II 

116TH CONGRESS 

1ST SESSION S. 427 

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, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 7, 2019 

Mr. MENENDEZ (for himself and Mr. ENZI) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

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, and for other purposes. 

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 2019’’ or the ‘‘Autism CARES Act of 2019’’. 


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1 SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINA2 TION OF ACTIVITIES OF THE NIH WITH RE3 SPECT TO RESEARCH ON AUTISM SPECTRUM 

4 DISORDER. 

5 Section 409C of the Public Health Service Act (42 

6 U.S.C. 284g) is amended— 

7 (1) in subsection (a)(1)— 

8 (A) in the first sentence, by striking ‘‘and 

9 toxicology’’ and inserting ‘‘toxicology, and inter10 ventions to maximize outcomes for persons with 

11 autism spectrum disorder’’; and 

12 (B) by striking the second sentence and in13 serting the following: ‘‘Such research shall in14 vestigate the causes (including possible environ15 mental causes), diagnosis or rule out, early and 

16 ongoing detection, prevention, services across 

17 the lifespan, supports, intervention, and treat18 ment of autism spectrum disorder, including 

19 dissemination and implementation of clinical 

20 care, supports, interventions, and treatments.’’; 

21 (2) in subsection (b)— 

22 (A) in paragraph (2)— 

23 (i) in the second sentence, by striking 

24 ‘‘cause’’ and all that follows through ‘‘dis25 order’’ and inserting ‘‘causes, diagnosis, 

26 early and ongoing detection, prevention, 


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1 and treatment of autism spectrum disorder 

2 across the lifespan’’; and 

3 (ii) in the third sentence, by striking 

4 ‘‘neurobiology’’ and all that follows 

5 through the period and inserting ‘‘neurobi6 ology, genetics, genomics, psychopharma7 cology, developmental psychology, behav8 ioral psychology, and clinical psychology.’’; 

9 and 

10 (B) in paragraph (3), by adding at the end 

11 the following: 

12 ‘‘(D) REDUCING DISPARITIES.—The Direc13 tor may consider, as appropriate, the extent to 

14 which a center can demonstrate availability and 

15 access to clinical services for youth and adults 

16 from diverse racial, ethnic, geographic, or lin17 guistic backgrounds in decisions about awarding 

18 grants to applicants which meet the scientific 

19 criteria for funding under this section.’’. 

20 SEC. 3. PROGRAMS RELATING TO AUTISM. 

21 (a) DEVELOPMENTAL DISABILITIES SURVEILLANCE

22 AND RESEARCH PROGRAM.—Section 399AA(e) of the 

23 Public Health Service Act (42 U.S.C. 280i(e)) is amended 

24 by striking ‘‘2019’’ and inserting ‘‘2024’’. 


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1 (b) AUTISM EDUCATION, EARLY DETECTION, AND

2 INTERVENTION.—Section 399BB of the Public Health 

3 Service Act (42 U.S.C. 280i–1) is amended— 

4 (1) in subsection (a)(1), by striking ‘‘children 

5 with autism spectrum disorder’’ and all that follows 

6 through ‘‘disabilities;’’ and inserting ‘‘individuals 

7 with autism spectrum disorder and other develop8 mental disabilities across their lifespan;’’; 

9 (2) in subsection (b)— 

10 (A) in paragraph (2), by inserting ‘‘indi11 viduals with’’ before ‘‘autism spectrum dis12 order’’; 

13 (B) by redesignating paragraphs (4) 

14 through (6) as paragraphs (5) through (7), re15 spectively; and 

16 (C) by inserting after paragraph (3) the 

17 following: 

18 ‘‘(4) promote evidence-based screening tech19 niques and interventions for individuals with autism 

20 spectrum disorder and other developmental disabil21 ities across their lifespan;’’; 

22 (3) in subsection (c)(1), in the matter preceding 

23 subparagraph (A), by inserting ‘‘across their life24 span’’ before ‘‘and their families’’; 

25 (4) in subsection (e)— 


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1 (A) in paragraph (1)— 

2 (i) in the matter preceding subpara3 graph (A), by inserting ‘‘across their life4 span’’ before ‘‘and ensure’’; and 

5 (ii) in subparagraph (B)(iv), by in6 serting ‘‘across their lifespan’’ after ‘‘other 

7 developmental disabilities’’; 

8 (B) by redesignating paragraphs (2) and 

9 (3) as paragraphs (3) and (4), respectively; and 

10 (C) by inserting after paragraph (1) the 

11 following: 

12 ‘‘(2) DEVELOPMENTAL-BEHAVIORAL PEDIATRI13 CIAN TRAINING PROGRAMS.— 

14 ‘‘(A) IN GENERAL.—In making awards 

15 under this subsection, the Secretary may 

16 prioritize awards to applicants that are develop17 mental-behavioral pediatrician training pro18 grams located in rural or underserved areas. 

19 ‘‘(B) DEFINITION OF UNDERSERVED

20 AREA.—In this paragraph, the term ‘under21 served area’ means— 

22 ‘‘(i) a health professional shortage 

23 area (as defined in section 332(a)(1)(A)); 

24 and 


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1 ‘‘(ii) an urban or rural area des2 ignated by the Secretary as an area with 

3 a shortage of personal health services as 

4 described in section 330(b)(3)(A)).’’; 

5 (5) in subsection (f), by inserting ‘‘across the 

6 lifespan of such individuals’’ after ‘‘other develop7 mental disabilities’’; and 

8 (6) in subsection (g), by striking ‘‘2019’’ and 

9 inserting ‘‘2024’’. 

10 (c) INTERAGENCY AUTISM COORDINATING COM11 MITTEE.—Section 399CC of the Public Health Service Act 

12 (42 U.S.C. 280i–2) is amended— 

13 (1) in subsection (b)— 

14 (A) in paragraph (2), by inserting ‘‘across 

15 the lifespan of such individuals’’ before the 

16 semicolon; and 

17 (B) in paragraph (5), by inserting ‘‘across 

18 the lifespan of such individuals’’ before ‘‘and 

19 the families’’; 

20 (2) in subsection (c)— 

21 (A) in paragraph (1)(D), by inserting ‘‘, 

22 the Department of Labor, the Department of 

23 Justice, the Department of Housing and Urban 

24 Development,’’ after ‘‘Department of Edu25 cation’’; and 


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1 (B) in paragraph (3)(A), by striking ‘‘one 

2 or more additional 4-year terms’’ and inserting 

3 ‘‘one additional 4-year term’’; and 

4 (3) in subsection (f), by striking ‘‘2019’’ and 

5 inserting ‘‘2024’’. 

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

7 Public Health Service Act (42 U.S.C. 280i–3) is amend8 ed— 

9 (1) in subsection (a)— 

10 (A) in paragraph (1), by striking ‘‘Autism 

11 CARES Act of 2014’’ and inserting ‘‘Autism 

12 CARES Act of 2019’’; and 

13 (B) in paragraph (2)— 

14 (i) in subparagraphs (A), (B), (D), 

15 and (E), by striking ‘‘Autism CARES Act 

16 of 2014’’ each place it appears and insert17 ing ‘‘Autism CARES Act of 2019’’; 

18 (ii) in subparagraph (G), by striking 

19 ‘‘age of the child’’ and inserting ‘‘age of 

20 the individual’’; 

21 (iii) in subparagraph (H), by striking 

22 ‘‘; and’’ and inserting ‘‘;’’; 

23 (iv) in subparagraph (I), by striking 

24 the period and inserting ‘‘; and’’; and 

25 (v) by adding at the end the following: 


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1 ‘‘(J) information on how States use home2 and community-based services and other sup3 ports to ensure that individuals with autism 

4 spectrum disorder and other developmental dis5 abilities are living, working, and participating in 

6 their community.’’; and 

7 (2) in subsection (b)— 

8 (A) in the heading, by striking ‘‘YOUNG

9 ADULTS AND TRANSITIONING YOUTH’’ and in10 serting ‘‘THE HEALTH AND WELL-BEING OF

11 INDIVIDUALS WITH AUTISM SPECTRUM DIS12 ORDER ACROSS THEIR LIFESPAN’’; 

13 (B) by amending paragraph (1) to read as 

14 follows: 

15 ‘‘(1) IN GENERAL.—Not later than 2 years 

16 after the date of enactment of the Autism CARES 

17 Act of 2019, the Secretary shall prepare and submit, 

18 to the Committee on Health, Education, Labor, and 

19 Pensions of the Senate and the Committee on En20 ergy and Commerce of the House of Representa21 tives, a report concerning the health and well-being 

22 of individuals with autism spectrum disorder.’’; and 

23 (C) in paragraph (2)— 

24 (i) by amending subparagraph (A) to 

25 read as follows: 


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1 ‘‘(A) demographic factors associated with 

2 the health and well-being of individuals with au3 tism spectrum disorder;’’; 

4 (ii) in subparagraph (B), by striking 

5 ‘‘young adults’’ and all that follows 

6 through the semicolon and inserting ‘‘the 

7 health and well-being of individuals with 

8 autism spectrum disorder, including an 

9 identification of existing Federal laws, reg10 ulations, policies, research, and pro11 grams;’’; and 

12 (iii) by amending subparagraphs (C), 

13 (D), and (E) to read as follows: 

14 ‘‘(C) recommendations on establishing best 

15 practices guidelines to ensure interdisciplinary 

16 coordination between all relevant service pro17 viders receiving Federal funding; 

18 ‘‘(D) comprehensive approaches to improv19 ing health outcomes and well-being for individ20 uals with autism spectrum disorder, including— 

21 ‘‘(i) community-based behavioral sup22 ports and interventions; 

23 ‘‘(ii) nutrition, recreational, and social 

24 activities; and 


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1 ‘‘(iii) personal safety services related 

2 to public safety agencies or the criminal 

3 justice system for such individuals; and 

4 ‘‘(E) recommendations that seek to im5 prove health outcomes for such individuals, in6 cluding across their lifespan, by addressing— 

7 ‘‘(i) screening and diagnosis of chil8 dren and adults; 

9 ‘‘(ii) behavioral and other therapeutic 

10 approaches; 

11 ‘‘(iii) primary and preventative care; 

12 ‘‘(iv) communication challenges; 

13 ‘‘(v) aggression, self-injury, elope14 ment, and other behavioral issues; 

15 ‘‘(vi) emergency room visits and acute 

16 care hospitalization; 

17 ‘‘(vii) treatment for co-occurring phys18 ical and mental health conditions; 

19 ‘‘(viii) premature mortality; 

20 ‘‘(ix) medical practitioner training; 

21 and 

22 ‘‘(x) caregiver mental health.’’. 

23 (e) AUTHORIZATION OF APPROPRIATIONS.—Section 

24 399EE of the Public Health Service Act (42 U.S.C. 280i– 

25 4) is amended— 


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1 (1) in subsection (a), by striking ‘‘$22,000,000 

2 for each of fiscal years 2015 through 2019’’ and in3 serting ‘‘$23,100,000 for each of fiscal years 2020 

4 through 2024’’; 

5 (2) in subsection (b), by striking ‘‘$48,000,000 

6 for each of fiscal years 2015 through 2019’’ and in7 serting ‘‘$50,599,000 for each of fiscal years 2020 

8 through 2024’’; and 

9 (3) in subsection (c), by striking ‘‘there is au10 thorized to be appropriated $190,000,000 for each 

11 of fiscal years 2015 through 2019’’ and inserting 

12 ‘‘there are authorized to be appropriated such sums 

13 as may be necessary for each of fiscal years 2020 

14 through 2024’’. 

Æ 


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