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Statistics indicate that Alzheimer’s disease affects estimated 5 million individual Americans. It is also estimated that 16 million may have Alzheimer’s by mid-century (2050). The Alzheimer's Breakthrough Act of 2009 (S. 1492 & H.R. 3286) was an incredible step in the country’s struggle against Alzheimer's.

Identify the policy

The publication of the bill by The Bill: S.1492 (111th ) indicated that it was meant “To  amend the Public Health Service Act to fund breakthrough in Alzheimer’s disease research while providing more help to caregivers and increasing public education about prevention” (2009). The policy was aimed at helping Alzheimer’s sufferers and their families. According to an article published by Pacific Progressive, the policy was aimed at doubling-up funding for Alzheimer’s research at the National Institutes of Health to $2 billion in 2010 (The Bill: S. 1492, 2009). The bill sanctions the necessary resources to restore momentum in the search of improved diagnosis, prevention and treatment of Alzheimer.

What is the statutory name or common name?

The Alzheimer’s Breakthrough Act of 2009 statutory name is S. 1492. The Bill was introduced in senate in July 22nd 2009. The latest version of the Bill available on GovTrack is S 1492 IS. The bill was introduced in the Senate by Sens. Barbara Mikulski (D-Md.) and Christopher Bond (R-Mo.) and by Reps. Edward Markey (D-Mass.) and Christopher Smith (R-N.J.) in the House (The Bill: S. 1492, 2009). The legislation offers great promise for someday having a world without Alzheimer's disease.

If it is pending legislation, what is the bill number?

The bill number was S1492 and is not pending. The Act was cited as the “Alzheimer’s Breakthrough Act of 2009”

Discuss its mission statement.

According to publication by GovTrack, Read The Bill: S. 1492 the mission statement of the bill was “To increase the Federal commitment to Alzheimer’s research”. In line with this the mission statement was meant to double NIH funding for Alzheimer disease. For the purpose of carrying out and supporting research on Alzheimer’s disease it was authorized to be appropriated $2 billion for the year 2010 and such amounts be available for fiscal years 2011 through 2014 (The Bill: S. 1492, 2009). The director of NIH will in expending amounts appropriated to give priority to conducting and supporting Alzheimer’s disease research.  

What are the intended short and long term goals of the policy?

One of the intended short term goals of the policy is to double NIH funding for Alzheimer’s disease research. It was resolved that the funding be increased to $2 billion for the fiscal year 2010 as well as 2011 through 2014 (The Bill: S. 1492, 2009). Secondly, the policy intended to give priority to Alzheimer’s disease research. This implied that the director of the institute was, in expending amounts appropriated to carry out this subpart and give priority to conducting and supporting Alzheimer’s disease research (The Bill: S. 1492, 2009).

According to The Bill: S. 1492 (2009) the policy was intended to provide Alzheimer’s disease prevention initiative. This included prevention trials and neuroscience initiative. In prevention trials the director of the institute was to increase the need to conduct the disease prevention trials within the National Institutes of Health (NIH). As far as neuroscience initiative is concerned, the director was to ascertain that Alzheimer’s disease is maintained as high priority for the neuroscience initiative of the National Institutes of Health (NIH) (The Bill: S. 1492, 2009). 

The fourth goal of the policy was to conduct Alzheimer Disease clinical research. In this goal the policy entitled the director of NIH to conduct and support cooperative clinical research regarding Alzheimer’s disease (The Bill: S. 1492, 2009). The clinical research was intended to investigate therapies, interventions and agents to detect, treat, slow the progression of or prevent Alzheimer’s disease.

The firth goal of the policy was to ensure formation of a national summit on Alzheimer’s disease (The Bill: S. 1492, 2009). According to the publication by GovTrack publication titled “The Bill: S. 1492” the policy stipulated that “in not later than 3 years after the date of enactment of this act, and every three years thereafter, the secretary of Health and Human Services was to convene a National Summit on Alzheimer’s Disease in order to provide a detailed overview of current research and discuss and solicit input related to potential areas of collaboration between all the agencies involved” (The Bill: S. 1492, 2009).

Are there hidden agendas? What do you believe these to be? What resources and/or opportunities is the policy intended to provide? What benefits will be delivered and in what form?

The policy did not have hidden agendas. This is because it was enacted by the Senate and House of Representatives of the United States of America in Congress. The policy was intended to provide considerable amount of funding up to 2 billion dollars in the fiscal year 2010 and the same amount in the subsequent years 2011 to 2014 (The Bill: S. 1492, 2009). The policy would provide great opportunities for individual suffering from Alzheimer’s, help provide financial support to caregivers of Alzheimer’s disease. Alzheimer’s disease researchers were funded and supported the through National Institutes of Health.

One of the main benefits of the Alzheimer’s disease policy was the prevention trials of the disease which carried out through the National Institutes of Health. The second benefit was that clinical research regarding Alzheimer’s disease was conducted and supported by NIH. GovTrack says that through the policy national infrastructure will be enhanced for conducting clinical trials on Alzheimer’s disease and ensure the enrolment of patients for trials. The policy will ensure improved diagnostics and means of patient assessment for Alzheimer’s disease (GovTrack, 2009). The policy will ensure that research is carried out to develop better methods of early diagnosis and ensure the use of new imaging techniques.

Through the policy, public information about Alzheimer’s disease research, education, and other related activities was readily available. The Bill: S. 1492 (2009) indicated that “with regard to treatment and prevention, the director of NIH was to place more efforts on expediting the translation of research findings into effective treatment and prevention strategies for individuals at risk of Alzheimer’s disease”.    

Who will the policy serve? What resources will they receive? In what form? How will the benefits be delivered?

The policy will serve a wide range of individuals. These include people with Alzheimer’s disease, families of those people and care providers of those individuals. It will also serve, Medicare which spends enormously for the care of individuals with the disease and nursing home residents in which half of them have Alzheimer. According to GovTrack the policy will serve nursing home care in which Medicaid expenditures for nursing home care for people with Alzheimer’s disease were known to increase to 24 billion dollars in the 2010 (The Bill: S. 1492, 2009). The policy will also serve individual family caregivers because the disease comes with big physical, emotional and financial sacrifice hence putting the whole system at risk (The Bill: S. 1492, 2009). 

In addition, the policy will encourage grantees to coordinate activities with other State officials administering efforts to promote long-term care options that enable older individuals to receive long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers (The Bill: S. 1492, 2009). The Bill: S. 1492 publication identified that “the policy will provide training about how Alzheimer’s disease can affect behaviour and impede communication in medical and community settings to medical personnel, including hospital staff, emergency room personnel, home health care workers and physician office staff; rehabilitation services providers; and caregivers of individuals with Alzheimer’s disease”.

How will the recipients of the policy be determined? What are the eligibility criteria?

GovTrack publication “The Bill: S. 1492” says that 95% of Alzheimer disease recipients have one or more chronic conditions such as coronary heart disease (26%), congestive heart failure 16%, diabetes 23% and chronic obstructive pulmonary disease 15%. Other recipients of the policy are determined through nursing home care. The GovTrack publication says that caregivers are also recipients of the policy. This type of recipients are determined on basis of if care giving forces them to miss work, cut-back to part-time and give up work altogether (The Bill: S. 1492, 2009). The eligibility criteria should be based on the universal coverage, means-tested and entitlement.    

Universal coverage?

Universal coverage towards Alzheimer’s is paid regardless of an individual’s social insurance record or income. These payments only require that you satisfy specific personal circumstances. Through the universal coverage the recipient has a universal access to healthcare for Alzheimer’s disease (Whitehouse, Maurer & Ballenger, 2000). Under the universal coverage a global budget for national Alzheimer health care expenditures. This coverage is tax-based rather than employer-based and it promotes health care rationing. Much of the savings of universal coverage come from reductions in overhead that runs 12% to 37% in the current for-profit insurance plans (Whitehouse, Maurer & Ballenger, 2000).

Entitlements

Entitlements include Medicare and Medicaid because the government is legally obligated to cover all those who meet eligibility requirements for Alzheimer’s disease (Leonard, 2009). For individuals suffering from Alzheimer’s disease, Medicaid entitlement pays half of the total nursing home bill and helps 2 out of 3 residents pay for their care and it is mainly provides health coverage for low-income families (The Bill: S. 1492, 2009). On the other hand Medicare entitlements for Alzheimer’s disease are partially funded as the Social Security through dedicated payroll taxes.

Means-tested?

If an individual’s means are below a certain level their qualification for means-tested payments depends on your income and assets as well as other conditions attached to the payment. The means-tested will be essential for determining the recipients of Alzheimer’s disease. Those who do not have means they are eligible recipients. Those who have means their healthcare payment is reduced (Entitlements for over sixties, 2009). When an individual applies to be a recipient of means-tested payment, their means are assessed as a certain amount hence it is decided if they are recipients.

Who will pay for the cost of the implemented policy? Is the funding a budget line item appropriated annually? Is funding shared by federal, state, and local governments? Charity organization? For profit organizations?

The federal government assisted by other charitable organizations will pay the cost of the implemented policy. The funding is a budget line item appropriated annually. The budget is shared between the federal, state, local, charitable and not for profit organizations. For example, the Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research (Leonard, 2009).

What is the balance of contribution from all sources? Give exact dollar amounts and percentages of contributions. This will tell you who takes most responsibility for the policy implementation.

For the purpose of carrying out and supporting research on Alzheimer’s disease it was authorized to be appropriated $2 billion for the year 2010 and such amounts be available for fiscal years 2011 through 2014 (The Bill: S. 1492, 2009). GovTrack publication says that Medicare alone spent $91 billion dollars in the year 2005 and the amount increased to $160,000,000,000 billion in 2010. The publication continues to indicate that in the year 2009, the Federal Government spent an estimated $411,000,000 on Alzheimer’s disease research. It is also estimated that annual value of the informal care system of Alzheimer is $94,000,000,000 (The Bill: S. 1492, 2009).

What agency (ies) or organization(s) will have the overall responsibilities of overseeing the implementation and evaluation of the policy?

The National Institutes of Health (NIH) has the overall responsibilities of overseeing the implementation and evaluation of the policy. According to The Bill: S. 1492 (2009) the “Director of the National Institutes of Health, in discussion with the directors of other pertinent institutes and centres of the National Institutes of Health, have the mandate to conduct, or make funding for the conduct of, research related to the early detection, diagnosis, and prevention of Alzheimer’s disease”. The National Institutes of Health in association with the Alzheimer's Association funds a widespread range of assessments by researchers at each stage of their careers (The Bill: S. 1492, 2009). Each funding is intended to meet the requirements of the Alzheimer’s disease and to initiate fresh ideas in Alzheimer's research (Leonard, 2009). Over the years the Alzheimer’s Association has developed into the largest private, non-profit funder of Alzheimer's research, granting more than $292 million to 2,000 paramount applications in the field (The Bill: S. 1492, 2009).

The National Institutes of Health works in collaboration with other Federal health agencies, such as the Centres for Disease Control and Prevention, the Administration on Aging, the Agency for Healthcare Research and Quality, and the Health Resources and Services Administration, associated to research, prevention, and cure of Alzheimer’s disease (The Bill: S. 1492, 2009).

What is the knowledge base or scientific grounding upon which the policy is based? In other words, how do we logically make sense of the policy? What are its underlying assumptions embedded in the policy?

Alzheimer’s disease is a disorder that destroys cells in the brain. As the Alzheimer disease progresses, people become unable to take care for themselves. The loss of brain cells eventually leads to the malfunctioning of other systems in the body (The Bill: S. 1492, 2009). In this context, The Bill: S. 1492 (2009) indicated that an estimated 5,300,000 Americans have Alzheimer’s disease and 1 in 10 individuals have a family member with the disease. By 2050, it is estimated that the number of individuals with the disease could reach 16,000,000 unless researchers finds a way to prevent or cure the disease (The Bill: S. 1492, 2009). Consequently, one in 8 people over the age of 65, and nearly half of those over the age of 85 have Alzheimer’s disease (The Bill: S. 1492, 2009). Younger people are also affected by the disease.

The policy is embedded on the fact that most Alzheimer’s disease caregivers work outside the home before beginning their care-giving careers (The Bill: S. 1492, 2009). Care-giving forces some individuals to miss work, cut back to part-time, take less demanding jobs, choose early retirement, or give up work altogether (The Bill: S. 1492, 2009). As a result the publication estimated that Alzheimer’s disease cost American business about $36,500,000,000 in lost productivity, as well as an extra $24,600,000,000 in business inputs to the entire cost of care of the disease.

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