IB 

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] 


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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. 


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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Autism Collaboration, 

5 Accountability, Research, Education, and Support Act of 

6 2024’’ or the ‘‘Autism CARES Act of 2024’’. 

7 SEC. 2. NATIONAL INSTITUTES OF HEALTH ACTIVITIES. 

8 (a) EXPANSION OF ACTIVITIES.—Paragraph (1) of sec9 tion 409C(a) of the Public Health Service Act (42 U.S.C. 

10 284g(a)) is amended to read as follows: 

11 ‘‘(1) EXPANSION OF ACTIVITIES.—The Director 

12 of NIH (in this section referred to as the ‘Director’), 

13 in coordination and consultation with the Adminis14 trator of the Administration for Community Living, 

15 and other agencies as appropriate, shall— 

16 ‘‘(A) subject to the availability of appro17 priations, expand, intensify, and coordinate the 

18 activities of the National Institutes of Health 

19 with respect to research on autism spectrum dis20 order, including— 

21 ‘‘(i) basic and clinical research in 

22 fields including pathology, developmental 

23 neurobiology, genetics, epigenetics, pharma24 cology, nutrition, immunology, 

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1 ment, endocrinology, gastroenterology, toxi2 cology, speech, language and hearing 

3 science, psychiatry, psychology, develop4 mental behavioral pediatrics, and geron5 tology; and 

6 ‘‘(ii) research on interventions to 

7 maximize outcomes for individuals with au8 tism spectrum disorder; and 

9 ‘‘(B) ensure that research referred to in sub10 paragraph (A)— 

11 ‘‘(i) investigates the causes (including 

12 possible environmental causes), diagnosis or 

13 ruling out, early and ongoing detection, 

14 prevention, intervention, services, supports 

15 across the lifespan for autistic individuals 

16 and caregivers, and treatment for autism 

17 spectrum disorder and co-occurring condi18 tions, including dissemination and imple19 mentation of clinical care, supports, inter20 ventions, and treatments; and 

21 ‘‘(ii) reflects the entire population of 

22 individuals with autism spectrum disorder, 

23 including the full range of cognitive, com24 municative, behavioral, and adaptive func25 tioning, as well as co-occurring conditions 


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1 and needs for support and services, includ2 ing care necessary for physical safety.’’. 

3 (b) CENTERS OF EXCELLENCE.—Section 409C(b) of 

4 the Public Health Service Act (42 U.S.C. 284g(b)) is 

5 amended— 

6 (1) in paragraph (2)— 

7 (A) by striking ‘‘prevention, and treatment’’ 

8 and inserting ‘‘prevention, services, and treat9 ment’’; 

10 (B) by striking ‘‘including the fields’’ and 

11 inserting ‘‘including in the fields’’; and 

12 (C) by striking ‘‘behavioral psychology, and 

13 clinical psychology’’ and inserting ‘‘behavioral 

14 psychology, clinical psychology, and geron15 tology’’; 

16 (2) in paragraph (5)(A), by striking ‘‘not less 

17 than five centers’’ and inserting ‘‘not fewer than six 

18 centers’’; and 

19 (3) in paragraph (5)(B), by striking ‘‘period of 

20 not to exceed’’ and inserting ‘‘period not to exceed’’. 

21 (c) PUBLIC INPUT.—Section 409C(d) of the Public 

22 Health Service Act (42 U.S.C. 284g(d)) is amended to read 

23 as follows: 

24 ‘‘(d) PUBLIC INPUT.— 


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1 ‘‘(1) IN GENERAL.—The Director shall under 

2 subsection (a)(1) provide for means through which the 

3 public can obtain information on the existing and 

4 planned programs and activities of the National In5 stitutes of Health with respect to autism spectrum 

6 disorder and through which the Director can receive 

7 comments from the public regarding such programs 

8 and activities. 

9 ‘‘(2) OPPORTUNITIES.—Such public input oppor10 tunities may include encouraging the centers under 

11 subsection (b)(1) to establish an external advisory 

12 board or adopting a comprehensive plan to ensure in13 dividuals with various backgrounds and perspectives 

14 are represented, among other activities. Such opportu15 nities should consider including, as appropriate, indi16 viduals, family members, and caregivers of individ17 uals with autism spectrum disorder who represent the 

18 entire population of individuals with autism spec19 trum disorder, including the full range of cognitive, 

20 communicative, behavioral, and adaptive functioning, 

21 to better inform research findings and future stud22 ies.’’. 


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1 SEC. 3. PROGRAMS RELATING TO AUTISM. 

2 (a) DEVELOPMENTAL DISABILITIES SURVEILLANCE

3 AND RESEARCH PROGRAM.—Section 399AA of the Public 

4 Health Service Act (42 U.S.C. 280i) is amended— 

5 (1) in subsection (b)(1), by striking ‘‘and causes’’ 

6 and inserting ‘‘causes, and life course’’; and 

7 (2) in subsection (e), by striking ‘‘2024’’ and in8 serting ‘‘2029’’. 

9 (b) AUTISM EDUCATION, EARLY DETECTION, AND

10 INTERVENTION.—Section 399BB of the Public Health Serv11 ice Act (42 U.S.C. 280i–1) is amended— 

12 (1) in subsection (a)(2), by striking ‘‘subsequent 

13 interventions’’ and inserting ‘‘subsequent interven14 tions and services’’; 

15 (2) in subsection (b)(1), by striking ‘‘culturally 

16 competent information’’ and inserting ‘‘culturally 

17 and linguistically responsive information’’; 

18 (3) in subsection (b)(2)— 

19 (A) by striking ‘‘promote research’’ and in20 serting ‘‘promote research, which may include 

21 community-based participatory research,’’; and 

22 (B) by striking ‘‘screening tools’’ each place 

23 it appears and inserting ‘‘screening and diag24 nostic tools’’; 

25 (4) in subsection (b)(3), by striking ‘‘at higher 

26 risk’’ and inserting ‘‘at increased likelihood’’; 


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1 (5) in subsection (b)(4), by inserting ‘‘, which 

2 may include such individuals utilizing parents and 

3 guardians trained to provide interventions, services, 

4 and supports’’ before the semicolon at the end; 

5 (6) in subsection (c)(1), by striking ‘‘culturally 

6 competent information’’ and inserting ‘‘culturally 

7 and linguistically responsive information’’; 

8 (7) in subsection (c)(2)(A)(ii)— 

9 (A) by striking ‘‘advocates,’’ and inserting 

10 ‘‘advocates, self-advocates,’’; and 

11 (B) by striking ‘‘culturally competent infor12 mation’’ and inserting ‘‘culturally and linguis13 tically responsive information’’; 

14 (8) by amending paragraph (1) of subsection (e) 

15 to read as follows: 

16 ‘‘(1) TRAINING.—The Secretary, in coordination 

17 with activities conducted under title V of the Social 

18 Security Act, shall, subject to the availability of ap19 propriations, strengthen the capacity of existing 

20 training programs and expand existing interdiscipli21 nary training opportunities or opportunities to in22 crease the number of programs that address the health 

23 and well-being of individuals who have or are at in24 creased likelihood for autism spectrum disorder and 

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1 span. Activities under the preceding sentence shall in2 clude— 

3 ‘‘(A) awarding competitive grants or coop4 erative agreements to public or nonprofit agen5 cies, including institutions of higher education, 

6 to expand existing or develop new maternal and 

7 child health interdisciplinary leadership edu8 cation in neurodevelopmental and related dis9 abilities programs (similar to the programs de10 veloped under section 501(a)(2) of the Social Se11 curity Act) in States that do not have such a 

12 program; 

13 ‘‘(B) ensuring that trainees under such 

14 training programs— 

15 ‘‘(i) receive an appropriate balance of 

16 academic, clinical, and community oppor17 tunities; 

18 ‘‘(ii) are culturally and linguistically 

19 responsive; 

20 ‘‘(iii) are from various backgrounds; 

21 ‘‘(iv) demonstrate a capacity to evalu22 ate, diagnose or rule out, develop, and pro23 vide evidence-based interventions and pro24 grams to individuals with autism spectrum 


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1 disorder and other developmental disabil2 ities across their lifespan; and 

3 ‘‘(v) demonstrate an ability to use a 

4 person- and family-centered approach, 

5 which may include collaborating with re6 search centers or networks to provide train7 ing for providers of respite care (as defined 

8 in section 2901); 

9 ‘‘(C) ensuring that program sites provide 

10 culturally and linguistically responsive services; 

11 and 

12 ‘‘(D) encouraging training programs to 

13 partner with appropriate entities to build com14 munity capacity.’’; 

15 (9) in subsection (e)(2), by adding at the end the 

16 following new subparagraph: 

17 ‘‘(C) REPORT.—Not later than 2 years after 

18 September 30, 2024, the Comptroller General of 

19 the United States shall prepare and submit to 

20 the Committee on Energy and Commerce of the 

21 House of Representatives and the Committee on 

22 Health, Education, Labor, and Pensions of the 

23 Senate a report examining how to increase the 

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1 cians, including through the developmental be2 havioral pediatrician training program.’’; 

3 (10) in subsection (f)— 

4 (A) by striking ‘‘promote research’’ and in5 serting ‘‘promote research, including community6 based participatory research,’’; 

7 (B) by striking ‘‘physical and behavioral 

8 health of individuals’’ and inserting ‘‘physical 

9 and behavioral health, and communication 

10 needs, of individuals’’; and 

11 (C) by striking ‘‘disseminate information 

12 related to such research and guidelines’’ and in13 serting ‘‘disseminate information relating to 

14 such research and guidelines to improve the 

15 quality of life and long-term outcomes’’; and 

16 (11) in subsection (g), by striking ‘‘2024’’ and 

17 inserting ‘‘2029’’. 

18 (c) INTERAGENCY AUTISM COORDINATING COM19 MITTEE.—Section 399CC of the Public Health Service Act 

20 (42 U.S.C. 280i–2) is amended— 

21 (1) in subsection (b)— 

22 (A) in paragraph (2), by striking ‘‘develop 

23 a summary’’ and inserting ‘‘develop and update 

24 a summary’’; 


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1 (B) in paragraphs (3) and (4), by striking 

2 ‘‘make recommendations’’ and inserting ‘‘make 

3 and update recommendations’’; and 

4 (C) by striking paragraphs (5) and (6) and 

5 inserting the following: 

6 ‘‘(5) develop and update a strategic plan for the 

7 conduct of, and support for, autism spectrum disorder 

8 research, including as practicable for services and 

9 supports, for individuals with an autism spectrum 

10 disorder across the lifespan of such individuals and 

11 the families of such individuals, and across the entire 

12 population of individuals with autism spectrum dis13 order, including the full range of cognitive, commu14 nicative, behavioral, and adaptive functioning, as 

15 well as co-occurring conditions and needs for support 

16 and services, including care necessary for physical 

17 safety, which such plan shall include proposed budg18 etary requirements and recommendations to ensure 

19 that autism spectrum disorder research, and services 

20 and support activities to the extent practicable, of the 

21 Department of Health and Human Services and of 

22 other Federal departments and agencies are not un23 necessarily duplicative; and 

24 ‘‘(6) submit to the Congress and President— 


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1 ‘‘(A) an annual update on the summary of 

2 advances described in paragraph (2); and 

3 ‘‘(B) each update to the strategic plan de4 scribed in paragraph (5), including any steps 

5 that have already been taken to implement the 

6 recommendations in such updated strategic plan 

7 and progress made in achieving the goals out8 lined in such updated strategic plan.’’; and 

9 (2) in subsection (f), by striking ‘‘2024’’ and in10 serting ‘‘2029’’. 

11 (d) REPORTS TO CONGRESS.—Section 399DD of the 

12 Public Health Service Act (42 U.S.C. 280i–3) is amended— 

13 (1) by striking ‘‘Autism CARES Act of 2019’’ 

14 each place it appears and inserting ‘‘Autism CARES 

15 Act of 2024’’; 

16 (2) in subsection (a), by amending paragraph 

17 (1) to read as follows: 

18 ‘‘(1) IN GENERAL.—Not later than 4 years after 

19 September 30, 2024, the Secretary, in consultation 

20 and coordination with other Federal departments and 

21 agencies that serve individuals with autism spectrum 

22 disorder, shall prepare and submit to the Committee 

23 on Health, Education, Labor, and Pensions of the 

24 Senate and the Committee on Energy and Commerce 

25 of the House of Representatives, and make publicly 


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1 available, including through posting on the internet 

2 website of the Department of Health and Human 

3 Services, a progress report on activities related to au4 tism spectrum disorder and other developmental dis5 abilities. Such report shall include activities and re6 search related to the entire population of individuals 

7 with autism spectrum disorder, including the full 

8 range of cognitive, communicative, behavioral, and 

9 adaptive functioning, as well as co-occurring condi10 tions and needs for support and services, including 

11 care necessary for physical safety.’’; and 

12 (3) by adding at the end the following: 

13 ‘‘(c) UPDATE ON YOUNG ADULTS AND YOUTH

14 TRANSITIONING TO ADULTHOOD.—Not later than 2 years 

15 after the date of enactment of the Autism CARES Act of 

16 2024, the Secretary, in coordination with other Federal de17 partments and agencies that serve individuals with autism 

18 spectrum disorder, shall prepare and submit to the Com19 mittee on Energy and Commerce of the House of Represent20 atives and the Committee on Health, Education, Labor, and 

21 Pensions of the Senate an update to the report required pur22 suant to section 6 of the Autism Cares Act of 2014 (Public 

23 Law 113–157) concerning young adults with autism spec24 trum disorder and the challenges related to the transition 


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1 from existing school-based services to those services available 

2 during adulthood. 

3 ‘‘(d) PROFESSIONAL JUDGMENT BUDGET.—For each 

4 fiscal year through fiscal year 2029, the Director of the Na5 tional Institutes of Health, in coordination with other rel6 evant agencies, as appropriate, shall prepare and submit, 

7 directly to the President for review and transmittal to Con8 gress, after reasonable opportunity for comment, but with9 out change, by the Secretary and the Interagency Autism 

10 Coordinating Committee established under section 

11 399CC(a), an annual budget estimate for carrying out the 

12 strategic plan developed and updated under section 

13 399CC(b)(5).’’. 

14 (e) AUTHORIZATION OF APPROPRIATIONS.—Section 

15 399EE of the Public Health Service Act (42 U.S.C. 280i– 

16 4) is amended— 

17 (1) in subsection (a), by striking ‘‘$23,100,000 

18 for each of fiscal years 2020 through 2024’’ and in19 serting ‘‘$28,100,000 for each of fiscal years 2025 

20 through 2029’’; 

21 (2) in subsection (b), by striking ‘‘$50,599,000 

22 for each of fiscal years 2020 through 2024’’ and in23 serting ‘‘$56,344,000 for each of fiscal years 2025 

24 through 2029’’; and 


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1 (3) in subsection (c), by striking ‘‘there are au2 thorized to be appropriated $296,000,000 for each of 

3 fiscal years 2020 through 2024’’ and inserting ‘‘there 

4 is authorized to be appropriated $341,000,000 for 

5 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.’’. 


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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 [enother purposes. spect to autism spectrum disorder?], and for autism / reauthorize certain programs with re- trum disorder and enhance programs relating to Health with respect to research on autism spec- hance activities of the National Institutes of 

JULY 30, 2024 

Reported with amendments, committed to the Committee 

dered to be printed of the Whole House on the State of the Union, and orVerDate Sep 11 2014 20:28 Jul 30, 2024 Jkt 049200 PO 00000 Frm 00018 Fmt 6651 Sfmt 6651 E:\BILLS\H7213.RH H7213

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