In March, the Health Subcommittee of the US House Committee on Energy & Commerce unanimously passed the bipartisan National Alzheimer's Project Act (NAPA) Reauthorization Act (H.R. 619/S. 133), the Alzheimer's Accountability and Investment Act (AAIA; H.R. 620/S. 134), the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Reauthorization Act (H.R. 7218/S. 3775), and the Lifespan Respite Care Reauthorization Act (LRCA; H.R. 6160). Passage happened just weeks after Alzheimer's Association president and CEO Joanne Pike, DrPH, testified before the subcommittee.

“Each of these bipartisan bills would reauthorize critical laws set to expire without Congressional action,” said Pike. “The Association's leadership and advocacy work brought the original bills before Congress and got them signed into law—moving us into the era of treatment. The reauthorization of these laws will continue that good work.”

NAPA and AAIA

Signed into law in 2011 after unanimous approval by the US Congress, NAPA requires the Department of Health and Human Services to create a national strategic plan to address the Alzheimer's disease (AD) crisis and to update it annually. The first National Plan to Address Alzheimer's Disease was released in 2012. The plan must be submitted to Congress each year to include outcome-driven objectives, recommendations for priority actions, and coordination of all federally funded programs in AD research, care, and services.

In addition to these goals, the NAPA Reauthorization Act underscores and addresses health disparities among underrepresented populations. It also adds new federal representatives to the NAPA Advisory Council from the Department of Justice, the Federal Emergency Management Agency, and the Social Security Administration.

When NAPA passed Congress, annual federal funding for AD research at the National Institutes of Health (NIH) was $448 million. For every dollar the federal government spent on the cost of AD care, it invested less than a penny on research for AD. This changed dramatically after the passage of NAPA. Today, the annual federal investment at the NIH is more than $3.7 billion annually.

NAPA will expire in 2025 unless reauthorized by Congress. Reauthorization would extend NAPA through 2035.

The AAIA builds upon the original Alzheimer's Accountability Act (AAA), which was enacted in 2014 and is set to expire in 2025. Critical to the success of NAPA and the National Plan, the AAA ensures that Congress hears directly from scientists at the NIH about the resources needed to achieve the milestones of the National Plan. AAA does this by requiring that a professional judgment budget formulated by scientists be submitted to Congress annually. The AAIA ensures that Congress continues to hear directly from scientists through 2035.

BOLD

The passage of NAPA was the foundation for other legislative advances in care, support, risk reduction, and infrastructure comparable to what already works in communities nationwide for cancer, heart disease, and diabetes. This includes the BOLD Infrastructure for Alzheimer's Act, which was passed in 2018. BOLD created an AD public health infrastructure across the country to implement effective interventions to increase early detection and diagnosis, risk reduction, caregiving support, and health equity.

Since the enactment of BOLD, the Centers for Disease Control and Prevention (CDC) has awarded funding to 66 state, local, and tribal health departments. In 2023, the CDC announced 43 BOLD award recipients, the most in a single year since BOLD was signed into law. These award recipients are working to implement public health strategies that promote brain health, address dementia, and support individuals living with dementia and their caregivers.

In addition, each year Congress provides critical funding that supports the BOLD Public Health Centers of Excellence and the Healthy Brain Initiative (HBI). The HBI is a longstanding collaboration to advance understanding of cognitive decline as a central part of public health practice. The Healthy Brain Initiative: State and Local Road Map for Public Health, 2023–2027 provides a framework for BOLD award recipients to lead with urgency and act for impact in their communities to improve brain health across the life course and support caregivers.

The BOLD Reauthorization Act continues the strategies put in place by BOLD through 2029.

LRCA

The LRCA reauthorizes and extends the Lifespan Respite Care Program that assists family caregivers in accessing affordable and high-quality respite care. The Lifespan Respite Care Program plays a crucial role in supporting caregivers and enhancing the overall quality of life for individuals with chronic conditions or disabilities, such as AD or other dementia. By providing funding opportunities to states and programs, these programs offer caregivers a temporary break from the heavy physical, mental, and financial tolls associated with caregiving that may go unnoticed. This can, in turn, improve the quality of life for both caregivers and individuals living with chronic illness. Reauthorizing this program through the Lifespan Respite Care Reauthorization Act will maintain a public health infrastructure that has been shown to help alleviate caregiver burden and enhance care quality for individuals with chronic illness. Passage of the reauthorization act would continue support of the Lifespan Respite Care Program through 2035.

For more information about these legislative initiatives, visit alzimpact.org.

3月，美国众议院能源与商业委员会健康小组委员会一致通过了两党《国家阿尔茨海默病项目法案（NAPA）再授权法案》（HR 619/S.133）、《阿尔茨海默病责任与投资法案》（AAIA；HR 620/S） . 134）、《为阿尔茨海默氏症再授权法案建设我们最大的痴呆症 (BOLD) 基础设施法案》(HR 7218/S. 3775) 和《终生暂托护理再授权法案》(LRCA; HR 6160)。就在阿尔茨海默病协会主席兼首席执行官 Joanne Pike（公共卫生博士）在小组委员会作证几周后，该法案就通过了。

派克说：“这些两党法案中的每一项都将重新授权在没有国会采取行动的情况下即将到期的关键法律。” “该协会的领导和宣传工作将最初的法案提交给国会并签署成为法律，使我们进入了治疗时代。这些法律的重新授权将继续这项良好的工作。”

NAPA 和 AAIA

NAPA 经美国国会一致批准于 2011 年签署成为法律，要求卫生与公共服务部制定一项国家战略计划来应对阿尔茨海默病 (AD) 危机，并每年更新一次。第一个解决阿尔茨海默氏病的国家计划于 2012 年发布。该计划必须每年提交给国会，其中包括结果驱动的目标、优先行动建议以及所有联邦政府资助的阿尔茨海默病研究、护理和服务项目的协调。

除了这些目标之外，《国家适应行动计划重新授权法案》还强调并解决了代表性不足的人群中的健康差异。它还增加了来自司法部、联邦紧急事务管理局和社会保障管理局的新联邦代表加入 NAPA 咨询委员会。

当 NAPA 通过国会时，美国国立卫生研究院 (NIH) 每年为 AD 研究提供的联邦资金为 4.48 亿美元。联邦政府在 AD 护理上花费的每一美元，在 AD 研究上的投入不到一分钱。 NAPA 通过后，这种情况发生了巨大变化。如今，NIH 每年的联邦投资超过 37 亿美元。

除非国会重新授权，NAPA 将于 2025 年到期。重新授权将使 NAPA 延长至 2035 年。

AAIA 建立在最初的《阿尔茨海默病责任法案》(AAA) 的基础上，该法案于 2014 年颁布，预计将于 2025 年到期。AAA 对 NAPA 和国家计划的成功至关重要，它确保国会直接听取 NIH 科学家的意见实现国家计划里程碑所需的资源。 AAA 要求每年向国会提交由科学家制定的专业判断预算来实现这一目标。 AAIA 确保国会在 2035 年之前继续直接听取科学家的意见。

大胆的

NAPA 的通过为护理、支持、降低风险和基础设施方面的其他立法进步奠定了基础，这些进步可与全国社区针对癌症、心脏病和糖尿病的现有做法相媲美。其中包括 2018 年通过的《阿尔茨海默病 BOLD 基础设施法案》。BOLD 在全国范围内创建了阿尔茨海默病公共卫生基础设施，以实施有效的干预措施，以加强早期检测和诊断、降低风险、护理支持和健康公平。

自 BOLD 颁布以来，疾病控制与预防中心 (CDC) 已向 66 个州、地方和部落卫生部门提供资金。 2023 年，CDC 宣布了 43 名 BOLD 获奖者，这是自 BOLD 签署成为法律以来单年获奖人数最多的一年。这些获奖者正在努力实施公共卫生战略，促进大脑健康，解决痴呆症问题，并支持痴呆症患者及其护理人员。

此外，国会每年都会提供重要资金来支持 BOLD 卓越公共卫生中心和健康大脑计划 (HBI)。 HBI 是一项长期合作，旨在增进对认知衰退作为公共卫生实践核心部分的理解。健康大脑倡议：2023-2027 年州和地方公共卫生路线图为 BOLD 奖获得者提供了一个框架，让他们能够紧迫地领导并采取行动，影响其社区，以改善整个生命周期的大脑健康并为护理人员提供支持。

BOLD 再授权法案延续了 BOLD 到 2029 年实施的战略。

LRCA

LRCA 重新授权并延长了生命周期暂息护理计划，该计划帮助家庭护理人员获得负担得起的高质量暂息护理。终生暂托护理计划在支持护理人员和提高患有慢性疾病或残疾（如 AD 或其他痴呆症）的个人的整体生活质量方面发挥着至关重要的作用。通过向各州和项目提供资助机会，这些项目让护理人员暂时摆脱与护理相关的沉重的身体、精神和财务负担，而这些负担可能会被忽视。反过来，这可以改善护理人员和慢性病患者的生活质量。通过《终生暂息护理重新授权法案》重新授权该计划将维持公共卫生基础设施，事实证明，该基础设施有助于减轻护理人员的负担并提高慢性病患者的护理质量。重新授权法案的通过将在 2035 年之前继续支持终身暂托护理计划。

有关这些立法举措的更多信息，请访问 alzimpact.org。