, including patients from diverse populations;
``(5) developing improved diagnostics and means of patient
assessment for Alzheimer's disease; and
``(6) as determined appropriate by the Director of the
Institute, the Alzheimer's Disease Centers and Alzheimer's
Disease Research Centers established under section 445.
``(b) Early Diagnosis and Detection Research.--
``(1) In general.--The Director of the Institute, in
consultation with the directors of other relevant institutes
and centers of the National Institutes of Health, shall
conduct, or make grants for the conduct of, research related to
the early detection and diagnosis of Alzheimer's disease and of
mild cognitive impairment or other potential precursors to
Alzheimer's disease.
``(2) Evaluation.--The research described in paragraph (1)
may include the evaluation of diagnostic tests and imaging
techniques.
``(c) Vascular Disease.--The Director of the Institute, in
consultation with the directors of other relevant institutes and
centers of the National Institutes of Health, shall conduct, or make
grants for the conduct of, research related to the relationship of
vascular disease and Alzheimer's disease, including clinical trials to
determine whether drugs developed to prevent cerebrovascular disease
can prevent the onset or progression of Alzheimer's disease.
``(d) National Alzheimer's Coordinating Center.--The Director of
the Institute may establish a National Alzheimer's Coordinating Center
to facilitate collaborative research among the Alzheimer's Disease
Centers and Alzheimer's Disease Research Centers established under
section 445.''.
(b) Alzheimer's Disease Centers.--Section 445(a)(1) of the Public
Health Service Act (42 U.S.C. 285e-2(a)(1)) is amended by inserting ``,
and outcome measures and disease management'' after ``treatment
methods''.
SEC. 6. RESEARCH ON ALZHEIMER'S DISEASE CAREGIVING.
Section 445C of the Public Health Service Act (42 U.S.C. 285e-5) is
amended--
(1) by striking ``Sec. 445C. (a)'' and inserting the
following:
``SEC. 445C. RESEARCH ON ALZHEIMER'S DISEASE SERVICES AND CAREGIVING.
``(a) Services Research.--'';
(2) by striking subsections (b), (c), and (e);
(3) by inserting after subsection (a) the following:
``(b) Interventions Research.--The Director shall, in collaboration
with the directors of the other relevant institutes and centers of the
National Institutes of Health, conduct, or make grants for the conduct
of, clinical, social, and behavioral research related to interventions
designed to help caregivers of patients with Alzheimer's disease and
related disorders and improve patient outcomes.''; and
(4) in subsection (d) by striking ``(d) the Director'' and
inserting ``(c) Model Curricula and Techniques.--The
Director''.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--Section 445J of the Public Health Service Act (42
U.S.C. 285e-11) is amended by striking ``$500,000,000 for fiscal year
1994, and such sums as may be necessary for each of the fiscal years
1995 and 1996.'' and inserting ``$1,100,000,000 for fiscal year 2004,
$1,200,000,000 for fiscal year 2005, $1,300,000,000 for fiscal year
2006, $1,400,000,000 for fiscal year 2007, and $1,500,000,000 for
fiscal year 2008.''.
(b) Aging Process Regarding Women.--Section 445H(b) of the Public
Health Service Act (42 U.S.C. 285e-10(b)) is amended by striking
``2003'' and inserting ``2008''.
(c) Clinical Research and Training Awards.--Section 445I(d) of the
Public Health Service Act (42 U.S.C. 285e-10a(d)) is amended by
striking ``2005'' and inserting ``2008''.
SEC. 8. ALZHEIMER'S DISEASE DEMONSTRATION GRANTS.
Section 398B(e) of the Public Health Service Act (42 U.S.C. 280c-
5(e)) is amended--
(1) by striking ``and such'' and inserting ``such''; and
(2) by inserting before the period ``, $20,000,000 for
fiscal year 2004, and such sums as may be necessary for each of
the fiscal years 2005 through 2008''.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S3325-3326)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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