[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7213 Engrossed Amendment Senate (EAS)]

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                  In the Senate of the United States,

                                                     November 21, 2024.
    Resolved, That the bill from the House of Representatives (H.R. 
7213) entitled ``An Act to amend the Public Health Service Act to 
enhance and reauthorize activities and programs relating to autism 
spectrum disorder, and for other purposes.'', do pass with the 
following

                               AMENDMENT:

             Strike all after the enacting clause and insert the 
      following:

SECTION 1. SHORT TITLE.

     This Act may be cited as the ``Autism Collaboration, 
Accountability, Research, Education, and Support Act of 2024'' or the 
``Autism CARES Act of 2024''.

SEC. 2. NATIONAL INSTITUTES OF HEALTH ACTIVITIES.

    (a) Expansion of Activities.--Section 409C(a)(1) of the Public 
Health Service Act (42 U.S.C. 284g(a)(1)) is amended--
            (1) by striking ``) shall, subject to the availability'' 
        and inserting the following: ``), in consultation with relevant 
        Federal departments and agencies, as appropriate, shall--
                    ``(A) subject to the availability'';
            (2) by striking ``basic and clinical research in fields 
        including pathology'' and inserting the following: ``basic and 
        clinical research--
                            ``(i) in fields, such as pathology'';
            (3) by striking ``toxicology, and interventions'' and 
        inserting the following: ``toxicology, psychiatry, psychology, 
        developmental behavioral pediatrics, audiology, and 
        gerontology; and
                            ``(ii) on interventions'';
            (4) by striking ``disorder. Such research shall 
        investigate'' and inserting the following: ``disorder; and
                    ``(B) ensure that research referred to in 
                subparagraph (A)--
                            ``(i) investigates'';
            (5) by striking ``prevention, services across the lifespan, 
        supports, intervention, and treatment of autism spectrum 
        disorder'' and inserting ``prevention, services and supports 
        across the lifespan, intervention, and treatment of autism 
        spectrum disorder and co-occurring conditions''; and
            (6) by striking ``treatments.'' and inserting the 
        following: ``treatments;
                            ``(ii) examines supports for caregivers; 
                        and
                            ``(iii) reflects the entire population of 
                        individuals with autism spectrum disorder, 
                        including those individuals with co-occurring 
                        conditions and the full range of needs for 
                        supports and services, including such supports 
                        and services to ensure the safety, and promote 
                        the well-being, of such individuals.''.
    (b) Centers of Excellence.--Section 409C(b) of the Public Health 
Service Act (42 U.S.C. 284g(b)) is amended--
            (1) in paragraph (2)--
                    (A) by striking ``including the fields of'' and 
                inserting ``in fields such as''; and
                    (B) by striking ``behavioral psychology, and 
                clinical psychology'' and inserting ``behavioral 
                psychology, clinical psychology, and gerontology'';
            (2) in paragraph (5)(A), by striking ``five'' and inserting 
        ``seven''; and
            (3) in paragraph (5)(B), by striking ``period of not to 
        exceed'' and inserting ``period not to exceed''.
    (c) Public Input.--Section 409C(d) of the Public Health Service Act 
(42 U.S.C. 284g(d)) is amended to read as follows:
    ``(d) Public Input.--
            ``(1) In general.--The Director shall under subsection 
        (a)(1) provide for means through which the public can obtain 
        information on the existing and planned programs and activities 
        of the National Institutes of Health with respect to autism 
        spectrum disorder and through which the Director can receive 
        comments from the public regarding such programs and 
        activities.
            ``(2) Guidance.--The Director may provide guidance to 
        centers under subsection (b)(1) on strategies, activities, and 
        opportunities to promote engagement with, and solicit input 
        from, individuals with autism spectrum disorder and their 
        family members, guardians, advocates or authorized 
        representatives, providers, or other appropriate individuals to 
        inform the activities of the center. Such strategies, 
        activities, and opportunities should consider including, as 
        appropriate, individuals, family members, and caregivers of 
        individuals with autism spectrum disorder who represent the 
        entire population of individuals with autism spectrum disorder, 
        including those individuals with co-occurring conditions and 
        the full range of needs for supports and services, including 
        such supports and services to ensure the safety, and promote 
        the well-being, of such individuals, to inform the activities 
        of the center.''.
    (d) Budget Estimate.--Section 409C of the Public Health Service Act 
(42 U.S.C. 284g) is amended by adding at the end the following:
    ``(e) Budget Estimate.--For each of fiscal years 2026 through 2029, 
the Director shall prepare and submit, directly to the President for 
review and transmittal to Congress, an annual budget estimate for the 
initiatives of the National Institutes of Health pursuant to the 
strategic plan developed under section 399CC(b)(5) and updated under 
section 399CC(b)(6)(B), after reasonable opportunity for comment (but 
without change) by the Secretary and the Interagency Autism 
Coordinating Committee established under section 399CC.''.

SEC. 3. PROGRAMS RELATING TO AUTISM.

    (a) Developmental Disabilities Surveillance and Research Program.--
Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is 
amended--
            (1) in subsection (a)(3), by striking ``an Indian tribe, or 
        a tribal organization'' and inserting ``an Indian Tribe, or a 
        Tribal organization'';
            (2) in subsection (b)(1), by inserting ``across the 
        lifespan'' before the period at the end;
            (3) in subsection (d)(1)--
                    (A) in the paragraph heading, by striking ``tribe; 
                tribal'' and inserting ``Tribe; tribal'';
                    (B) by striking ``tribe'' and inserting ``Tribe''; 
                and
                    (C) by striking ``tribal'' and inserting 
                ``Tribal''; and
            (4) in subsection (e), by striking ``December 20, 2024'' 
        and inserting ``September 30, 2029''.
    (b) Autism Education, Early Detection, and Intervention.--Section 
399BB of the Public Health Service Act (42 U.S.C. 280i-1) is amended--
            (1) in subsection (b)(1), by striking ``culturally 
        competent information'' and inserting ``culturally and 
        linguistically appropriate information'';
            (2) in subsection (b)(2)--
                    (A) by striking ``promote research'' and inserting 
                ``promote research, which may include research that 
                takes a community-based approach,''; and
                    (B) by striking ``screening tools'' each place it 
                appears and inserting ``screening and diagnostic 
                tools'';
            (3) in subsection (b)(3), by striking ``at higher risk'' 
        and inserting ``at increased likelihood'';
            (4) in subsection (b)(4), by inserting ``, which may give 
        consideration to the perspectives of parents and guardians'' 
        before the semicolon at the end;
            (5) in subsection (b)(7), by striking ``at higher risk'' 
        and inserting ``at increased likelihood'';
            (6) in subsection (c)(1), by striking ``culturally 
        competent information'' and inserting ``culturally and 
        linguistically appropriate information'';
            (7) in subsection (c)(2)(A)(ii), by striking ``culturally 
        competent information'' and inserting ``culturally and 
        linguistically appropriate information'';
            (8) by amending paragraph (1) of subsection (e) to read as 
        follows:
            (9) in subsection (e)(1)--
                    (A) in the matter preceding subparagraph (A), by 
                inserting ``, and strengthen the capacity of,'' after 
                ``expand''; and
                    (B) in subparagraph (A)--
                            (i) by striking ``expand existing or 
                        develop new'' and inserting ``expand and 
                        strengthen the capacity of existing, or, in 
                        States that do not have such a program, develop 
                        new,''; and
                            (ii) by striking ``Act) in States that do 
                        not have such a program'' and inserting 
                        ``Act)'';
                    (C) in subparagraph (B)(v), by inserting ``or other 
                providers, as applicable'' before the semicolon at the 
                end; and
                    (D) by amending subparagraph (C) to read as 
                follows:
                    ``(C) program sites--
                            ``(i) provide culturally and linguistically 
                        appropriate services;
                            ``(ii) take a multidisciplinary approach 
                        and have experience working with underserved 
                        populations; and
                            ``(iii) identify opportunities to partner 
                        with community-based organizations to expand 
                        the capacity of communities to serve 
                        individuals with autism spectrum disorder or 
                        other developmental disabilities.'';
            (10) in subsection (e)(2), by adding at the end the 
        following new subparagraph:
                    ``(C) Report.--Not later than 2 years after the 
                date of the enactment of the Autism CARES Act of 2024, 
                the Secretary shall submit to the Committee on Energy 
                and Commerce of the House of Representatives and the 
                Committee on Health, Education, Labor, and Pensions of 
                the Senate a report that examines the need for, and 
                feasibility of, expanding the developmental-behavioral 
                pediatrician training programs described in 
                subparagraph (A).'';
            (11) by amending subsection (f) to read as follows:
    ``(f) Intervention.--The Secretary shall promote research through 
grants or contracts, which may include grants or contracts to research 
centers or networks, to--
            ``(1) develop and evaluate evidence-based practices and 
        interventions to improve outcomes for individuals with autism 
        spectrum disorder or other developmental disabilities by 
        addressing physical and behavioral health and communication 
        needs of such individuals across the lifespan;
            ``(2) develop guidelines for such evidence-based practices 
        and interventions; and
            ``(3) disseminate information related to such evidence-
        based practices and interventions and guidelines.''; and
            (12) in subsection (g), by striking ``December 20, 2024'' 
        and inserting ``September 30, 2029''.
    (c) Interagency Autism Coordinating Committee.--Section 399CC of 
the Public Health Service Act (42 U.S.C. 280i-2) is amended--
            (1) in subsection (b)--
                    (A) in the matter preceding paragraph (1), by 
                inserting ``, on a regular basis'' after ``shall'';
                    (B) in paragraph (2), by striking ``develop a 
                summary'' and inserting ``summarize''; and
                    (C) by striking paragraphs (5) and (6) and 
                inserting the following:
            ``(5) develop a strategic plan for the conduct of, and 
        support for, autism spectrum disorder research, as described in 
        section 409C(a)(1), which shall include--
                    ``(A) proposed budgetary requirements; and
                    ``(B) recommendations to ensure that autism 
                spectrum disorder research, and services and support 
                activities to the extent practicable, of the Department 
                of Health and Human Services and of other Federal 
                departments and agencies are not unnecessarily 
                duplicative; and
            ``(6) submit to the Congress and the President--
                    ``(A) an annual update on the summary of advances 
                described in paragraph (2); and
                    ``(B) a biennial update on the strategic plan 
                described in paragraph (5), including progress made in 
                achieving the goals outlined in such strategic plan and 
                any specific measures taken pursuant to such strategic 
                plan.''; and
            (2) in subsection (f), by striking ``December 20, 2024'' 
        and inserting ``September 30, 2029''.
    (d) Reports to Congress.--Section 399DD of the Public Health 
Service Act (42 U.S.C. 280i-3) is amended--
            (1) by striking ``2019'' each place it appears and 
        inserting ``2024''; and
            (2) in subsection (a), by amending paragraph (1) to read as 
        follows:
            ``(1) In general.--Not later than 4 years after September 
        30, 2024, the Secretary, in consultation with other relevant 
        Federal departments and agencies, shall prepare and submit to 
        the Committee on Health, Education, Labor, and Pensions of the 
        Senate and the Committee on Energy and Commerce of the House of 
        Representatives, and make publicly available, including through 
        posting on the website of the Department of Health and Human 
        Services, a progress report on activities related to autism 
        spectrum disorder and other developmental disabilities. Such 
        report shall include activities and research related to the 
        entire population of individuals with autism spectrum disorder, 
        including those individuals with co-occurring conditions and 
        the full range of needs for supports and services, including 
        such supports and services to ensure the safety, and promote 
        the well-being, of such individuals.'';
            (3) in subsection (b)--
                    (A) in the heading of subsection (b), by striking 
                ``Health and Well-Being'' and inserting ``Mental Health 
                Needs'';
                    (B) in paragraph (1), by striking ``health and 
                well-being'' and inserting ``mental health needs''; and
                    (C) by amending paragraph (2) to read as follows:
            ``(2) Contents.--The report submitted under paragraph (1) 
        shall contain--
                    ``(A) an overview of policies and programs relevant 
                to the mental health of individuals with autism 
                spectrum disorder across their lifespan, including an 
                identification of existing Federal laws, regulations, 
                policies, research, and programs; and
                    ``(B) recommendations to improve mental health 
                outcomes and address related disparities in mental 
                health care for individuals with autism spectrum 
                disorder, including prevention, care coordination, and 
                community-based services.'';
            (4) by adding at the end the following:
    ``(c) Update on Young Adults and Youth Transitioning to 
Adulthood.--Not later than 2 years after the date of enactment of the 
Autism CARES Act of 2024, the Secretary, in coordination with other 
relevant Federal departments and agencies, as appropriate, shall 
prepare and submit to the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Health, Education, Labor, and 
Pensions of the Senate an update to the report required pursuant to 
subsection (b) of this section, as added by section 6 of the Autism 
Cares Act of 2014 (Public Law 113-157), and in effect before the date 
of enactment of the Autism CARES Act of 2019 (Public Law 116-60), 
concerning young adults with autism spectrum disorder and the 
challenges related to the transition from existing school-based 
services to those services available during adulthood.''.
    (e) Authorization of Appropriations.--Section 399EE of the Public 
Health Service Act (42 U.S.C. 280i-4) is amended--
            (1) in subsection (a), by striking ``$23,100,000 for each 
        of fiscal years 2020 through 2024'' and inserting ``$28,100,000 
        for each of fiscal years 2025 through 2029'';
            (2) in subsection (b), by striking ``$50,599,000 for each 
        of fiscal years 2020 through 2024'' and inserting ``$56,344,000 
        for each of fiscal years 2025 through 2029''; and
            (3) in subsection (c), by striking ``there are authorized 
        to be appropriated $296,000,000 for each of fiscal years 2020 
        through 2024'' and inserting ``there is authorized to be 
        appropriated $306,000,000 for each of fiscal years 2025 through 
        2029''.

SEC. 4. TECHNICAL ASSISTANCE TO IMPROVE ACCESS TO COMMUNICATION TOOLS.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') may, at the request 
of a State, Indian Tribe, Tribal organization, locality, or territory, 
provide training and technical assistance to such jurisdiction on the 
manner in which Federal funding administered by the Secretary may be 
used to provide individuals with autism spectrum disorder and other 
developmental disabilities with access to evidence-based services, 
tools, and technologies that support communication needs.
    (b) Annual Report.--The Secretary shall annually prepare and submit 
to the Committee on Health, Education, Labor, and Pensions of the 
Senate and the Committee on Energy and Commerce of the House of 
Representatives a report summarizing any technical assistance provided 
by the Secretary in the preceding fiscal year under subsection (a) and 
any advancements in the development or evaluation of such evidence-
based services, tools, and technologies.

            Attest:

                                                             Secretary.
118th CONGRESS

  2d Session

                               H.R. 7213

_______________________________________________________________________

                               AMENDMENT