[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7213 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 518
118th CONGRESS
  2d Session
                                H. R. 7213

                          [Report No. 118-620]

 To amend the Public Health Service Act to [enhance activities of the 
   National Institutes of Health with respect to research on autism 
spectrum disorder and enhance programs relating to autism / reauthorize 
 certain programs with respect to autism spectrum disorder?], and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 1, 2024

 Mr. Smith of New Jersey (for himself and Mr. Cuellar) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

                             July 30, 2024

Additional sponsors: Mr. Carter of Georgia, Mrs. Dingell, Mr. Molinaro, 
 Ms. Kuster, Mr. Fitzpatrick, Mr. Moulton, Mr. Kean of New Jersey, Mr. 
   Soto, Mr. Kiley, Mr. Gottheimer, Mr. Davis of North Carolina, Ms. 
Matsui, Mr. Stauber, Ms. Clarke of New York, Mr. Bacon, Ms. Spanberger, 
 Mr. Harder of California, Ms. Tlaib, Mr. Moore of Utah, Ms. Slotkin, 
 Ms. Omar, Mr. Joyce of Pennsylvania, Mr. Kim of New Jersey, Ms. Blunt 
  Rochester, Ms. Kaptur, Ms. Salazar, Ms. Tenney, Mr. Harris, Mr. Van 
Drew, Mrs. Miller of West Virginia, Mr. Graves of Louisiana, Mr. Larson 
 of Connecticut, Ms. Waters, Ms. Sewell, Mr. Suozzi, Mr. Panetta, Mrs. 
  Peltola, Mr. Ryan, Mr. Lawler, Mr. Pappas, Ms. Adams, Mr. Kelly of 
 Pennsylvania, Mr. Van Orden, Mr. Neguse, Ms. Stevens, Ms. Budzinski, 
 Mr. Bilirakis, Ms. Pingree, Ms. Tokuda, Ms. Pettersen, Mr. Courtney, 
 Mr. Landsman, Mr. Jackson of Illinois, Mr. Thompson of Pennsylvania, 
Mr. Pocan, Mr. Schneider, Ms. Lee of Nevada, Mr. Williams of New York, 
                        Mr. Meuser, and Mr. Crow

                             July 30, 2024

Reported with amendments, committed to the Committee of the Whole House 
          on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           February 1, 2024]


_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to [enhance activities of the 
   National Institutes of Health with respect to research on autism 
spectrum disorder and enhance programs relating to autism / reauthorize 
 certain programs with respect to autism spectrum disorder?], and for 
                            other purposes.


 


    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 ``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.--Paragraph (1) of section 409C(a) of 
the Public Health Service Act (42 U.S.C. 284g(a)) is amended to read as 
follows:
            ``(1) Expansion of activities.--The Director of NIH (in 
        this section referred to as the `Director'), in coordination 
        and consultation with the Administrator of the Administration 
        for Community Living, and other agencies as appropriate, 
        shall--
                    ``(A) subject to the availability of 
                appropriations, expand, intensify, and coordinate the 
                activities of the National Institutes of Health with 
                respect to research on autism spectrum disorder, 
                including--
                            ``(i) basic and clinical research in fields 
                        including pathology, developmental 
                        neurobiology, genetics, epigenetics, 
                        pharmacology, nutrition, immunology, 
                        neuroimmunology, neurobehavioral development, 
                        endocrinology, gastroenterology, toxicology, 
                        speech, language and hearing science, 
                        psychiatry, psychology, developmental 
                        behavioral pediatrics, and gerontology; and
                            ``(ii) research on interventions to 
                        maximize outcomes for individuals with autism 
                        spectrum disorder; and
                    ``(B) ensure that research referred to in 
                subparagraph (A)--
                            ``(i) investigates the causes (including 
                        possible environmental causes), diagnosis or 
                        ruling out, early and ongoing detection, 
                        prevention, intervention, services, supports 
                        across the lifespan for autistic individuals 
                        and caregivers, and treatment for autism 
                        spectrum disorder and co-occurring conditions, 
                        including dissemination and implementation of 
                        clinical care, supports, interventions, and 
                        treatments; and
                            ``(ii) reflects the entire population of 
                        individuals with autism spectrum disorder, 
                        including the full range of cognitive, 
                        communicative, behavioral, and adaptive 
                        functioning, as well as co-occurring conditions 
                        and needs for support and services, including 
                        care necessary for physical safety.''.
    (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 ``prevention, and treatment'' and 
                inserting ``prevention, services, and treatment'';
                    (B) by striking ``including the fields'' and 
                inserting ``including in the fields''; and
                    (C) by striking ``behavioral psychology, and 
                clinical psychology'' and inserting ``behavioral 
                psychology, clinical psychology, and gerontology'';
            (2) in paragraph (5)(A), by striking ``not less than five 
        centers'' and inserting ``not fewer than six centers''; 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) Opportunities.--Such public input opportunities may 
        include encouraging the centers under subsection (b)(1) to 
        establish an external advisory board or adopting a 
        comprehensive plan to ensure individuals with various 
        backgrounds and perspectives are represented, among other 
        activities. Such 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 the full range of cognitive, communicative, 
        behavioral, and adaptive functioning, to better inform research 
        findings and future studies.''.

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 (b)(1), by striking ``and causes'' and 
        inserting ``causes, and life course''; and
            (2) in subsection (e), by striking ``2024'' and inserting 
        ``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 (a)(2), by striking ``subsequent 
        interventions'' and inserting ``subsequent interventions and 
        services'';
            (2) in subsection (b)(1), by striking ``culturally 
        competent information'' and inserting ``culturally and 
        linguistically responsive information'';
            (3) in subsection (b)(2)--
                    (A) by striking ``promote research'' and inserting 
                ``promote research, which may include community-based 
                participatory research,''; and
                    (B) by striking ``screening tools'' each place it 
                appears and inserting ``screening and diagnostic 
                tools'';
            (4) in subsection (b)(3), by striking ``at higher risk'' 
        and inserting ``at increased likelihood'';
            (5) in subsection (b)(4), by inserting ``, which may 
        include such individuals utilizing parents and guardians 
        trained to provide interventions, services, and supports'' 
        before the semicolon at the end;
            (6) in subsection (c)(1), by striking ``culturally 
        competent information'' and inserting ``culturally and 
        linguistically responsive information'';
            (7) in subsection (c)(2)(A)(ii)--
                    (A) by striking ``advocates,'' and inserting 
                ``advocates, self-advocates,''; and
                    (B) by striking ``culturally competent 
                information'' and inserting ``culturally and 
                linguistically responsive information'';
            (8) by amending paragraph (1) of subsection (e) to read as 
        follows:
            ``(1) Training.--The Secretary, in coordination with 
        activities conducted under title V of the Social Security Act, 
        shall, subject to the availability of appropriations, 
        strengthen the capacity of existing training programs and 
        expand existing interdisciplinary training opportunities or 
        opportunities to increase the number of programs that address 
        the health and well-being of individuals who have or are at 
        increased likelihood for autism spectrum disorder and other 
        neurodevelopmental disabilities across their lifespan. 
        Activities under the preceding sentence shall include--
                    ``(A) awarding competitive grants or cooperative 
                agreements to public or nonprofit agencies, including 
                institutions of higher education, to expand existing or 
                develop new maternal and child health interdisciplinary 
                leadership education in neurodevelopmental and related 
                disabilities programs (similar to the programs 
                developed under section 501(a)(2) of the Social 
                Security Act) in States that do not have such a 
                program;
                    ``(B) ensuring that trainees under such training 
                programs--
                            ``(i) receive an appropriate balance of 
                        academic, clinical, and community 
                        opportunities;
                            ``(ii) are culturally and linguistically 
                        responsive;
                            ``(iii) are from various backgrounds;
                            ``(iv) demonstrate a capacity to evaluate, 
                        diagnose or rule out, develop, and provide 
                        evidence-based interventions and programs to 
                        individuals with autism spectrum disorder and 
                        other developmental disabilities across their 
                        lifespan; and
                            ``(v) demonstrate an ability to use a 
                        person- and family-centered approach, which may 
                        include collaborating with research centers or 
                        networks to provide training for providers of 
                        respite care (as defined in section 2901);
                    ``(C) ensuring that program sites provide 
                culturally and linguistically responsive services; and
                    ``(D) encouraging training programs to partner with 
                appropriate entities to build community capacity.'';
            (9) in subsection (e)(2), by adding at the end the 
        following new subparagraph:
                    ``(C) Report.--Not later than 2 years after 
                September 30, 2024, the Comptroller General of the 
                United States 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 a report examining how to 
                increase the number of developmental-behavioral 
                pediatricians, including through the developmental 
                behavioral pediatrician training program.'';
            (10) in subsection (f)--
                    (A) by striking ``promote research'' and inserting 
                ``promote research, including community-based 
                participatory research,'';
                    (B) by striking ``physical and behavioral health of 
                individuals'' and inserting ``physical and behavioral 
                health, and communication needs, of individuals''; and
                    (C) by striking ``disseminate information related 
                to such research and guidelines'' and inserting 
                ``disseminate information relating to such research and 
                guidelines to improve the quality of life and long-term 
                outcomes''; and
            (11) in subsection (g), by striking ``2024'' and inserting 
        ``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 paragraph (2), by striking ``develop a 
                summary'' and inserting ``develop and update a 
                summary'';
                    (B) in paragraphs (3) and (4), by striking ``make 
                recommendations'' and inserting ``make and update 
                recommendations''; and
                    (C) by striking paragraphs (5) and (6) and 
                inserting the following:
            ``(5) develop and update a strategic plan for the conduct 
        of, and support for, autism spectrum disorder research, 
        including as practicable for services and supports, for 
        individuals with an autism spectrum disorder across the 
        lifespan of such individuals and the families of such 
        individuals, and across the entire population of individuals 
        with autism spectrum disorder, including the full range of 
        cognitive, communicative, behavioral, and adaptive functioning, 
        as well as co-occurring conditions and needs for support and 
        services, including care necessary for physical safety, which 
        such plan shall include proposed budgetary requirements and 
        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 President--
                    ``(A) an annual update on the summary of advances 
                described in paragraph (2); and
                    ``(B) each update to the strategic plan described 
                in paragraph (5), including any steps that have already 
                been taken to implement the recommendations in such 
                updated strategic plan and progress made in achieving 
                the goals outlined in such updated strategic plan.''; 
                and
            (2) in subsection (f), by striking ``2024'' and inserting 
        ``2029''.
    (d) Reports to Congress.--Section 399DD of the Public Health 
Service Act (42 U.S.C. 280i-3) is amended--
            (1) by striking ``Autism CARES Act of 2019'' each place it 
        appears and inserting ``Autism CARES Act of 2024'';
            (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 and coordination with 
        other Federal departments and agencies that serve individuals 
        with autism spectrum disorder, 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 internet 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 the full range of cognitive, communicative, 
        behavioral, and adaptive functioning, as well as co-occurring 
        conditions and needs for support and services, including care 
        necessary for physical safety.''; and
            (3) 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 
Federal departments and agencies that serve individuals with autism 
spectrum disorder, 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 section 6 of the Autism Cares Act of 2014 
(Public Law 113-157) 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.
    ``(d) Professional Judgment Budget.--For each fiscal year through 
fiscal year 2029, the Director of the National Institutes of Health, in 
coordination with other relevant agencies, as appropriate, shall 
prepare and submit, directly to the President for review and 
transmittal to Congress, after reasonable opportunity for comment, but 
without change, by the Secretary and the Interagency Autism 
Coordinating Committee established under section 399CC(a), an annual 
budget estimate for carrying out the strategic plan developed and 
updated under section 399CC(b)(5).''.
    (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 $341,000,000 for each of fiscal years 2025 through 
        2029''.
            Amend the title so as to read: ``A bill to amend the Public 
        Health Service Act to enhance and reauthorize activities and 
        programs relating to autism spectrum disorder, and for other 
        purposes.''.
                                                 Union Calendar No. 518

118th CONGRESS

  2d Session

                               H. R. 7213

                          [Report No. 118-620]

_______________________________________________________________________

                                 A BILL

 To amend the Public Health Service Act to [enhance activities of the 
   National Institutes of Health with respect to research on autism 
spectrum disorder and enhance programs relating to autism / reauthorize 
 certain programs with respect to autism spectrum disorder?], and for 
                            other purposes.

_______________________________________________________________________

                             July 30, 2024

Reported with amendments, committed to the Committee of the Whole House 
          on the State of the Union, and ordered to be printed