I 

111TH CONGRESS 

1ST SESSION H. R. 2413 

To provide for enhanced treatment, support, services, and research for 

individuals with autism spectrum disorders and their families. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 14, 2009 

Mr. DOYLE (for himself, Mr. SMITH of New Jersey, Mr. ENGEL, and Mr. 

JOHNSON of Georgia) introduced the following bill; which was referred to 

the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, Oversight and Government Reform, and 

Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To provide for enhanced treatment, support, services, and 

research for individuals with autism spectrum disorders 

and their families. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Autism Treatment Acceleration Act of 2009’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 


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Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Parental rights rule of construction. 

Sec. 4. Definitions; technical amendment to the Public Health Service Act. 

Sec. 5. Autism Care Centers Demonstration Project. 

Sec. 6. Planning and demonstration grants for services for adults. 

Sec. 7. Multimedia campaign. 

Sec. 8. Interdepartmental Autism Coordinating Committee. 

Sec. 9. National Network for Autism Spectrum Disorders Research and Services. 

Sec. 10. National training initiatives on autism spectrum disorders. 

Sec. 11. Amendments relating to health insurance. 

Sec. 12. Authorization of appropriations. 

1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Autism (sometimes called ‘‘classical au4 tism’’) is the most common condition in a group of 

5 developmental disorders known as autism spectrum 

6 disorders. 

7 (2) Autism spectrum disorders include autism 

8 as well as Asperger syndrome, Retts syndrome, 

9 childhood disintegrative disorder, and pervasive de10 velopmental disorder not otherwise specified (usually 

11 referred to as PDD–NOS), as well as other related 

12 developmental disorders. 

13 (3) Individuals with autism spectrum disorders 

14 have the same rights as other individuals to exert 

15 control and choice over their own lives, to live inde16 pendently, and to participate fully in, and contribute 

17 to, their communities and society through full inte18 gration and inclusion in the economic, political, so19 cial, cultural, and educational mainstream of society. 


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1 Individuals with autism spectrum disorders have the 

2 right to a life with dignity and purpose. 

3 (4) While there is no uniform prevalence or se4 verity of symptoms associated with autism spectrum 

5 disorders, the National Institutes of Health has de6 termined that autism spectrum disorders are charac7 terized by 3 distinctive behaviors: impaired social 

8 interaction, problems with verbal and nonverbal 

9 communication, and unusual, repetitive, or severely 

10 limited activities and interests. 

11 (5) Both children and adults with autism spec12 trum disorders can show difficulties in verbal and 

13 nonverbal communication, social interactions, and 

14 sensory processing. Individuals with autism spec15 trum disorders exhibit different symptoms or behav16 iors, which may range from mild to significant, and 

17 require varying degrees of support from friends, 

18 families, service providers, and communities. 

19 (6) Individuals with autism spectrum disorders 

20 often need assistance in the areas of comprehensive 

21 early intervention, communication, health, recre22 ation, job training, employment, housing, transpor23 tation, and early, primary, and secondary education. 

24 With access to, and assistance with, these types of 

25 services and supports, individuals with autism specVerDate Nov 24 2008 03:05 May 16, 2009 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2413.IH H2413

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1 trum disorders can live rich, full, and productive 

2 lives. Greater coordination and streamlining within 

3 the service delivery system will enable individuals 

4 with autism spectrum disorders and their families to 

5 access assistance from all sectors throughout an in6 dividual’s lifespan. 

7 (7) A 2007 report from the Centers for Disease 

8 Control and Prevention found that the prevalence of 

9 autism spectrum disorders is estimated to be 1 in 

10 150 people in the United States. 

11 (8) The Harvard School of Public Health re12 ported that the cost of caring for and treating indi13 viduals with autism spectrum disorders in the 

14 United States is more than $35,000,000,000 annu15 ally (an estimated $3,200,000 over an individual’s 

16 lifetime). 

17 (9) Although the overall incidence of autism is 

18 consistent around the globe, researchers with the 

19 Journal of Paediatrics and Child Health have found 

20 that males are 4 times more likely to develop an au21 tism spectrum disorder than females. Autism spec22 trum disorders know no racial, ethnic, or social 

23 boundaries, nor differences in family income, life24 style, or educational levels, and can affect any child. 


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1 (10) Individuals with autism spectrum disorders 

2 from low-income, rural, and minority communities 

3 often face significant obstacles to accurate diagnosis 

4 and necessary specialized services, supports, and 

5 education. 

6 (11) There is strong consensus within the re7 search community that intensive treatment as soon 

8 as possible following diagnosis not only can reduce 

9 the cost of lifelong care by two-thirds, but also yields 

10 the most positive life outcomes for children with au11 tism spectrum disorders. 

12 (12) Individuals with autism spectrum disorders 

13 and their families experience a wide range of medical 

14 issues. Few common standards exist for the diag15 nosis and management of many aspects of clinical 

16 care. Behavioral difficulties may be attributed to the 

17 overarching disorder rather than to the pain and dis18 comfort of a medical condition, which may go unde19 tected and untreated. The health care and other 

20 treatments available in different communities can 

21 vary widely. Many families, lacking access to com22 prehensive and coordinated health care, must fend 

23 for themselves to find the best health care, treat24 ments, and services in a complex clinical world. 


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1 (13) Effective health care, treatment, and serv2 ices for individuals with autism spectrum disorders 

3 depends upon a continuous exchange among re4 searchers and caregivers. Evidence-based and prom5 ising autism practices should move quickly into com6 munities, allowing individuals with autism spectrum 

7 disorders and their families to benefit from the new8 est research and enabling researchers to learn from 

9 the life experiences of the people whom their work 

10 most directly affects. 

11 (14) There is a critical shortage of appro12 priately trained personnel across numerous impor13 tant disciplines who can assess, diagnose, treat, and 

14 support children and adults with autism spectrum 

15 disorders and their families. Practicing professionals, 

16 as well as those in training to become professionals, 

17 need the most up-to-date practices informed by the 

18 most current research findings. 

19 (15) The appropriate goals of the Nation re20 garding individuals with autism spectrum disorder 

21 are the same as the appropriate goals of the Nation 

22 regarding individuals with disabilities in general, as 

23 established in the Americans with Disabilities Act of 

24 1990 (42 U.S.C. 12101 et seq.): to assure equality 


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1 of opportunity, full participation, independent living, 

2 and economic self-sufficiency for such individuals. 

3 (16) Finally, individuals with autism spectrum 

4 disorders are often denied health care benefits solely 

5 because of their diagnosis, even though proven, ef6 fective treatments for autism spectrum disorders do 

7 exist. 

8 SEC. 3. PARENTAL RIGHTS RULE OF CONSTRUCTION. 

9 Nothing in this Act shall be construed to modify the 

10 legal rights of parents or legal guardians under Federal, 

11 State, or local law regarding the care of their children. 

12 SEC. 4. DEFINITIONS; TECHNICAL AMENDMENT TO THE 

13 PUBLIC HEALTH SERVICE ACT. 

14 Part R of title III of the Public Health Service Act 

15 (42 U.S.C. 280i et seq.) is amended— 

16 (1) by inserting after the header for part R the 

17 following: 

18 ‘‘Subpart 1—Surveillance and Research Program; 

19 Education, Early Detection, and Intervention; 

20 and Reporting’’; 

21 (2) in section 399AA(d), by striking ‘‘part’’ and 

22 inserting ‘‘subpart’’; and 

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


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1 ‘‘Subpart 2—Care for People With Autism Spectrum 

2 Disorders, Registry, and Public Education 

3 ‘‘SEC. 399GG. DEFINITIONS. 

4 ‘‘Except as otherwise provided, in this subpart: 

5 ‘‘(1) AUTISM SPECTRUM DISORDER.—The term 

6 ‘autism spectrum disorder’ means a developmental 

7 disability that causes substantial impairments in the 

8 areas of social interaction, emotional regulation, 

9 communication, and the integration of higher-order 

10 cognitive processes and which may be characterized 

11 by the presence of unusual behaviors and interests. 

12 Such term includes autistic disorder, pervasive devel13 opmental disorder (not otherwise specified), 

14 Asperger syndrome, Retts disorder, childhood dis15 integrative disorder, and other related developmental 

16 disorders. 

17 ‘‘(2) ADULT WITH AUTISM SPECTRUM DIS18 ORDER.—The term ‘adult with autism spectrum dis19 order’ means an individual with an autism spectrum 

20 disorder who has attained 22 years of age. 

21 ‘‘(3) AFFECTED INDIVIDUAL.—The term ‘af22 fected individual’ means an individual with an au23 tism spectrum disorder. 

24 ‘‘(4) AUTISM.—The term ‘autism’ means an au25 tism spectrum disorder or a related developmental 

26 disability. 


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1 ‘‘(5) AUTISM MANAGEMENT TEAM.—The term 

2 ‘autism management team’ means a group of autism 

3 care providers, including behavioral specialists, phy4 sicians, speech-language pathologists, audiologists, 

5 psychologists, social workers, family therapists, 

6 nurse practitioners, nurses, educators, other appro7 priate personnel, and family members who work in 

8 a coordinated manner to treat individuals with au9 tism spectrum disorders and their families. Such 

10 team shall determine the specific structure and oper11 ational model of its specific autism care center, tak12 ing into consideration cultural, regional, and geo13 graphical factors. 

14 ‘‘(6) CARE MANAGEMENT MODEL.—The term 

15 ‘care management model’ means a model of care 

16 that with respect to autism— 

17 ‘‘(A) is centered on the relationship be18 tween an individual with an autism spectrum 

19 disorder and his or her family and their per20 sonal autism care coordinator; 

21 ‘‘(B) provides services to individuals with 

22 autism spectrum disorders to improve the man23 agement and coordination of care provided to 

24 patients and their families; and 


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1 ‘‘(C) has established, where practicable, ef2 fective referral relationships between the autism 

3 care coordinator and the major medical, edu4 cational, and behavioral specialties and ancillary 

5 services in the region. 

6 ‘‘(7) CHILD WITH AUTISM SPECTRUM DIS7 ORDER.—The term ‘child with autism spectrum dis8 order’ means an individual with an autism spectrum 

9 disorder who has not attained 22 years of age. 

10 ‘‘(8) INTERVENTIONS.—The term ‘interven11 tions’ means the educational methods, communica12 tion services and supports, and positive behavioral 

13 support strategies designed to improve or ameliorate 

14 symptoms associated with autism spectrum dis15 orders. 

16 ‘‘(9) NETWORK.—The term ‘Network’ means 

17 the Network for Autism Spectrum Disorders Re18 search and Services described in section 10 of the 

19 Autism Treatment Acceleration Act of 2009. 

20 ‘‘(10) PERSONAL PRIMARY CARE COORDI21 NATOR.—The term ‘personal primary care coordi22 nator’ means a physician, occupational therapist, 

23 speech-language pathologist, audiologist, nurse, 

24 nurse practitioner, psychologist, social worker, fam25 ily therapist, educator, or other appropriate perVerDate Nov 24 2008 03:05 May 16, 2009 Jkt 079200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2413.IH H2413

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1 sonnel (as determined by the Secretary) who has ex2 tensive expertise in treatment and services for indi3 viduals with autism spectrum disorders, who— 

4 ‘‘(A) practices in an autism care center; 

5 and 

6 ‘‘(B) has been trained to coordinate and 

7 manage comprehensive autism care for the 

8 whole person. 

9 ‘‘(11) PROJECT.—The term ‘project’ means the 

10 autism care center demonstration project established 

11 under section 399HH. 

12 ‘‘(12) SERVICES.—The term ‘services’ means 

13 services to assist individuals with autism spectrum 

14 disorders to live more independently in their commu15 nities and to improve their quality of life. 

16 ‘‘(13) TREATMENTS.—The term ‘treatments’ 

17 means the health services, including mental health 

18 and behavioral therapy services, designed to improve 

19 or ameliorate symptoms associated with autism spec20 trum disorders. 

21 ‘‘(14) AUTISM CARE CENTER.—In this subpart, 

22 the term ‘autism care center’ means a center that is 

23 directed by a primary care coordinator who is an ex24 pert in autism spectrum disorder treatment and 

25 practice and provides an array of medical, psychoVerDate Nov 24 2008 03:05 May 16, 2009 Jkt 079200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2413.IH H2413

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1 logical, behavioral, educational, and family services 

2 to individuals with autism and their families. Such 

3 a center shall— 

4 ‘‘(A) incorporate the attributes of the care 

5 management model; 

6 ‘‘(B) offer, through on-site service provi7 sion or through detailed referral and coordi8 nated care arrangements, an autism manage9 ment team of appropriate providers, including 

10 behavioral specialists, physicians, psychologists, 

11 social workers, family therapists, nurse practi12 tioners, nurses, educators, and other appro13 priate personnel; and 

14 ‘‘(C) have the capability to achieve im15 provements in the management and coordina16 tion of care for targeted beneficiaries.’’. 

17 SEC. 5. AUTISM CARE CENTERS DEMONSTRATION 

18 PROJECT. 

19 Part R of title III of the Public Health Service Act 

20 (42 U.S.C. 280i), as amended by section 4, is further 

21 amended by adding at the end the following: 

22 ‘‘SEC. 399HH. AUTISM CARE CENTER DEMONSTRATION 

23 PROJECT. 

24 ‘‘(a) IN GENERAL.—Not later than 1 year after the 

25 date of enactment of the Autism Treatment Acceleration 


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1 Act of 2009, the Secretary, acting through the Adminis2 trator of the Health Resources and Services Administra3 tion, shall establish a demonstration project for the imple4 mentation of an Autism Care Center Program (referred 

5 to in this section as the ‘Program’) to provide grants and 

6 other assistance to improve the effectiveness and efficiency 

7 in providing comprehensive care to individuals diagnosed 

8 with autism spectrum disorders and their families. 

9 ‘‘(b) GOALS.—The Program shall be designed— 

10 ‘‘(1) to increase— 

11 ‘‘(A) comprehensive autism spectrum dis12 order care delivery; 

13 ‘‘(B) access to appropriate health care 

14 services, especially wellness and prevention care, 

15 at times convenient for patients; 

16 ‘‘(C) patient satisfaction; 

17 ‘‘(D) communication among autism spec18 trum disorder health care providers, 

19 behaviorists, educators, specialists, hospitals, 

20 and other autism spectrum disorder care pro21 viders; 

22 ‘‘(E) school placement and attendance; 

23 ‘‘(F) successful transition to postsecondary 

24 education, vocational or job training and place25 ment, and comprehensive adult services for inVerDate Nov 24 2008 03:05 May 16, 2009 Jkt 079200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H2413.IH H2413

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1 dividuals with autism spectrum disorders, focus2 ing in particular upon the transitional period 

3 for individuals between the ages of 18 and 25; 

4 ‘‘(G) the quality of health care services, 

5 taking into account nationally developed stand6 ards and measures; 

7 ‘‘(H) development, review, and promulga8 tion of common clinical standards and guide9 lines for medical care to individuals with autism 

10 spectrum disorders; 

11 ‘‘(I) development of clinical research 

12 projects to support clinical findings in a search 

13 for recommended practices; and 

14 ‘‘(J) the quality of life of individuals with 

15 autism spectrum disorders, including commu16 nication abilities, social skills, community inte17 gration, and employment and other related 

18 services; and 

19 ‘‘(2) to decrease— 

20 ‘‘(A) inappropriate emergency room utiliza21 tion, which can be accomplished through initia22 tives such as expanded hours of care; 

23 ‘‘(B) avoidable hospitalizations; 

24 ‘‘(C) the duplication of health care serv25 ices; 


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1 ‘‘(D) the inconvenience of multiple provider 

2 locations; 

3 ‘‘(E) health disparities and inequalities 

4 that individuals with autism spectrum disorders 

5 face; and 

6 ‘‘(F) preventable and inappropriate in7 volvement with the juvenile and criminal justice 

8 systems. 

9 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

10 assistance under the Program, an entity shall— 

11 ‘‘(1) be a State or a public or private nonprofit 

12 entity; 

13 ‘‘(2) agree to establish and implement an au14 tism care center that— 

15 ‘‘(A) enables targeted beneficiaries to des16 ignate a personal primary care coordinator in 

17 such center to be their source of first contact 

18 and to recommend comprehensive and coordi19 nated care for the whole of the individual; 

20 ‘‘(B) provides for the establishment of a 

21 coordination of care committee that is com22 posed of clinicians and practitioners trained in 

23 and working in autism spectrum disorder inter24 vention; 


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1 ‘‘(C) establishes a network of physicians, 

2 psychologists, family therapists, behavioral spe3 cialists, social workers, educators, and health 

4 centers that have expressed willingness to par5 ticipate as consultants to patient-centered au6 tism care centers to provide high-quality care, 

7 focusing on autism spectrum disorder care, at 

8 the appropriate times and places and in a cost9 effective manner; 

10 ‘‘(D) works in cooperation with hospitals, 

11 local public health departments, and the net12 work of patient-centered autism care centers, to 

13 coordinate and provide health care; 

14 ‘‘(E) utilizes health information technology 

15 to facilitate the provision and coordination of 

16 health care by network participants; and 

17 ‘‘(F) collaborates with other entities to fur18 ther the goals of the program, particularly by 

19 collaborating with entities that provide transi20 tional adult services to individuals between the 

21 ages of 18 and 25 with autism spectrum dis22 order, to ensure successful transition of such in23 dividuals to adulthood; and 


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1 ‘‘(3) submit to the Secretary an application, at 

2 such time, in such manner, and containing such in3 formation as the Secretary may require, including— 

4 ‘‘(A) a description of the treatments, inter5 ventions, or services that the eligible entity pro6 poses to provide under the Program; 

7 ‘‘(B) a demonstration of the capacity of 

8 the eligible entity to provide or establish such 

9 treatments, interventions, and services within 

10 such entity; 

11 ‘‘(C) a demonstration of the capacity of 

12 the eligible entity to monitor and evaluate the 

13 outcomes of the treatments, interventions, and 

14 services described in subparagraph (A); 

15 ‘‘(D) estimates of the number of individ16 uals and families who will be served by the eli17 gible entity under the Program, including an es18 timate of the number of such individuals and 

19 families in medically underserved areas; 

20 ‘‘(E) a description of the ability of the eli21 gible entity to enter into partnerships with com22 munity-based or nonprofit providers of treat23 ments, interventions, and services, which may 

24 include providers that act as advocates for indi25 viduals with autism spectrum disorders and 


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1 local governments that provide services for indi2 viduals with autism spectrum disorders at the 

3 community level; 

4 ‘‘(F) a description of the ways in which ac5 cess to such treatments and services may be 

6 sustained following the Program period; 

7 ‘‘(G) a description of the ways in which the 

8 eligible entity plans to collaborate with other 

9 entities to develop and sustain an effective pro10 tocol for successful transition from children’s 

11 services to adult services for individuals with 

12 autism spectrum disorder, particularly for indi13 viduals between the ages of 18 and 25; and 

14 ‘‘(H) a description of the compliance of the 

15 eligible entity with the integration requirement 

16 provided under section 302 of the Americans 

17 with Disabilities Act of 1990. 

18 ‘‘(d) GRANTS.—The Secretary shall award 3-year 

19 grants to eligible entities whose applications are approved 

20 under subsection (c). Such grants shall be used to— 

21 ‘‘(1) carry out a program designed to meet the 

22 goals described in subsection (b) and the require23 ments described in subsection (c); and 

24 ‘‘(2) facilitate coordination with local commu25 nities to be better prepared and positioned to underVerDate Nov 24 2008 03:05 May 16, 2009 Jkt 079200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H2413.IH H2413

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1 stand and meet the needs of the communities served 

2 by autism care centers. 

3 ‘‘(e) ADVISORY COUNCILS.— 

4 ‘‘(1) IN GENERAL.—Each recipient of a grant 

5 under this section shall establish an autism care cen6 ter advisory council, which shall advise the autism 

7 care center regarding policies, priorities, and serv8 ices. 

9 ‘‘(2) MEMBERSHIP.—Each recipient of a grant 

10 shall appoint members of the recipient’s advisory 

11 council, which shall include a variety of autism care 

12 center service providers, individuals from the public 

13 who are knowledgeable about autism spectrum dis14 orders, individuals receiving services through the 

15 Program, and family members of such individuals. 

16 At least 60 percent of the membership shall be com17 prised of individuals who have received, or are re18 ceiving, services through the Program or who are 

19 family members of such individuals. 

20 ‘‘(3) CHAIRPERSON.—The recipient of a grant 

21 shall appoint a chairperson to the advisory council of 

22 the recipient’s autism care center who shall be— 

23 ‘‘(A) an individual with autism spectrum 

24 disorder who has received, or is receiving, serv25 ices through the Program; or 


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1 ‘‘(B) a family member of such an indi2 vidual. 

3 ‘‘(f) EVALUATION.—The Secretary shall enter into a 

4 contract with an independent third-party organization 

5 with expertise in evaluation activities to conduct an eval6 uation and, not later than 180 days after the conclusion 

7 of the 3-year grant program under this section, submit 

8 a report to the Secretary, which may include measures 

9 such as whether and to what degree the treatments, inter10 ventions, and services provided through the Program have 

11 resulted in improved health, educational, employment, and 

12 community integration outcomes for individuals with au13 tism spectrum disorders, or other measures, as the Sec14 retary determines appropriate. 

15 ‘‘(g) ADMINISTRATIVE EXPENSES.—Of the amounts 

16 appropriated to carry out this section, the Secretary shall 

17 allocate not more than 7 percent for administrative ex18 penses, including the expenses related to carrying out the 

19 evaluation described in subsection (f). 

20 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Amounts pro21 vided to an entity under this section shall be used to sup22 plement, not supplant, amounts otherwise expended for 

23 existing treatments, interventions, and services for individ24 uals with autism spectrum disorders.’’. 


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1 SEC. 6. PLANNING AND DEMONSTRATION GRANTS FOR 

2 SERVICES FOR ADULTS. 

3 Part R of title III of the Public Health Service Act 

4 (42 U.S.C. 280i), as amended by section 5, is further 

5 amended by adding at the end the following: 

6 ‘‘SEC. 399II. PLANNING AND DEMONSTRATION GRANT FOR 

7 SERVICES FOR ADULTS. 

8 ‘‘(a) IN GENERAL.—In order to enable selected eligi9 ble entities to provide appropriate services to adults with 

10 autism spectrum disorders, to enable such adults to be as 

11 independent as possible, the Secretary shall establish— 

12 ‘‘(1) a one-time, single-year planning grant pro13 gram for eligible entities; and 

14 ‘‘(2) a multiyear service provision demonstra15 tion grant program for selected eligible entities. 

16 ‘‘(b) PURPOSE OF GRANTS.—Grants shall be award17 ed to eligible entities to provide all or part of the funding 

18 needed to carry out programs that focus on critical aspects 

19 of adult life, such as— 

20 ‘‘(1) postsecondary education, vocational train21 ing, self-advocacy skills, and employment; 

22 ‘‘(2) residential services and supports, housing, 

23 and transportation; 

24 ‘‘(3) nutrition, health and wellness, recreational 

25 and social activities; and 


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1 ‘‘(4) personal safety and the needs of individ2 uals with autism spectrum disorders who become in3 volved with the criminal justice system. 

4 ‘‘(c) ELIGIBLE ENTITY.—An eligible entity desiring 

5 to receive a grant under this section shall be a State or 

6 other public or private nonprofit organization, including 

7 an autism care center. 

8 ‘‘(d) PLANNING GRANTS.— 

9 ‘‘(1) IN GENERAL.—The Secretary shall award 

10 one-time grants to eligible entities to support the 

11 planning and development of initiatives that will ex12 pand and enhance service delivery systems for adults 

13 with autism spectrum disorders. 

14 ‘‘(2) APPLICATION.—In order to receive such a 

15 grant, an eligible entity shall— 

16 ‘‘(A) submit an application at such time 

17 and containing such information as the Sec18 retary may require; and 

19 ‘‘(B) demonstrate the ability to carry out 

20 such planning grant in coordination with the 

21 State Developmental Disabilities Council and 

22 organizations representing or serving individ23 uals with autism spectrum disorders and their 

24 families. 

25 ‘‘(e) IMPLEMENTATION GRANTS.— 


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1 ‘‘(1) IN GENERAL.—The Secretary shall award 

2 grants to eligible entities that have received a plan3 ning grant under subsection (d) to enable such enti4 ties to provide appropriate services to adults with 

5 autism spectrum disorders. 

6 ‘‘(2) APPLICATION.—In order to receive a grant 

7 under paragraph (1), the eligible entity shall submit 

8 an application at such time and containing such in9 formation as the Secretary may require, including— 

10 ‘‘(A) the services that the eligible entity 

11 proposes to provide and the expected outcomes 

12 for adults with autism spectrum disorders who 

13 receive such services; 

14 ‘‘(B) the number of adults and families 

15 who will be served by such grant, including an 

16 estimate of the adults and families in under17 served areas who will be served by such grant; 

18 ‘‘(C) the ways in which services will be co19 ordinated among both public and nonprofit pro20 viders of services for adults with disabilities, in21 cluding community-based services; 

22 ‘‘(D) where applicable, the process through 

23 which the eligible entity will distribute funds to 

24 a range of community-based or nonprofit pro25 viders of services, including local governments, 


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1 and such entity’s capacity to provide such serv2 ices; 

3 ‘‘(E) the process through which the eligible 

4 entity will monitor and evaluate the outcome of 

5 activities funded through the grant, including 

6 the effect of the activities upon adults with au7 tism spectrum disorders who receive such serv8 ices; 

9 ‘‘(F) the plans of the eligible entity to co10 ordinate and streamline transitions from youth 

11 to adult services; 

12 ‘‘(G) the process by which the eligible enti13 ty will ensure compliance with the integration 

14 requirement provided under section 302 of the 

15 Americans with Disabilities Act of 1990; and 

16 ‘‘(H) a description of how such services 

17 may be sustained following the grant period. 

18 ‘‘(f) EVALUATION.—The Secretary shall contract 

19 with a third-party organization with expertise in evalua20 tion to evaluate such demonstration grant program and, 

21 not later than 180 days after the conclusion of the grant 

22 program under subsection (e), submit a report to the Sec23 retary. The evaluation and report may include an analysis 

24 of whether and to what extent the services provided 

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1 sulted in improved health, education, employment, and 

2 community integration outcomes for adults with autism 

3 spectrum disorders, or other measures, as the Secretary 

4 determines appropriate. 

5 ‘‘(g) ADMINISTRATIVE EXPENSES.—Of the amounts 

6 appropriated to carry out this section, the Secretary shall 

7 set aside not more than 7 percent for administrative ex8 penses, including the expenses related to carrying out the 

9 evaluation described in subsection (f). 

10 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Demonstration 

11 grant funds provided under this section shall supplement, 

12 not supplant, existing treatments, interventions, and serv13 ices for individuals with autism spectrum disorders.’’. 

14 SEC. 7. MULTIMEDIA CAMPAIGN. 

15 Part R of title III of the Public Health Service Act 

16 (42 U.S.C. 280i), as amended by section 7, is further 

17 amended by adding at the end the following: 

18 ‘‘SEC. 399JJ. MULTIMEDIA CAMPAIGN. 

19 ‘‘(a) IN GENERAL.—The Secretary, in order to en20 hance existing awareness campaigns and provide for the 

21 implementation of new campaigns, shall award grants to 

22 public and nonprofit private entities for the purpose of 

23 carrying out multimedia campaigns to increase public edu24 cation and awareness and reduce stigma concerning— 


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1 ‘‘(1) healthy developmental milestones for in2 fants and children that may assist in the early iden3 tification of the signs and symptoms of autism spec4 trum disorders; and 

5 ‘‘(2) autism spectrum disorders through the 

6 lifespan and the challenges that individuals with au7 tism spectrum disorders face, which may include 

8 transitioning into adulthood, securing appropriate 

9 job training or postsecondary education, securing 

10 and holding jobs, finding suitable housing, inter11 acting with the correctional system, increasing inde12 pendence, and attaining a good quality of life. 

13 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

14 under subsection (a), an entity shall— 

15 ‘‘(1) submit to the Secretary an application at 

16 such time, in such manner, and containing such in17 formation as the Secretary may require; and 

18 ‘‘(2) provide assurance that the multimedia 

19 campaign implemented under such grant will provide 

20 information that is tailored to the intended audience, 

21 which may be a diverse public audience or a specific 

22 audience, such as health professionals, criminal jus23 tice professionals, or emergency response profes24 sionals.’’. 


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1 SEC. 8. INTERDEPARTMENTAL AUTISM COORDINATING 

2 COMMITTEE. 

3 (a) ESTABLISHMENT.—There is established a com4 mittee, to be known as the ‘‘Interdepartmental Autism Co5 ordinating Committee’’ (referred to in this section as the 

6 ‘‘Committee’’), to coordinate all Federal efforts concerning 

7 autism spectrum disorders. 

8 (b) RESPONSIBILITIES.—In carrying out its duties 

9 under this section, the Committee shall— 

10 (1) develop and annually update a summary of 

11 developments in research on autism spectrum dis12 orders, services for people on the autism spectrum 

13 and their families, and programs that focus on peo14 ple on the autism spectrum; 

15 (2) monitor governmental and nongovernmental 

16 activities with respect to autism spectrum disorders; 

17 (3) make recommendations to the Secretary of 

18 Health and Human Services and other relevant 

19 heads of agencies (referred to in this subsection as 

20 the ‘‘agency heads’’) regarding any appropriate 

21 changes to such activities and any ethical consider22 ations relating to those activities; 

23 (4) make recommendations to the agency heads 

24 regarding public participation in decisions relating to 

25 autism spectrum disorders; 


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1 (5) develop and annually update a strategic 

2 plan, including proposed budgetary requirements, for 

3 conducting and supporting research related to au4 tism spectrum disorders, services for individuals on 

5 the autism spectrum and their families, and pro6 grams that focus on such individuals and their fami7 lies; and 

8 (6) annually submit to Congress and the Presi9 dent such strategic plan and any updates to such 

10 plan. 

11 (c) MEMBERSHIP.— 

12 (1) FEDERAL MEMBERS.—The Committee shall 

13 be composed of— 

14 (A) the Director of the National Institutes 

15 of Health, and the directors of such national re16 search institutes of the National Institutes of 

17 Health as the Director determines appropriate; 

18 (B) the heads of other agencies within the 

19 Department of Health and Human Services, as 

20 the Secretary determines appropriate; and 

21 (C) representatives of the Department of 

22 Education, the Department of Defense, and 

23 other Federal agencies that provide services to 

24 individuals with autism spectrum disorders and 

25 their families or that have programs that affect 


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1 individuals with autism spectrum disorders, as 

2 the Secretary determines appropriate. 

3 (2) NON-FEDERAL MEMBERS.—Not less than 

2 4 ⁄5 of the total membership of the Committee shall 

5 be composed of public members to be appointed by 

6 the Secretary, of which— 

7 (A) at least one such member shall be an 

8 individual with an autism spectrum disorder; 

9 (B) at least one such member shall be a 

10 parent or legal guardian of an individual with 

11 an autism spectrum disorder; 

12 (C) at least one such member shall be a 

13 representative of a nongovernmental organiza14 tion that provides services to individuals with 

15 autism spectrum disorders or their families; and 

16 (D) at least one such member shall be a 

17 representative of a leading research, advocacy, 

18 and service organization for individuals with au19 tism spectrum disorders and their families. 

20 (d) ADMINISTRATIVE SUPPORT; TERMS OF SERVICE; 

21 OTHER PROVISIONS.—The following provisions shall apply 

22 with respect to the Committee: 

23 (1) The Committee shall receive necessary and 

24 appropriate administrative support from the Sec25 retary. 


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1 (2) Members of the Committee appointed under 

2 subsection (c)(2) shall serve for a term of 4 years 

3 and may be reappointed for one or more additional 

4 4-year terms. The term of any member appointed 

5 under subsection (c)(2)(C) or subsection (c)(2)(D) 

6 shall expire if the member no longer represents the 

7 organization described in such subsections. Any 

8 member appointed to fill a vacancy for an unexpired 

9 term shall be appointed for the remainder of such 

10 term. A member may serve after the expiration of 

11 the member’s term until a successor has taken of12 fice. 

13 (3) The Committee shall be chaired by the Sec14 retary or the Secretary’s designee. The Committee 

15 shall meet at the call of the chairperson and not 

16 fewer than 2 times each year. 

17 (4) All meetings of the Committee or its sub18 committees shall be public and shall include appro19 priate time periods for questions and presentations 

20 by the public. 

21 (5) The Committee may convene workshops and 

22 conferences. 

23 (e) SUBCOMMITTEES: ESTABLISHMENT AND MEM24 BERSHIP.— 


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1 (1) ESTABLISHMENT OF SUBCOMMITTEES.—In 

2 carrying out its functions, the Committee may estab3 lish— 

4 (A) a subcommittee on research on autism 

5 spectrum disorders; 

6 (B) a subcommittee on services for individ7 uals with autism spectrum disorders and their 

8 families and programs that focus on individuals 

9 with autism spectrum disorders; and 

10 (C) such other subcommittees as the Com11 mittee determines appropriate. 

12 (2) MEMBERSHIP.—Subcommittees may include 

13 as members individuals who are not members of the 

14 Committee. 

15 (3) MEETINGS.—Subcommittees may hold such 

16 meetings as are necessary. 

17 (f) INTERAGENCY AUTISM COORDINATING COM18 MITTEE.—Part R of title III of the Public Health Service 

19 Act (42 U.S.C. 280i) is amended by striking section 

20 399CC (42 U.S.C. 284i–2). 

21 SEC. 9. NATIONAL NETWORK FOR AUTISM SPECTRUM DIS22 ORDERS RESEARCH AND SERVICES. 

23 (a) DEFINITIONS.—In this section: 

24 (1) SERVICES.—The term ‘‘services’’ means 

25 services to assist individuals with autism spectrum 


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1 disorders to live more independently in their commu2 nities and improve the quality of life of such individ3 uals. 

4 (2) SECRETARY.—The term ‘‘Secretary’’ means 

5 the Secretary of Health and Human Services. 

6 (3) TREATMENTS.—The term ‘‘treatments’’ 

7 means the health services, including mental health 

8 and behavioral therapy services, designed to improve 

9 or ameliorate symptoms associated with autism spec10 trum disorders. 

11 (4) AUTISM CARE CENTER.—In this subpart, 

12 the term ‘‘autism care center’’ means a center that 

13 is directed by a primary care coordinator who is an 

14 expert in autism spectrum disorder treatment and 

15 practice and provides an array of medical, commu16 nication, psychological, behavioral, educational, and 

17 family services to individuals with autism and their 

18 families. Such a center shall— 

19 (A) incorporate the attributes of the care 

20 management model; 

21 (B) offer, through on-site service provision 

22 or through detailed referral and coordinated 

23 care arrangements, an autism management 

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1 pists, speech-language pathologists, audiol2 ogists, psychologists, social workers, family 

3 therapists, nurse practitioners, nurses, edu4 cators, and other appropriate personnel; and 

5 (C) have the capability to achieve improve6 ments in the management and coordination of 

7 care for targeted beneficiaries. 

8 (b) ESTABLISHMENT OF THE NATIONAL NETWORK

9 FOR AUTISM SPECTRUM DISORDERS RESEARCH AND

10 SERVICES.—Not later than 1 year after the date of enact11 ment of this Act, the Secretary shall establish the National 

12 Network for Autism Spectrum Disorders Research and 

13 Services (referred to in this section as the ‘‘National Net14 work’’). The National Network shall provide resources for, 

15 and facilitate communication between, autism spectrum 

16 disorder researchers and service providers for individuals 

17 with autism spectrum disorders and their families. 

18 (c) PURPOSES.—The purposes of the National Net19 work are to— 

20 (1) build upon the infrastructure relating to au21 tism spectrum disorders that exists on the date of 

22 enactment of this Act; 

23 (2) strengthen linkages between autism spec24 trum disorders research and service initiatives at the 

25 Federal, regional, State, and local levels; 


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1 (3) facilitate the translation of research on au2 tism spectrum disorders into services and treatments 

3 to improve the quality of life for individuals with au4 tism and their families; and 

5 (4) ensure the rapid dissemination of evidence6 based or promising autism spectrum disorder prac7 tices through the National Data Repository for Au8 tism Spectrum Disorders Research and Services de9 scribed in subsection (e). 

10 (d) ORGANIZATION AND ACTIVITIES OF THE NA11 TIONAL NETWORK.—In establishing the National Net12 work, the Secretary, acting through Administrator of the 

13 Health Resources and Services Administration, shall en14 sure that the National Network is composed of entities 

15 at the Federal, regional, State, and local levels. 

16 (e) NATIONAL DATA REPOSITORY FOR AUTISM

17 SPECTRUM DISORDERS RESEARCH AND SERVICES.— 

18 (1) IN GENERAL.—The Secretary shall establish 

19 a National Data Repository for Autism Spectrum 

20 Disorders Research and Services (referred to in this 

21 section as the ‘‘Data Repository’’) and shall contract 

22 with one eligible third-party entity to develop and 

23 administer such repository (referred to in this sec24 tion as the ‘‘Data Repository Administrator’’). The 

25 Data Repository shall be used to collect, store, and 


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1 disseminate information regarding research, data, 

2 findings, models of treatment, training modules, and 

3 technical assistance materials related to autism spec4 trum disorders in order to facilitate the development 

5 and rapid dissemination of research into best prac6 tices that improve care. 

7 (2) ELIGIBILITY.—To be eligible to receive the 

8 contract described in paragraph (1), an entity 

9 shall— 

10 (A) be a public or private nonprofit entity; 

11 and 

12 (B) have experience— 

13 (i) collecting data; 

14 (ii) developing systems to store data 

15 in a secure manner that does not person16 ally identify individuals; 

17 (iii) developing internet web portals 

18 and other means of communicating with a 

19 wide audience; and 

20 (iv) making information available to 

21 the public. 

22 (3) CONTENTS.—The Data Repository shall in23 clude— 


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1 (A) emerging research, data, and findings 

2 regarding autism spectrum disorders from basic 

3 and applied researchers and service providers; 

4 (B) emerging or promising models of treat5 ment, service provision, and training related to 

6 autism spectrum disorders that are developed in 

7 individual care centers or programs; and 

8 (C) training modules and technical assist9 ance materials. 

10 (4) DUTIES OF THE ADMINISTRATOR.—The 

11 Data Repository Administrator shall— 

12 (A) collect information from autism spec13 trum disorders research and service provision 

14 agencies and organizations including— 

15 (i) Centers of Excellence in Autism 

16 Spectrum Disorder Epidemiology under 

17 section 399AA(b) of the Public Health 

18 Service Act (42 U.S.C. 280i(b)); 

19 (ii) autism care centers; 

20 (iii) recipients of grants through the 

21 grant program for adult services under 

22 section 399II of the Public Health Service 

23 Act, as added by section 6 of this Act; and 

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1 trum disorders under section 399KK of the 

2 Public Health Service Act, as added by 

3 section 11 of this Act; 

4 (B) securely store and maintain informa5 tion in the Data Repository in a manner that 

6 does not personally identify individuals; 

7 (C) make information in the Data Reposi8 tory accessible through an Internet web portal 

9 or other appropriate means of sharing informa10 tion; 

11 (D) ensure that the information contained 

12 in the Data Repository is accessible to the Na13 tional Network, including health care providers, 

14 educators, and other autism spectrum disorders 

15 service providers at the national, State, and 

16 local levels; and 

17 (E) provide a means through the Internet 

18 web portal, or through other means, for mem19 bers of the National Network to share informa20 tion, research, and best practices on autism 

21 spectrum disorders. 

22 (f) SUPPLEMENT NOT SUPPLANT.—Amounts pro23 vided under this section shall be used to supplement, not 

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1 work or organizational structures relating to autism spec2 trum disorders. 

3 SEC. 10. NATIONAL TRAINING INITIATIVES ON AUTISM 

4 SPECTRUM DISORDERS. 

5 Part R of title III of the Public Health Service Act 

6 (42 U.S.C. 280i), as amended by section 8, is further 

7 amended by adding at the end the following: 

8 ‘‘SEC. 399KK. NATIONAL TRAINING INITIATIVES ON AUTISM 

9 SPECTRUM DISORDERS. 

10 ‘‘(a) NATIONAL TRAINING INITIATIVE SUPPLE11 MENTAL GRANTS.— 

12 ‘‘(1) IN GENERAL.—The Secretary shall award 

13 multiyear national training initiative supplemental 

14 grants to eligible entities so that such entities may 

15 provide training and technical assistance and to dis16 seminate information, in order to enable such enti17 ties to address the unmet needs of individuals with 

18 autism spectrum disorders and their families. 

19 ‘‘(2) ELIGIBLE ENTITY.—To be eligible to re20 ceive assistance under this section an entity shall— 

21 ‘‘(A) be a public or private nonprofit enti22 ty, including University Centers for Excellence 

23 in Developmental Disabilities and other service, 

24 training, and academic entities; and 


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1 ‘‘(B) submit an application as described in 

2 paragraph (3). 

3 ‘‘(3) REQUIREMENTS.—An eligible entity that 

4 desires to receive a grant under this paragraph shall 

5 submit to the Secretary an application containing 

6 such agreements and information as the Secretary 

7 may require, including agreements that the training 

8 program shall— 

9 ‘‘(A) provide trainees with an appropriate 

10 balance of interdisciplinary academic and com11 munity-based experiences; 

12 ‘‘(B) have a demonstrated capacity to in13 clude individuals with autism spectrum dis14 orders, parents, and family members as part of 

15 the training program to ensure that a person 

16 and family-centered approach is used; 

17 ‘‘(C) provide to the Secretary, in the man18 ner prescribed by the Secretary, data regarding 

19 the outcomes of the provision of training and 

20 technical assistance; 

21 ‘‘(D) demonstrate a capacity to share and 

22 disseminate materials and practices that are de23 veloped and evaluated to be effective in the pro24 vision of training and technical assistance; and 


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1 ‘‘(E) provide assurances that training, 

2 technical assistance, and information dissemina3 tion performed under grants made pursuant to 

4 this paragraph shall be consistent with the 

5 goals established under already existing dis6 ability programs authorized under Federal law 

7 and conducted in coordination with other rel8 evant State agencies and service providers. 

9 ‘‘(4) ACTIVITIES.—An entity that receives a 

10 grant under this section shall expand and develop 

11 interdisciplinary training and continuing education 

12 initiatives for health, allied health, and educational 

13 professionals by engaging in the following activities: 

14 ‘‘(A) Promoting and engaging in training 

15 for health, allied health, and educational profes16 sionals to identify, diagnose, and develop inter17 ventions for individuals with, or at risk of devel18 oping, autism spectrum disorders. 

19 ‘‘(B) Working to expand the availability of 

20 training and information regarding effective, 

21 lifelong interventions, educational services, and 

22 community supports, including specific training 

23 for criminal justice system, emergency health 

24 care, legal, and other mainstream first re25 sponder professionals, to identify characteristics 


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1 of individuals with autism spectrum disorders 

2 and to develop appropriate responses and inter3 ventions. 

4 ‘‘(C) Providing technical assistance in col5 laboration with relevant State, regional, or na6 tional agencies, institutions of higher education, 

7 advocacy groups for individuals with autism 

8 spectrum disorders and their families, or com9 munity-based service providers. 

10 ‘‘(D) Developing mechanisms to provide 

11 training and technical assistance, including for12 credit courses, intensive summer institutes, con13 tinuing education programs, distance-based pro14 grams, and web-based information dissemina15 tion strategies. 

16 ‘‘(E) Collecting data on the outcomes of 

17 training and technical assistance programs to 

18 meet statewide needs for the expansion of serv19 ices to children with autism spectrum disorders 

20 and adults with autism spectrum disorders. 

21 ‘‘(b) TECHNICAL ASSISTANCE.—The Secretary shall 

22 reserve 2 percent of the appropriated funds to make a 

23 grant to a national organization with demonstrated capac24 ity for providing training and technical assistance to the 


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1 entities receiving grants under subsection (a) to enable 

2 such entities to— 

3 ‘‘(1) assist in national dissemination of specific 

4 information, including evidence-based and promising 

5 best practices, from interdisciplinary training pro6 grams, and when appropriate, other entities whose 

7 findings would inform the work performed by enti8 ties awarded grants; 

9 ‘‘(2) compile and disseminate strategies and 

10 materials that prove to be effective in the provision 

11 of training and technical assistance so that the en12 tire network can benefit from the models, materials, 

13 and practices developed in individual centers; 

14 ‘‘(3) assist in the coordination of activities of 

15 grantees under this section; 

16 ‘‘(4) develop an Internet web portal that will 

17 provide linkages to each of the individual training 

18 initiatives and provide access to training modules, 

19 promising training, and technical assistance prac20 tices and other materials developed by grantees; 

21 ‘‘(5) convene experts from multiple interdiscipli22 nary training programs and individuals with autism 

23 spectrum disorders and their families to discuss and 

24 make recommendations with regard to training 

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1 ment, interventions and services for, children with 

2 autism spectrum disorders and adults with autism 

3 spectrum disorders; and 

4 ‘‘(6) undertake any other functions that the 

5 Secretary determines to be appropriate. 

6 ‘‘(c) SUPPLEMENT NOT SUPPLANT.—Amounts pro7 vided under this section shall be used to supplement, not 

8 supplant, amounts otherwise expended for existing net9 work or organizational structures.’’. 

10 SEC. 11. AMENDMENTS RELATING TO HEALTH INSURANCE. 

11 (a) ERISA.— 

12 (1) IN GENERAL.—Subpart B of part 7 of sub13 title B of title I of the Employee Retirement Income 

14 Security Act of 1974 (29 U.S.C. 1185 et seq.) is 

15 amended by adding at the end the following: 

16 ‘‘SEC. 715. REQUIRED COVERAGE FOR AUTISM SPECTRUM 

17 DISORDERS. 

18 ‘‘(a) IN GENERAL.—A group health plan, and a 

19 health insurance issuer providing health insurance cov20 erage in connection with a group health plan, shall provide 

21 coverage for the diagnosis of autism spectrum disorders 

22 and the treatment of autism spectrum disorders. 

23 ‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec24 tion shall be construed— 


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1 ‘‘(1) as preventing a group health plan or 

2 health insurance issuer from imposing financial re3 quirements or limits in relation to benefits for the 

4 diagnosis and treatment of autism spectrum dis5 orders, except that such financial requirements or 

6 limits for any such benefits may not be less favor7 able to the individual than such financial require8 ments or limits for substantially all other medical 

9 and surgical benefits covered by the plan, and there 

10 shall be no separate financial requirements or limits 

11 that are applicable only with respect to benefits for 

12 the diagnosis or treatment of autism spectrum dis13 orders; and 

14 ‘‘(2) to prevent a group health plan or a health 

15 insurance issuer from negotiating the level and type 

16 of reimbursement with a provider for care provided 

17 in accordance with this section. 

18 ‘‘(c) NOTICE UNDER GROUP HEALTH PLAN.—The 

19 imposition of the requirements of this section shall be 

20 treated as a material modification in the terms of the plan 

21 described in section 102(a)(1), for purposes of assuring 

22 notice of such requirements under the plan, except that 

23 the summary description required to be provided under the 

24 last sentence of section 104(b)(1) with respect to such 


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1 modification shall be provided not later than the earlier 

2 of— 

3 ‘‘(1) 60 days after the first day of the first plan 

4 year in which such requirements apply; or 

5 ‘‘(2) in the first mailing after the date of enact6 ment of the Autism Treatment Acceleration Act of 

7 2009 made by the plan or issuer to the participant 

8 or beneficiary. 

9 ‘‘(d) PROHIBITIONS.—A group health plan, and a 

10 health insurance issuer offering group health insurance 

11 coverage in connection with a group health plan, shall 

12 not— 

13 ‘‘(1) deny to an individual eligibility, or contin14 ued eligibility, to enroll or to renew coverage under 

15 the terms of the plan, solely for the purpose of 

16 avoiding the requirements of this section; or 

17 ‘‘(2) deny coverage otherwise available under 

18 this section on the basis that such coverage will 

19 not— 

20 ‘‘(A) develop skills or functioning; 

21 ‘‘(B) maintain skills or functioning; 

22 ‘‘(C) restore skills or functioning; or 

23 ‘‘(D) prevent the loss of skills or func24 tioning. 

25 ‘‘(e) PREEMPTION; RELATION TO STATE LAW.— 


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1 ‘‘(1) IN GENERAL.—Nothing in this section 

2 shall be construed to preempt any State law (or cost 

3 sharing requirements under State law) with respect 

4 to health insurance coverage that requires coverage 

5 of at least the coverage for autism spectrum dis6 orders otherwise required under this section. 

7 ‘‘(2) EFFECT ON OTHER LAWS.—Nothing in 

8 this section shall be construed to affect or modify 

9 the provisions of section 514 with respect to group 

10 health plans. 

11 ‘‘(f) DEFINITIONS.—In this section: 

12 ‘‘(1) AUTISM SPECTRUM DISORDERS.—The 

13 term ‘autism spectrum disorders’ means develop14 mental disabilities that cause substantial impair15 ments in the areas of social interaction, emotional 

16 regulation, communication, and the integration of 

17 higher-order cognitive processes and which may be 

18 characterized by the presence of unusual behaviors 

19 and interests. Such term includes autistic disorder, 

20 pervasive developmental disorder (not otherwise 

21 specified), Asperger syndrome, Retts disorder, and 

22 childhood disintegrative disorder. 

23 ‘‘(2) DIAGNOSIS OF AUTISM SPECTRUM DIS24 ORDERS.—The term ‘diagnosis of autism spectrum 

25 disorders’ means medically necessary assessments, 


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1 evaluations, or tests to diagnose whether an indi2 vidual has an autism spectrum disorder. 

3 ‘‘(3) TREATMENT OF AUTISM SPECTRUM DIS4 ORDERS.—The term ‘treatment of autism spectrum 

5 disorders’ means the following care prescribed, pro6 vided, or ordered for an individual diagnosed with an 

7 autism spectrum disorder by a physician, psycholo8 gist, or other qualified professional who determines 

9 the care to be medically necessary: 

10 ‘‘(A) Medications prescribed by a physician 

11 and any health-related services necessary to de12 termine the need or effectiveness of the medica13 tions. 

14 ‘‘(B) Occupational therapy, physical ther15 apy, and speech-language pathology. 

16 ‘‘(C) Direct or consultative services pro17 vided by a psychiatrist or psychologist. 

18 ‘‘(D) Professional, counseling, and guid19 ance services and treatment programs, includ20 ing applied behavior analysis and other struc21 tured behavioral programs. In this subpara22 graph, the term ‘applied behavior analysis’ 

23 means the design, implementation and evalua24 tion of environmental modifications, using be25 havioral stimuli and consequences, to produce 


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1 socially significant improvement in human be2 havior, including the use of direct observation, 

3 measurement, and functional analysis of the re4 lationship between environment and behavior. 

5 ‘‘(E) Augmentative communication devices 

6 and other assistive technology devices.’’. 

7 (2) CLERICAL AMENDMENT.—The table of con8 tents in section 1 of the Employee Retirement In9 come Security Act of 1974 (29 U.S.C. 1001 note) is 

10 amended by inserting after the item relating to sec11 tion 714 the following: 

‘‘Sec. 715. Required coverage for autism spectrum disorders.’’. 

12 (b) PUBLIC HEALTH SERVICE ACT.— 

13 (1) GROUP MARKET.—Subpart 2 of part A of 

14 title XXVII of the Public Health Service Act (42 

15 U.S.C. 300gg–4 et seq.) is amended by adding at 

16 the end the following: 

17 ‘‘SEC. 2708. REQUIRED COVERAGE FOR AUTISM SPECTRUM 

18 DISORDERS. 

19 ‘‘(a) IN GENERAL.—A group health plan, and a 

20 health insurance issuer providing health insurance cov21 erage in connection with a group health plan, shall provide 

22 coverage for the diagnosis of autism spectrum disorders 

23 and the treatment of autism spectrum disorders. 

24 ‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec25 tion shall be construed— 


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1 ‘‘(1) as preventing a group health plan or 

2 health insurance issuer from imposing financial re3 quirements or limits in relation to benefits for the 

4 diagnosis and treatment of autism spectrum dis5 orders, except that such financial requirements or 

6 limits for any such benefits may not be less favor7 able to the individual than such financial require8 ments or limits for substantially all other medical 

9 and surgical benefits covered by the plan, and there 

10 shall be no separate financial requirements or limits 

11 that are applicable only with respect to benefits for 

12 the diagnosis or treatment of autism spectrum dis13 orders; or 

14 ‘‘(2) to prevent a group health plan or a health 

15 insurance issuer from negotiating the level and type 

16 of reimbursement with a provider for care provided 

17 in accordance with this section. 

18 ‘‘(c) NOTICE UNDER GROUP HEALTH PLAN.—The 

19 imposition of the requirements of this section shall be 

20 treated as a material modification in the terms of the plan 

21 described in section 102(a)(1), for purposes of assuring 

22 notice of such requirements under the plan, except that 

23 the summary description required to be provided under the 

24 last sentence of section 104(b)(1) with respect to such 


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1 modification shall be provided not later than the earlier 

2 of— 

3 ‘‘(1) 60 days after the first day of the first plan 

4 year in which such requirements apply; or 

5 ‘‘(2) in the first mailing after the date of enact6 ment of the Autism Treatment Acceleration Act of 

7 2009 made by the plan or issuer to the enrollee. 

8 ‘‘(d) PROHIBITIONS.—A group health plan, and a 

9 health insurance issuer offering group health insurance 

10 coverage in connection with a group health plan, shall 

11 not— 

12 ‘‘(1) deny to an individual eligibility, or contin13 ued eligibility, to enroll or to renew coverage under 

14 the terms of the plan, solely for the purpose of 

15 avoiding the requirements of this section; or 

16 ‘‘(2) deny coverage otherwise available under 

17 this section on the basis that such coverage will 

18 not— 

19 ‘‘(A) develop skills or functioning; 

20 ‘‘(B) maintain skills or functioning; 

21 ‘‘(C) restore skills or functioning; or 

22 ‘‘(D) prevent the loss of skills or func23 tioning. 

24 ‘‘(e) PREEMPTION; RELATION TO STATE LAW.— 


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1 ‘‘(1) IN GENERAL.—Nothing in this section 

2 shall be construed to preempt any State law (or cost 

3 sharing requirements under State law) with respect 

4 to health insurance coverage that requires coverage 

5 of at least the coverage for autism spectrum dis6 orders otherwise required under this section. 

7 ‘‘(2) ERISA.—Nothing in this section shall be 

8 construed to affect or modify the provisions of sec9 tion 514 of the Employee Income Retirement Secu10 rity Act of 1974 with respect to group health plans. 

11 ‘‘(f) DEFINITIONS.—In this section: 

12 ‘‘(1) AUTISM SPECTRUM DISORDERS.—The 

13 term ‘autism spectrum disorders’ means develop14 mental disabilities that cause substantial impair15 ments in the areas of social interaction, emotional 

16 regulation, communication, and the integration of 

17 higher-order cognitive processes and which may be 

18 characterized by the presence of unusual behaviors 

19 and interests. Such term includes autistic disorder, 

20 pervasive developmental disorder (not otherwise 

21 specified), and Asperger syndrome. 

22 ‘‘(2) DIAGNOSIS OF AUTISM SPECTRUM DIS23 ORDERS.—The term ‘diagnosis of autism spectrum 

24 disorders’ means medically necessary assessments, 


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1 evaluations, or tests to diagnose whether an indi2 vidual has an autism spectrum disorder. 

3 ‘‘(3) TREATMENT OF AUTISM SPECTRUM DIS4 ORDERS.—The term ‘treatment of autism spectrum 

5 disorders’ means the following care prescribed, pro6 vided, or ordered for an individual diagnosed with an 

7 autism spectrum disorder by a physician, psycholo8 gist, or other qualified professional who determines 

9 the care to be medically necessary: 

10 ‘‘(A) Medications prescribed by a physician 

11 and any health-related services necessary to de12 termine the need or effectiveness of the medica13 tions. 

14 ‘‘(B) Occupational therapy, physical ther15 apy, and speech therapy-language pathology. 

16 ‘‘(C) Direct or consultative services pro17 vided by a psychiatrist or psychologist. 

18 ‘‘(D) Professional, counseling, and guid19 ance services and treatment programs, includ20 ing applied behavior analysis and other struc21 tured behavioral programs. In this subpara22 graph, the term ‘applied behavior analysis’ 

23 means the design, implementation and evalua24 tion of environmental modifications, using be25 havioral stimuli and consequences, to produce 


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1 socially significant improvement in human be2 havior, including the use of direct observation, 

3 measurement, and functional analysis of the re4 lationship between environment and behavior. 

5 ‘‘(E) Augmentative communication devices 

6 and other assistive technology devices.’’. 

7 (2) INDIVIDUAL MARKET.—Subpart 3 of part B 

8 of title XXVII of the Public Health Service Act (42 

9 U.S.C. 300gg–51 et seq.) is amended by adding at 

10 the end the following: 

11 ‘‘SEC. 2754. REQUIRED COVERAGE FOR AUTISM SPECTRUM 

12 DISORDERS. 

13 ‘‘The provisions of section 2708 shall apply to health 

14 insurance coverage offered by a health insurance issuer 

15 in the individual market in the same manner as they apply 

16 to health insurance coverage offered by a health insurance 

17 issuer in connection with a group health plan in the small 

18 or large group market.’’. 

19 (c) FEHBP.—The Director of the Office of Per20 sonnel Management shall require health benefits plans 

21 under chapter 89 of title 5, United States Code, to comply 

22 with the requirements of section 715 of Employee Retire23 ment Income Security Act of 1974, as added by subsection 

24 (a), insofar as such requirements apply to a group health 

25 plan. 


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1 (d) TITLE 10.—Coverage under chapter 55 of title 

2 10, United States Code, shall include benefits that are re3 quired to be covered by a group health plan under section 

4 715 of Employee Retirement Income Security Act of 1974, 

5 as added by subsection (a). 

6 (e) EFFECTIVE DATES.— 

7 (1) GROUP HEALTH PLANS.— 

8 (A) IN GENERAL.—The amendment made 

9 by subsections (a) and (b)(1) shall apply to 

10 group health plans for plan years beginning on 

11 or after the date of enactment of this Act. 

12 (B) SPECIAL RULE FOR COLLECTIVE BAR13 GAINING AGREEMENTS.—In the case of a group 

14 health plan maintained pursuant to one or more 

15 collective bargaining agreements between em16 ployee representatives and one or more employ17 ers, any plan amendment made pursuant to a 

18 collective bargaining agreement relating to the 

19 plan which amends the plan solely to conform 

20 to any requirement added by the amendment 

21 made by subsections (a) and (b)(1) shall not be 

22 treated as a termination of such collective bar23 gaining agreement. 

24 (2) INDIVIDUAL PLANS.—The amendment made 

25 by subsection (b)(2) shall apply with respect to 


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1 health insurance coverage offered, sold, issued, re2 newed, in effect, or operated in the individual mar3 ket on or after the date of enactment of this Act. 

4 (f) NO RELATION TO AUTISM CARE CENTERS DEM5 ONSTRATION PROJECT.—The provisions of this section 

6 and the amendments made by this section shall not be con7 strued to require an individual to be participating in, or 

8 to seek to participate in, the demonstration program under 

9 section 399HH of the Public Health Service Act, as added 

10 by section 5 of this Act, in order for such provisions to 

11 apply in whole or in part with respect to such individual. 

12 SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 

13 There are authorized to be appropriated for fiscal 

14 years 2010 through 2014 such sums as may be necessary 

15 to carry out this Act. 

Æ 


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