S AMDT 1492

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S.1348 A bill to provide for comprehensive immigration reform and for other purposes.
Sponsor: Harry Reid (D) NV
 
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S 1492 IS

111th CONGRESS

1st Session

S. 1492

To amend the Public Health Service Act to fund breakthroughs in Alzheimer’s disease research while providing more help to caregivers and increasing public education about prevention.

IN THE SENATE OF THE UNITED STATES

July 22, 2009

Mr. REID (for Ms. MIKULSKI (for herself, Mr. BOND, Mrs. GILLIBRAND, Mr. MENENDEZ, Mr. BURR, and Ms. COLLINS)) 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 fund breakthroughs in Alzheimer’s disease research while providing more help to caregivers and increasing public education about prevention.

    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 Breakthrough Act of 2009’.

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) An estimated 5,300,000 Americans have Alzheimer’s disease and 1 in 10 individuals has a family member with the disease. By 2050, the number of individuals with the disease could reach 16,000,000 unless science finds a way to prevent or cure the disease.

      (3) One in 8 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. An individual will live an average of 4 to 6 years, and as many as 20 years, once the symptoms of Alzheimer’s disease appear.

      (5) In 2005, Medicare alone spent $91,000,000,000 for the care of individuals with Alzheimer’s disease and this amount is projected to increase to $160,000,000,000 in 2010.

      (6) Ninety-five percent of Medicare beneficiaries with Alzheimer’s disease have one or more other chronic conditions that are common in the elderly, such as coronary heart disease (26 percent), congestive heart failure (16 percent), diabetes (23 percent), and chronic obstructive pulmonary disease (15 percent).

      (7) Seven in 10 individuals with Alzheimer’s disease live at home. Cost for care at home is higher for people with Alzheimer’s disease than other individuals. Almost all families pay some out-of-pocket costs.

      (8) Half of all nursing home residents have Alzheimer’s disease or a related disorder. The average annual cost of Alzheimer’s disease nursing home care is more than $77,000. Medicaid pays 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 $21,000,000,000 in 2005 to $24,000,000,000 in 2010.

      (9) In fiscal year 2007, the Federal Government spent an estimated $411,000,000 on Alzheimer’s disease research. Over the next 40 years, Alzheimer’s disease-related costs to Medicare and Medicaid alone are projected to total $20,000,000,000,000 in constant dollars, rising to over $1,000,000,000,000 per year by 2050. This amounts to less than a penny spent on Alzheimer’s disease research for each dollar that the Federal Government spends on Alzheimer’s disease-related costs each year.

      (10) It is estimated that the annual value of the informal care system is $94,000,000,000. Family caregiving comes at enormous physical, emotional, and financial sacrifice, putting the whole system at risk.

      (11) Almost 60 percent of caregivers of individuals with Alzheimer’s disease are women, and over one-fourth have 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.

      (12) 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.

TITLE I--INCREASING THE FEDERAL COMMITMENT TO ALZHEIMER’S RESEARCH

SEC. 101. DOUBLING NIH FUNDING FOR ALZHEIMER’S DISEASE RESEARCH.

    For the purpose of conducting and supporting research on Alzheimer’s disease (including related activities under subpart 5 of part C of title IV of the Public Health Service Act (42 U.S.C. 285e et seq.)), there are authorized to be appropriated $2,000,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014.

SEC. 102. 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 the following:

    ‘(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 to carry out this subpart, give priority to conducting and supporting Alzheimer’s disease research.’.

SEC. 103. ALZHEIMER’S DISEASE PREVENTION INITIATIVE.

    Section 443 of the Public Health Service Act (42 U.S.C. 285e), as amended by section 102, is further amended by adding at the end the following:

    ‘(c) Prevention Trials- The Director of the Institute shall increase the emphasis on the need to conduct Alzheimer’s disease prevention trials within the National Institutes of Health.

    ‘(d) Neuroscience Initiative- The Director of the Institute shall ensure that Alzheimer’s disease is maintained as a high priority for the neuroscience initiative of the National Institutes of Health.’.

SEC. 104. ALZHEIMER’S DISEASE CLINICAL RESEARCH.

    (a) Clinical Research- Subpart 5 of part C of title IV of the Public Health Service Act (42 U.S.C. 285e et seq.) is amended by adding at the end the following:

‘SEC. 445J. ALZHEIMER’S DISEASE CLINICAL RESEARCH.

    ‘(a) In General- The Director of the Institute, pursuant to section 444(d), 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 on Alzheimer’s disease;

      ‘(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;

      ‘(6) the conduct of clinical trials on potential therapies, including readily available compounds such as herbal remedies and other alternative treatments;

      ‘(7) research to develop better methods of early diagnosis, including the use of current imaging techniques; and

      ‘(8) other research, as determined appropriate by the Director of the Institute after consultation with 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, diagnosis, and prevention 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.

      ‘(3) STUDY- Not later than 1 year after the date of enactment of this section, the Director of the Institute, in cooperation with the heads of other relevant Federal agencies, shall conduct a study, and submit to Congress a report, to estimate the number of individuals with early-onset Alzheimer’s disease (those diagnosed before the age of 65) and related dementias in the United States, the causes of early-onset dementia, and the unique problems faced by such individuals, including problems accessing government services.

    ‘(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) Treatments and Prevention- The Director of the Institute shall place special emphasis on expediting the translation of research findings under this section into effective treatments and prevention strategies for individuals at risk of Alzheimer’s disease and other dementias.

    ‘(e) 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 ‘, outcome measures, and disease management,’ after ‘treatment methods’.

SEC. 105. RESEARCH ON ALZHEIMER’S DISEASE CAREGIVING.


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6/7/2007
Amendment SA 1492 proposed by Senator Reid to Amendment SA 1235.
 
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