text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Cure and Understanding through 
  Research for Alzheimer's Act of 2008'' or the ``La Cura Act of 2008''.
  
  SEC. 2. FINDINGS.
  
      The Congress finds as follows:
              (1) The incidence and prevalence of Alzheimer's disease 
          increase with age. Alzheimer's disease is currently the seventh 
          leading cause of death of all ages in the United States (and 
          the fifth leading cause of death for people over 65 years of 
          age), with 5.2 million individuals in the United States living 
          with Alzheimer's disease. Currently, one of each eight 
          individuals in the United States over age 65 has Alzheimer's 
          disease. Every 71 seconds, an individual in the United States 
          develops Alzheimer's disease, and by 2050, every 33 seconds an 
          individual in the United States will develop this disease. By 
          2050, the number of individuals in the United States age 65 and 
          over with Alzheimer's disease will range from 11 million to 16 
          million individuals. It is projected that by 2050, more than 60 
          percent of individuals in the United States with Alzheimer's 
          disease will be age 85 or older.
              (2) The prevalence of Alzheimer's disease and dementia 
          seems to be higher among individuals with fewer years of 
          education. Individuals with fewer than 12 years of education 
          have a 15 percent greater risk of developing dementia than 
          individuals with 12 to 15 years of education and a 35 percent 
          greater risk of developing dementia than individuals with more 
          than 15 years of education.
              (3) Hispanics are the fastest growing population in the 
          Nation and by 2050, will have a life expectancy of 87 years, 
          longer than any other ethnic or racial group. The Hispanic 
          community in the United States is projected to experience a 
          six-fold increase in Alzheimer's disease (from fewer than 
          200,000 to as many as 1.3 million) by 2050.
              (4) Hispanics may be at a greater risk of developing 
          dementia than other ethnic or racial groups: Hispanics' 64-
          percent higher incidence of diabetes than non-Hispanic white 
          Americans is of particular concern in light of new findings 
          that diabetes is the one vascular risk factor that, in the 
          absence of stroke, is related to an increased risk of 
          Alzheimer's disease.
              (5) Research on disparities in Alzheimer's risk factors 
          between Hispanic and other ethnic and racial groups is only 
          beginning to sort out complex differences: for example, even in 
          the absence of the APOE-e4 allele, the one known genetic risk 
          factor for late onset Alzheimer's, Caribbean Hispanics have a 
          cumulative risk for Alzheimer's twice that of non-Hispanic 
          whites.
              (6) The shortage of bilingual health professionals, 
          combined with the large population of monolingual Spanish-
          speaking seniors, make adequate testing and diagnosis of 
          Alzheimer's among elderly Hispanics difficult and may lead to 
          cultural biases in cognitive testing. Moreover, inadequate 
          translation of diagnostic tools can lead to improper diagnoses, 
          and there may be poor understanding of recommended treatment 
          and self-care even among those who are properly diagnosed.
              (7) Hispanics are far more likely to be uninsured than any 
          other ethnic group: the Bureau of the Census reports that 34.1 
          percent of the Hispanic population in the United States is 
          uninsured, compared to 10.8 percent for non-Hispanic whites and 
          15.3 percent for all United States residents.
              (8) Lack of access to health care and a strong cultural 
          commitment to caring for one's elders within the family are 
          among the factors that make Hispanics with dementia less likely 
          than non-Hispanics to see a physician and use related services 
          provided by formal health professionals: delays in diagnosis 
          and lack of early and consistent treatment can lead to higher 
          levels of impairment and increased stress on family caregivers.
              (9) Hispanic elders are second most likely, after Asian 
          Americans, to live with their families rather than in long term 
          care facilities. More research is needed to better understand 
          the effects of differing care settings on family caregivers and 
          Alzheimer's patients.
              (10) Alzheimer's disease costs the United States $148 
          billion each year in direct and indirect costs to business, the 
          Medicare program, and the Medicaid program (not including 
          private health insurance costs).
  
  SEC. 3. NIH RESEARCH AND EDUCATION ON ALZHEIMER'S DISEASE.
  
      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 
  new section:
  
  ``SEC. 445J. NIH RESEARCH AND EDUCATION ON ALZHEIMER'S DISEASE.
  
      ``(a) Research Activities.--In conducting research relating to 
  Alzheimer's disease, the Director of the National Institutes of Health 
  shall ensure sufficient resources for activities relating to 
  Alzheimer's disease and Hispanic communities, including by--
              ``(1) increasing efforts in epidemiological work in 
          Hispanic subgroups;
              ``(2) allocating resources to the National Institute on 
          Aging Alzheimer's disease research centers and other academic 
          centers involved in Alzheimer's disease research to increase 
          participation of Hispanics and other under represented ethnic 
          groups in research and clinical trials in sufficient numbers to 
          draw valid conclusions; and
              ``(3) conducting social, behavioral, and health services 
          research--
                      ``(A) to understand more fully the underlying 
                  reasons that Hispanic individuals delay diagnosis and 
                  underutilize services;
                      ``(B) to identify culturally and linguistically 
                  appropriate approaches for addressing such delays and 
                  underutilization; and
                      ``(C) to identify approaches for providing, and 
                  improving the quality of, culturally competent care.
      ``(b) Education Activities.--The Director of the National 
  Institutes of Health shall expand and intensify efforts of the National 
  Institutes of Health--
              ``(1) to educate communities about the importance of 
          research relating to Alzheimer's disease; and
              ``(2) to respond effectively to cultural concerns about 
          participation in such research, especially with respect to 
          sensitive matters like the collection of brain tissue and 
          genetic information.''.
  
  SEC. 4. INCREASED FUNDING FOR 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 at the end ``, 
          $25,000,000 for fiscal year 2009, and such sums as may be 
          necessary for each of the fiscal years 2010 through 2013''.
  
  SEC. 5. CDC OUTREACH AND EDUCATION.
  
      Part B of title III of the Public Health Service Act (42 U.S.C. 243 
  et seq.) is amended by inserting after section 317S the following:
  
  ``SEC. 317T. EDUCATION AND OUTREACH ON ALZHEIMER'S DISEASE.
  
      ``(a) Purposes.--The purposes of this section are the following:
              ``(1) To reduce the risk of Alzheimer's disease through 
          reduction of vascular risk factors.
              ``(2) To encourage early recognition and diagnosis of 
          dementia.
              ``(3) To train public health personnel to recognize, 
          assess, diagnose, and treat Alzheimer's disease in ways that 
          are culturally appropriate and supportive of families.
      ``(b) Education and Outreach.--To achieve the purposes of this 
  section, the Secretary, acting through the Centers for Disease Control 
  and Prevention, shall conduct an aggressive, evidence-based education 
  and outreach program to promote public awareness and risk reduction 
  with respect to Alzheimer's disease. In conducting the outreach 
  program, the Secretary shall consult with State Health Departments and 
  may consult with other appropriate entities, including the Alzheimer's 
  Association.
      ``(c) Emphasis.--In carrying out this section, the Secretary shall 
  give particular emphasis to education and outreach in Hispanic 
  populations.''.
target: Cure and Understanding through Research for Alzheimer's Act of 2008 or La Cura Act of 2008 - Amends the Public Health Service Act to require the Director of the National Institutes of Health (NIH) to ensure sufficient resources for activities relating to Alzheimer's disease and Hispanic communities, including by: (1) increasing efforts in epidemiological work in Hispanic subgroups; (2) allocating resources to the National Institute on Aging Alzheimer's disease research centers and other academic centers involved in such research to increase participation of Hispanics and other underrepresented ethnic groups in research and clinical trials in sufficient numbers to draw valid conclusions; and (3) conducting social, behavioral, and health services research to understand the underlying reasons why Hispanic individuals delay diagnosis and underutilize services, to identify culturally and linguistically appropriate approaches to address such delays and underutilization, and to identify approaches for providing, and improving the quality of, culturally competent care.
  
  Requires the Director to expand and intensify NIH efforts to educate communities about the importance of research relating to Alzheimer's disease and to respond effectively to cultural concerns about participation in such research.
  
  Authorizes appropriations for a program of grants to states to carry out demonstration programs related to Alzheimer's disease.
  
  Requires the Secretary of Health and Human Services, acting through the Centers for Disease Control and Prevention (CDC), to conduct an aggressive, evidence-based education and outreach program to promote public awareness and risk reduction with respect to Alzheimer's disease, particularly to Hispanic populations.
feat_title: To amend the Public Health Service Act to ensure sufficient resources and increase efforts for research at the National Institutes of Health relating to Alzheimer's disease, to authorize an education and outreach program to promote public awareness and risk reduction with respect to Alzheimer's disease (with particular emphasis on education and outreach in Hispanic populations), and for other purposes.