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: 

1 SECTION 1. SHORT TITLE. 

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

3 Accountability, Research, Education, and Support Act of 

4 2024’’ or the ‘‘Autism CARES Act of 2024’’. 

5 SEC. 2. NATIONAL INSTITUTES OF HEALTH ACTIVITIES. 

6 (a) EXPANSION OF ACTIVITIES.—Section 409C(a)(1) 

7 of the Public Health Service Act (42 U.S.C. 284g(a)(1)) is 

8 amended— 
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1 (1) by striking ‘‘) shall, subject to the avail2 ability’’ and inserting the following: ‘‘), in consulta3 tion with relevant Federal departments and agencies, 

4 as appropriate, shall— 

5 ‘‘(A) subject to the availability’’; 

6 (2) by striking ‘‘basic and clinical research in 

7 fields including pathology’’ and inserting the fol8 lowing: ‘‘basic and clinical research— 

9 ‘‘(i) in fields, such as pathology’’; 

10 (3) by striking ‘‘toxicology, and interventions’’ 

11 and inserting the following: ‘‘toxicology, psychiatry, 

12 psychology, developmental behavioral pediatrics, 

13 audiology, and gerontology; and 

14 ‘‘(ii) on interventions’’; 

15 (4) by striking ‘‘disorder. Such research shall in16 vestigate’’ and inserting the following: ‘‘disorder; and 

17 ‘‘(B) ensure that research referred to in sub18 paragraph (A)— 

19 ‘‘(i) investigates’’; 

20 (5) by striking ‘‘prevention, services across the 

21 lifespan, supports, intervention, and treatment of au22 tism spectrum disorder’’ and inserting ‘‘prevention, 

23 services and supports across the lifespan, intervention, 

24 and treatment of autism spectrum disorder and co-oc25 curring conditions’’; and 
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1 (6) by striking ‘‘treatments.’’ and inserting the 

2 following: ‘‘treatments; 

3 ‘‘(ii) examines supports for caregivers; 

4 and 

5 ‘‘(iii) reflects the entire population of 

6 individuals with autism spectrum disorder, 

7 including those individuals with co-occur8 ring conditions and the full range of needs 

9 for supports and services, including such 

10 supports and services to ensure the safety, 

11 and promote the well-being, of such individ12 uals.’’. 

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

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

15 amended— 

16 (1) in paragraph (2)— 

17 (A) by striking ‘‘including the fields of’’ and 

18 inserting ‘‘in fields such as’’; and 

19 (B) by striking ‘‘behavioral psychology, and 

20 clinical psychology’’ and inserting ‘‘behavioral 

21 psychology, clinical psychology, and geron22 tology’’; 

23 (2) in paragraph (5)(A), by striking ‘‘five’’ and 

24 inserting ‘‘seven’’; and 
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1 (3) in paragraph (5)(B), by striking ‘‘period of 

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

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

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

5 as follows: 

6 ‘‘(d) PUBLIC INPUT.— 

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

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

9 public can obtain information on the existing and 

10 planned programs and activities of the National In11 stitutes of Health with respect to autism spectrum 

12 disorder and through which the Director can receive 

13 comments from the public regarding such programs 

14 and activities. 

15 ‘‘(2) GUIDANCE.—The Director may provide 

16 guidance to centers under subsection (b)(1) on strate17 gies, activities, and opportunities to promote engage18 ment with, and solicit input from, individuals with 

19 autism spectrum disorder and their family members, 

20 guardians, advocates or authorized representatives, 

21 providers, or other appropriate individuals to inform 

22 the activities of the center. Such strategies, activities, 

23 and opportunities should consider including, as ap24 propriate, individuals, family members, and care25 givers of individuals with autism spectrum disorder 
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1 who represent the entire population of individuals 

2 with autism spectrum disorder, including those indi3 viduals with co-occurring conditions and the full 

4 range of needs for supports and services, including 

5 such supports and services to ensure the safety, and 

6 promote the well-being, of such individuals, to inform 

7 the activities of the center.’’. 

8 (d) BUDGET ESTIMATE.—Section 409C of the Public 

9 Health Service Act (42 U.S.C. 284g) is amended by adding 

10 at the end the following: 

11 ‘‘(e) BUDGET ESTIMATE.—For each of fiscal years 

12 2026 through 2029, the Director shall prepare and submit, 

13 directly to the President for review and transmittal to Con14 gress, an annual budget estimate for the initiatives of the 

15 National Institutes of Health pursuant to the strategic plan 

16 developed under section 399CC(b)(5) and updated under 

17 section 399CC(b)(6)(B), after reasonable opportunity for 

18 comment (but without change) by the Secretary and the 

19 Interagency Autism Coordinating Committee established 

20 under section 399CC.’’. 

21 SEC. 3. PROGRAMS RELATING TO AUTISM. 

22 (a) DEVELOPMENTAL DISABILITIES SURVEILLANCE

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

24 Health Service Act (42 U.S.C. 280i) is amended— 
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1 (1) in subsection (a)(3), by striking ‘‘an Indian 

2 tribe, or a tribal organization’’ and inserting ‘‘an In3 dian Tribe, or a Tribal organization’’; 

4 (2) in subsection (b)(1), by inserting ‘‘across the 

5 lifespan’’ before the period at the end; 

6 (3) in subsection (d)(1)— 

7 (A) in the paragraph heading, by striking 

8 ‘‘TRIBE; TRIBAL’’ and inserting ‘‘TRIBE; TRIB9 AL’’; 

10 (B) by striking ‘‘tribe’’ and inserting 

11 ‘‘Tribe’’; and 

12 (C) by striking ‘‘tribal’’ and inserting 

13 ‘‘Tribal’’; and 

14 (4) in subsection (e), by striking ‘‘December 20, 

15 2024’’ and inserting ‘‘September 30, 2029’’. 

16 (b) AUTISM EDUCATION, EARLY DETECTION, AND

17 INTERVENTION.—Section 399BB of the Public Health Serv18 ice Act (42 U.S.C. 280i–1) is amended— 

19 (1) in subsection (b)(1), by striking ‘‘culturally 

20 competent information’’ and inserting ‘‘culturally 

21 and linguistically appropriate information’’; 

22 (2) in subsection (b)(2)— 

23 (A) by striking ‘‘promote research’’ and in24 serting ‘‘promote research, which may include re-
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1 search that takes a community-based approach,’’; 

2 and 

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

4 it appears and inserting ‘‘screening and diag5 nostic tools’’; 

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

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

8 (4) in subsection (b)(4), by inserting ‘‘, which 

9 may give consideration to the perspectives of parents 

10 and guardians’’ before the semicolon at the end; 

11 (5) in subsection (b)(7), by striking ‘‘at higher 

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

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

14 competent information’’ and inserting ‘‘culturally 

15 and linguistically appropriate information’’; 

16 (7) in subsection (c)(2)(A)(ii), by striking ‘‘cul17 turally competent information’’ and inserting ‘‘cul18 turally and linguistically appropriate information’’; 

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

20 to read as follows: 

21 (9) in subsection (e)(1)— 

22 (A) in the matter preceding subparagraph 

23 (A), by inserting ‘‘, and strengthen the capacity 

24 of,’’ after ‘‘expand’’; and 

25 (B) in subparagraph (A)— 
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1 (i) by striking ‘‘expand existing or de2 velop new’’ and inserting ‘‘expand and 

3 strengthen the capacity of existing, or, in 

4 States that do not have such a program, de5 velop new,’’; and 

6 (ii) by striking ‘‘Act) in States that do 

7 not have such a program’’ and inserting 

8 ‘‘Act)’’; 

9 (C) in subparagraph (B)(v), by inserting 

10 ‘‘or other providers, as applicable’’ before the 

11 semicolon at the end; and 

12 (D) by amending subparagraph (C) to read 

13 as follows: 

14 ‘‘(C) program sites— 

15 ‘‘(i) provide culturally and linguis16 tically appropriate services; 

17 ‘‘(ii) take a multidisciplinary ap18 proach and have experience working with 

19 underserved populations; and 

20 ‘‘(iii) identify opportunities to partner 

21 with community-based organizations to ex22 pand the capacity of communities to serve 

23 individuals with autism spectrum disorder 

24 or other developmental disabilities.’’; 
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1 (10) in subsection (e)(2), by adding at the end 

2 the following new subparagraph: 

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

4 the date of the enactment of the Autism CARES 

5 Act of 2024, the Secretary shall submit to the 

6 Committee on Energy and Commerce of the 

7 House of Representatives and the Committee on 

8 Health, Education, Labor, and Pensions of the 

9 Senate a report that examines the need for, and 

10 feasibility of, expanding the developmental-be11 havioral pediatrician training programs de12 scribed in subparagraph (A).’’; 

13 (11) by amending subsection (f) to read as fol14 lows: 

15 ‘‘(f) INTERVENTION.—The Secretary shall promote re16 search through grants or contracts, which may include 

17 grants or contracts to research centers or networks, to— 

18 ‘‘(1) develop and evaluate evidence-based prac19 tices and interventions to improve outcomes for indi20 viduals with autism spectrum disorder or other devel21 opmental disabilities by addressing physical and be22 havioral health and communication needs of such in23 dividuals across the lifespan; 

24 ‘‘(2) develop guidelines for such evidence-based 

25 practices and interventions; and 
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1 ‘‘(3) disseminate information related to such evi2 dence-based practices and interventions and guide3 lines.’’; and 

4 (12) in subsection (g), by striking ‘‘December 20, 

5 2024’’ and inserting ‘‘September 30, 2029’’. 

6 (c) INTERAGENCY AUTISM COORDINATING COM7 MITTEE.—Section 399CC of the Public Health Service Act 

8 (42 U.S.C. 280i–2) is amended— 

9 (1) in subsection (b)— 

10 (A) in the matter preceding paragraph (1), 

11 by inserting ‘‘, on a regular basis’’ after ‘‘shall’’; 

12 (B) in paragraph (2), by striking ‘‘develop 

13 a summary’’ and inserting ‘‘summarize’’; and 

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

15 inserting the following: 

16 ‘‘(5) develop a strategic plan for the conduct of, 

17 and support for, autism spectrum disorder research, 

18 as described in section 409C(a)(1), which shall in19 clude— 

20 ‘‘(A) proposed budgetary requirements; and 

21 ‘‘(B) recommendations to ensure that au22 tism spectrum disorder research, and services 

23 and support activities to the extent practicable, 

24 of the Department of Health and Human Serv-
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1 ices and of other Federal departments and agen2 cies are not unnecessarily duplicative; and 

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

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

5 advances described in paragraph (2); and 

6 ‘‘(B) a biennial update on the strategic 

7 plan described in paragraph (5), including 

8 progress made in achieving the goals outlined in 

9 such strategic plan and any specific measures 

10 taken pursuant to such strategic plan.’’; and 

11 (2) in subsection (f), by striking ‘‘December 20, 

12 2024’’ and inserting ‘‘September 30, 2029’’. 

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

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

15 (1) by striking ‘‘2019’’ each place it appears and 

16 inserting ‘‘2024’’; and 

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

18 (1) to read as follows: 

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

20 September 30, 2024, the Secretary, in consultation 

21 with other relevant Federal departments and agencies, 

22 shall prepare and submit to the Committee on Health, 

23 Education, Labor, and Pensions of the Senate and the 

24 Committee on Energy and Commerce of the House of 

25 Representatives, and make publicly available, includ-
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1 ing through posting on the website of the Department 

2 of Health and Human Services, a progress report on 

3 activities related to autism spectrum disorder and 

4 other developmental disabilities. Such report shall in5 clude activities and research related to the entire pop6 ulation of individuals with autism spectrum disorder, 

7 including those individuals with co-occurring condi8 tions and the full range of needs for supports and 

9 services, including such supports and services to en10 sure the safety, and promote the well-being, of such 

11 individuals.’’; 

12 (3) in subsection (b)— 

13 (A) in the heading of subsection (b), by 

14 striking ‘‘HEALTH AND WELL-BEING’’ and in15 serting ‘‘MENTAL HEALTH NEEDS’’; 

16 (B) in paragraph (1), by striking ‘‘health 

17 and well-being’’ and inserting ‘‘mental health 

18 needs’’; and 

19 (C) by amending paragraph (2) to read as 

20 follows: 

21 ‘‘(2) CONTENTS.—The report submitted under 

22 paragraph (1) shall contain— 

23 ‘‘(A) an overview of policies and programs 

24 relevant to the mental health of individuals with 

25 autism spectrum disorder across their lifespan, 
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1 including an identification of existing Federal 

2 laws, regulations, policies, research, and pro3 grams; and 

4 ‘‘(B) recommendations to improve mental 

5 health outcomes and address related disparities 

6 in mental health care for individuals with au7 tism spectrum disorder, including prevention, 

8 care coordination, and community-based serv9 ices.’’; 

10 (4) by adding at the end the following: 

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

12 TRANSITIONING TO ADULTHOOD.—Not later than 2 years 

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

14 2024, the Secretary, in coordination with other relevant 

15 Federal departments and agencies, as appropriate, shall 

16 prepare and submit to the Committee on Energy and Com17 merce of the House of Representatives and the Committee 

18 on Health, Education, Labor, and Pensions of the Senate 

19 an update to the report required pursuant to subsection (b) 

20 of this section, as added by section 6 of the Autism Cares 

21 Act of 2014 (Public Law 113–157), and in effect before the 

22 date of enactment of the Autism CARES Act of 2019 (Pub23 lic Law 116–60), concerning young adults with autism 

24 spectrum disorder and the challenges related to the transi-
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1 tion from existing school-based services to those services 

2 available during adulthood.’’. 

3 (e) AUTHORIZATION OF APPROPRIATIONS.—Section 

4 399EE of the Public Health Service Act (42 U.S.C. 280i– 

5 4) is amended— 

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

7 for each of fiscal years 2020 through 2024’’ and in8 serting ‘‘$28,100,000 for each of fiscal years 2025 

9 through 2029’’; 

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

11 for each of fiscal years 2020 through 2024’’ and in12 serting ‘‘$56,344,000 for each of fiscal years 2025 

13 through 2029’’; and 

14 (3) in subsection (c), by striking ‘‘there are au15 thorized to be appropriated $296,000,000 for each of 

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

17 is authorized to be appropriated $306,000,000 for 

18 each of fiscal years 2025 through 2029’’. 

19 SEC. 4. TECHNICAL ASSISTANCE TO IMPROVE ACCESS TO 

20 COMMUNICATION TOOLS. 

21 (a) IN GENERAL.—The Secretary of Health and 

22 Human Services (referred to in this section as the ‘‘Sec23 retary’’) may, at the request of a State, Indian Tribe, Trib24 al organization, locality, or territory, provide training and 

25 technical assistance to such jurisdiction on the manner in 
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1 which Federal funding administered by the Secretary may 

2 be used to provide individuals with autism spectrum dis3 order and other developmental disabilities with access to 

4 evidence-based services, tools, and technologies that support 

5 communication needs. 

6 (b) ANNUAL REPORT.—The Secretary shall annually 

7 prepare and submit to the Committee on Health, Edu8 cation, Labor, and Pensions of the Senate and the Com9 mittee on Energy and Commerce of the House of Represent10 atives a report summarizing any technical assistance pro11 vided by the Secretary in the preceding fiscal year under 

12 subsection (a) and any advancements in the development 

13 or evaluation of such evidence-based services, tools, and 

14 technologies. 

Attest: 

Secretary. 
118TH CONGRESS 

2D SESSION H.R. 7213 

AMENDMENT