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Union Calendar No. 137 

116TH CONGRESS 

1ST SESSION H. R. 1058 

[Report No. 116–177] 

To reauthorize certain provisions of the Public Health Service Act relating 

to autism, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 7, 2019 

Mr. SMITH of New Jersey (for himself and Mr. MICHAEL F. DOYLE of Pennsylvania) introduced the following bill; which was referred to the Committee on Energy and Commerce 

JULY 23, 2019 

Additional sponsors: Mr. FITZPATRICK, Mr. BRENDAN F. BOYLE of Pennsylvania, Mr. SEAN PATRICK MALONEY of New York, Mr. PETERSON, Mr. 

SAN NICOLAS, Mr. PAYNE, Mr. SERRANO, Mr. DEUTCH, Mr. CARSON of 

Indiana, Mr. KING of New York, Mr. GOTTHEIMER, Mr. LIPINSKI, Ms. 

NORTON, Mr. YARMUTH, Mr. MCGOVERN, Mr. HASTINGS, Mr. BRINDISI, 

Mr. MOULTON, Ms. SLOTKIN, Mr. MEEKS, Mr. KIM, Mr. WELCH, Mrs. 

WALORSKI, Mr. SCHIFF, Ms. LOFGREN, Mr. RYAN, Ms. MATSUI, Ms. 

WATERS, Mr. KENNEDY, Ms. KUSTER of New Hampshire, Mrs. DAVIS

of California, Mr. ROSE of New York, Mr. POCAN, Mr. RUPPERSBERGER, 

Mrs. HAYES, Mr. MARCHANT, Mr. STIVERS, Mr. KELLY of Pennsylvania, 

Mr. STAUBER, Mr. SIRES, Ms. SPANBERGER, Mr. YOUNG, Mr. COX of 

California, Mr. GARCI ́A of Illinois, Mr. GOLDEN, Mr. RESCHENTHALER, 

Mr. RASKIN, Ms. BROWNLEY of California, Ms. SHERRILL, Ms. WILD, 

Ms. JUDY CHU of California, Mr. DAVID P. ROE of Tennessee, Mr. 

BROWN of Maryland, Mr. MCKINLEY, Mr. COLE, Mr. LEVIN of Michigan, 

Mr. CLAY, Ms. MUCARSEL-POWELL, Mr. COURTNEY, Mr. LAMBORN, Ms. 

HAALAND, Mr. CORREA, Mr. COOPER, Ms. CLARKE of New York, Mrs. 

RODGERS of Washington, Mr. DEFAZIO, Mr. GRIJALVA, Mrs. WATSON

COLEMAN, Ms. CASTOR of Florida, Mr. BLUMENAUER, Mr. CONNOLLY, 

Ms. SCANLON, Mr. MORELLE, Miss RICE of New York, Ms. JOHNSON of 

Texas, Ms. OCASIO-CORTEZ, Mr. STEWART, Mr. HORSFORD, Mr. BOST, 

Ms. STEFANIK, Mr. COSTA, Ms. PINGREE, Mr. MALINOWSKI, Mrs. 

BEATTY, Mr. SWALWELL of California, Mrs. LEE of Nevada, Mrs. AXNE, 


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Mr. LAMB, Mr. THOMPSON of Mississippi, Mr. LOEBSACK, Ms. 

DELAURO, Mr. RODNEY DAVIS of Illinois, Mr. GALLEGO, Mr. SHIMKUS, 

Ms. PRESSLEY, Ms. TITUS, Mr. JOYCE of Ohio, Mr. CHABOT, Miss 

GONZA ́LEZ-COLO ́N of Puerto Rico, Mr. LARSON of Connecticut, Mr. 

JOYCE of Pennsylvania, Ms. JACKSON LEE, Ms. CRAIG, Mr. HURD of 

Texas, Ms. FINKENAUER, Ms. CLARK of Massachusetts, Mrs. DINGELL, 

Mrs. KIRKPATRICK, Mr. LUJA ́N, Ms. BLUNT ROCHESTER, Mr. 

BUTTERFIELD, Mrs. MILLER, Mr. HECK, Mr. HARDER of California, Mr. 

ROUDA, Mrs. LAWRENCE, Mr. GREEN of Texas, Mr. COLLINS of New 

York, Mr. SCHWEIKERT, Mr. GIANFORTE, Mr. ENGEL, Mr. CA ́RDENAS, 

Mr. TRONE, Mr. POSEY, Ms. LEE of California, Mrs. TRAHAN, Mr. 

RUSH, Mr. LATTA, Mr. UPTON, Mr. MCEACHIN, Mr. SOTO, Mr. SUOZZI, 

Mr. CARTER of Georgia, Mr. SPANO, Mr. TONKO, Mr. EMMER, Mr. 

LAWSON of Florida, Mr. CISNEROS, Mr. CARBAJAL, Mr. O’HALLERAN, 

Ms. OMAR, Mrs. BROOKS of Indiana, Mr. STEUBE, Mr. TED LIEU of 

California, Ms. ROYBAL-ALLARD, Mr. PHILLIPS, Ms. FUDGE, Ms. 

MCCOLLUM, Mr. GUTHRIE, Mr. PAPPAS, Mr. THOMPSON of Pennsylvania, Ms. UNDERWOOD, Mr. HUFFMAN, Ms. KAPTUR, Mr. MARSHALL, 

Mr. BARR, Ms. WEXTON, Ms. WASSERMAN SCHULTZ, Ms. SCHAKOWSKY, 

Mr. WALDEN, Mr. JOHNSON of South Dakota, Mr. HIMES, Mrs. LOWEY, 

Mr. ZELDIN, Mr. VAN DREW, Mr. NEGUSE, Mr. HAGEDORN, Ms. HERRERA BEUTLER, Mr. QUIGLEY, Mr. SABLAN, Mr. GONZALEZ of Ohio, and 

Ms. KENDRA S. HORN of Oklahoma 

JULY 23, 2019 

Reported with amendments, committed to the Committee of the Whole House 

on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on February 7, 2019] 

A BILL 

To reauthorize certain provisions of the Public Health 

Service Act relating to autism, and for other purposes. 


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

3 SECTION 1. SHORT TITLE. 

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

5 Accountability, Research, Education, and Support Act of 

6 2019’’ or the ‘‘Autism CARES Act of 2019’’. 

7 SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINA8 TION OF ACTIVITIES OF THE NIH WITH RE9 SPECT TO RESEARCH ON AUTISM SPECTRUM 

10 DISORDER. 

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

12 U.S.C. 284g) is amended— 

13 (1) in subsection (a)(1)— 

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

15 toxicology’’ and inserting ‘‘toxicology, and inter16 ventions to maximize outcomes for individuals 

17 with autism spectrum disorder’’; and 

18 (B) by striking the second sentence and in19 serting the following: ‘‘Such research shall inves20 tigate the causes (including possible environ21 mental causes), diagnosis or ruling out, early 

22 and ongoing detection, prevention, services across 

23 the lifespan, supports, intervention, and treat24 ment of autism spectrum disorder, including disVerDate Sep 11 2014 01:46 Jul 24, 2019 Jkt 034408 PO 00000 Frm 00003 Fmt 6652 Sfmt 6203 E:\BILLS\H1058.RH H1058

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1 semination and implementation of clinical care, 

2 supports, interventions, and treatments.’’; 

3 (2) in subsection (b)— 

4 (A) in paragraph (2)— 

5 (i) in the second sentence, by striking 

6 ‘‘cause’’ and all that follows through ‘‘dis7 order’’ and inserting ‘‘causes, diagnosis, 

8 early and ongoing detection, prevention, 

9 and treatment of autism spectrum disorder 

10 across the lifespan’’; and 

11 (ii) in the third sentence, by striking 

12 ‘‘neurobiology’’ and all that follows through 

13 the period and inserting ‘‘neurobiology, ge14 netics, genomics, psychopharmacology, de15 velopmental psychology, behavioral psy16 chology, and clinical psychology.’’; and 

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

18 the following: 

19 ‘‘(D) REDUCING DISPARITIES.—The Direc20 tor may consider, as appropriate, the extent to 

21 which a center can demonstrate availability and 

22 access to clinical services for youth and adults 

23 from diverse racial, ethnic, geographic, or lin24 guistic backgrounds in decisions about awarding 


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1 grants to applicants which meet the scientific 

2 criteria for funding under this section.’’. 

3 SEC. 3. PROGRAMS RELATING TO AUTISM. 

4 (a) DEVELOPMENTAL DISABILITIES SURVEILLANCE

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

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

7 (1) in subsection (a)(1), by striking ‘‘adults on 

8 autism spectrum disorder’’ and inserting ‘‘adults with 

9 autism spectrum disorder’’; 

10 (2) in subsection (a)(2)— 

11 (A) by striking ‘‘State and local public 

12 health officials’’ and inserting ‘‘State, local, and 

13 Tribal public health officials’’; 

14 (B) by striking ‘‘or other developmental dis15 abilities’’ and inserting ‘‘and other develop16 mental disabilities’’; 

17 (3) in subsection (a)(3), by striking ‘‘a univer18 sity, or any other educational institution’’ and insert19 ing ‘‘a university, any other educational institution, 

20 an Indian tribe, or a tribal organization’’; 

21 (4) in subsection (b)(2)(A), by striking ‘‘relevant 

22 State and local public health officials, private sector 

23 developmental disability researchers, and advocates 

24 for individuals with developmental disabilities’’ and 

25 inserting ‘‘State, local, and Tribal public health offiVerDate Sep 11 2014 01:46 Jul 24, 2019 Jkt 034408 PO 00000 Frm 00005 Fmt 6652 Sfmt 6203 E:\BILLS\H1058.RH H1058

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1 cials, private sector developmental disability research2 ers, advocates for individuals with autism spectrum 

3 disorder, and advocates for individuals with other de4 velopmental disabilities’’; 

5 (5) in subsection (d)— 

6 (A) by redesignating paragraphs (1) and 

7 (2) as paragraphs (2) and (3), respectively; and 

8 (B) by inserting before paragraph (2), as so 

9 redesignated, the following new paragraph: 

10 ‘‘(1) INDIAN TRIBE; TRIBAL ORGANIZATION.—The 

11 terms ‘Indian tribe’ and ‘tribal organization’ have the 

12 meanings given such terms in section 4 of the Indian 

13 Health Care Improvement Act.’’; and 

14 (6) in subsection (e), by striking ‘‘2019’’ and in15 serting ‘‘2024’’. 

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 (a)(1)— 

20 (A) by striking ‘‘individuals with autism 

21 spectrum disorder or other developmental dis22 abilities’’ and inserting ‘‘individuals with au23 tism spectrum disorder and other developmental 

24 disabilities’’; and 


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1 (B) by striking ‘‘children with autism spec2 trum disorder’’ and all that follows through ‘‘dis3 abilities;’’ and inserting ‘‘individuals with au4 tism spectrum disorder and other developmental 

5 disabilities across their lifespan;’’; 

6 (2) in subsection (b)— 

7 (A) in paragraph (2), by inserting ‘‘indi8 viduals with’’ before ‘‘autism spectrum disorder’’; 

9 (B) by redesignating paragraphs (4) 

10 through (6) as paragraphs (5) through (7), re11 spectively; and 

12 (C) by inserting after paragraph (3) the fol13 lowing: 

14 ‘‘(4) promote evidence-based screening techniques 

15 and interventions for individuals with autism spec16 trum disorder and other developmental disabilities 

17 across their lifespan;’’; 

18 (3) in subsection (c)— 

19 (A) in paragraph (1), in the matter pre20 ceding subparagraph (A), by striking ‘‘the needs 

21 of individuals with autism spectrum disorder or 

22 other developmental disabilities and their fami23 lies’’ and inserting ‘‘the needs of individuals 

24 with autism spectrum disorder and other develVerDate Sep 11 2014 01:46 Jul 24, 2019 Jkt 034408 PO 00000 Frm 00007 Fmt 6652 Sfmt 6203 E:\BILLS\H1058.RH H1058

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1 opmental disabilities across their lifespan and 

2 the needs of their families’’; and 

3 (B) in paragraph (2)— 

4 (i) in subparagraph (A)(ii), by strik5 ing ‘‘caregivers of individuals with an au6 tism spectrum disorder’’ and inserting 

7 ‘‘caregivers of individuals with autism spec8 trum disorder or other developmental dis9 abilities’’; 

10 (ii) in subparagraph (B)(i)(II), by in11 serting ‘‘autism spectrum disorder and’’ 

12 after ‘‘individuals with’’; and 

13 (iii) in subparagraph (B)(ii), by in14 serting ‘‘autism spectrum disorder and’’ 

15 after ‘‘individuals with’’; 

16 (4) in subsection (e)— 

17 (A) in paragraph (1)— 

18 (i) in the matter preceding subpara19 graph (A), by inserting ‘‘across their life20 span’’ before ‘‘and ensure’’; and 

21 (ii) in subparagraph (B)(iv), by in22 serting ‘‘across their lifespan’’ after ‘‘other 

23 developmental disabilities’’; 

24 (B) by redesignating paragraphs (2) and 

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


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1 (C) by inserting after paragraph (1) the fol2 lowing: 

3 ‘‘(2) DEVELOPMENTAL-BEHAVIORAL PEDIATRI4 CIAN TRAINING PROGRAMS.— 

5 ‘‘(A) IN GENERAL.—In making awards 

6 under this subsection, the Secretary may 

7 prioritize awards to applicants that are develop8 mental-behavioral pediatrician training pro9 grams located in rural or underserved areas. 

10 ‘‘(B) DEFINITION OF UNDERSERVED

11 AREA.—In this paragraph, the term ‘underserved 

12 area’ means— 

13 ‘‘(i) a health professional shortage area 

14 (as defined in section 332(a)(1)(A)); and 

15 ‘‘(ii) an urban or rural area des16 ignated by the Secretary as an area with a 

17 shortage of personal health services (as de18 scribed in section 330(b)(3)(A)).’’; 

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

20 lifespan of such individuals’’ after ‘‘other develop21 mental disabilities’’; and 

22 (6) in subsection (g), by striking ‘‘2019’’ and in23 serting ‘‘2024’’. 


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1 (c) INTERAGENCY AUTISM COORDINATING COM2 MITTEE.—Section 399CC of the Public Health Service Act 

3 (42 U.S.C. 280i–2) is amended— 

4 (1) in subsection (b)— 

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

6 the lifespan of such individuals’’ before the semi7 colon; and 

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

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

10 families’’; 

11 (2) in subsection (c)— 

12 (A) in paragraph (1)(D), by inserting ‘‘, the 

13 Department of Labor, the Department of Justice, 

14 the Department of Veterans Affairs, the Depart15 ment of Housing and Urban Development,’’ after 

16 ‘‘Department of Education’’; 

17 (B) in subparagraphs (A), (B), and (C) of 

18 paragraph (2), by striking ‘‘at least two such 

19 members’’ each place it appears and inserting 

20 ‘‘at least three such members’’; 

21 (C) in paragraph (3)(A), by striking ‘‘one 

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

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

24 (3) in subsection (f), by striking ‘‘2019’’ and in25 serting ‘‘2024’’. 


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

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

3 (1) in subsection (a)— 

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

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

6 CARES Act of 2019’’; and 

7 (B) in paragraph (2)— 

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

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

10 of 2014’’ each place it appears and insert11 ing ‘‘Autism CARES Act of 2019’’; 

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

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

14 individual’’; 

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

16 ‘‘; and’’ and inserting ‘‘;’’; 

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

18 the period and inserting ‘‘; and’’; and 

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

20 ‘‘(J) information on how States use home21 and community-based services and other sup22 ports to ensure that individuals with autism 

23 spectrum disorder and other developmental dis24 abilities are living, working, and participating 

25 in their community.’’; and 


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1 (2) in subsection (b)— 

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

3 ADULTS AND TRANSITIONING YOUTH’’ and in4 serting ‘‘THE HEALTH AND WELL-BEING OF IN5 DIVIDUALS WITH AUTISM SPECTRUM DISORDER

6 ACROSS THEIR LIFESPAN’’; 

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

8 follows: 

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

10 the date of enactment of the Autism CARES Act of 

11 2019, the Secretary shall prepare and submit, to the 

12 Committee on Health, Education, Labor, and Pen13 sions of the Senate and the Committee on Energy and 

14 Commerce of the House of Representatives, a report 

15 concerning the health and well-being of individuals 

16 with autism spectrum disorder.’’; and 

17 (C) in paragraph (2)— 

18 (i) by amending subparagraph (A) to 

19 read as follows: 

20 ‘‘(A) demographic factors associated with 

21 the health and well-being of individuals with au22 tism spectrum disorder;’’; 

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

24 ‘‘young adults’’ and all that follows through 

25 the semicolon and inserting ‘‘the health and 


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1 well-being of individuals with autism spec2 trum disorder, including an identification 

3 of existing Federal laws, regulations, poli4 cies, research, and programs;’’; and 

5 (iii) by amending subparagraphs (C), 

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

7 ‘‘(C) recommendations on establishing best 

8 practices guidelines to ensure interdisciplinary 

9 coordination between all relevant service pro10 viders receiving Federal funding; 

11 ‘‘(D) comprehensive approaches to improv12 ing health outcomes and well-being for individ13 uals with autism spectrum disorder, including— 

14 ‘‘(i) community-based behavioral sup15 ports and interventions; 

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

17 activities; and 

18 ‘‘(iii) personal safety services related to 

19 public safety agencies or the criminal jus20 tice system for such individuals; and 

21 ‘‘(E) recommendations that seek to improve 

22 health outcomes for such individuals, including 

23 across their lifespan, by addressing— 

24 ‘‘(i) screening and diagnosis of chil25 dren and adults; 


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1 ‘‘(ii) behavioral and other therapeutic 

2 approaches; 

3 ‘‘(iii) primary and preventative care; 

4 ‘‘(iv) communication challenges; 

5 ‘‘(v) aggression, self-injury, elopement, 

6 and other behavioral issues; 

7 ‘‘(vi) emergency room visits and acute 

8 care hospitalization; 

9 ‘‘(vii) treatment for co-occurring phys10 ical and mental health conditions; 

11 ‘‘(viii) premature mortality; 

12 ‘‘(ix) medical practitioner training; 

13 and 

14 ‘‘(x) caregiver mental health.’’. 

15 (e) AUTHORIZATION OF APPROPRIATIONS.—Section 

16 399EE of the Public Health Service Act (42 U.S.C. 280i– 

17 4) is amended— 

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

19 for each of fiscal years 2015 through 2019’’ and in20 serting ‘‘$23,100,000 for each of fiscal years 2020 

21 through 2024’’; 

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

23 for each of fiscal years 2015 through 2019’’ and in24 serting ‘‘$50,599,000 for each of fiscal years 2020 

25 through 2024’’; and 


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1 (3) in subsection (c), by striking ‘‘there is au2 thorized to be appropriated $190,000,000 for each of 

3 fiscal years 2015 through 2019’’ and inserting ‘‘there 

4 are authorized to be appropriated $296,000,000 for 

5 each of fiscal years 2020 through 2024’’. 

Amend the title so as to read: ‘‘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.’’. 


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Union Calendar No. 137 

116TH CONGRESS 

1ST SESSION H. R. 1058 

[Report No. 116–177] 

A BILL 

To reauthorize certain provisions of the Public 

other purposes. Health Service Act relating to autism, and for 

JULY 23, 2019 

Reported with amendments, committed to the Committee 

dered to be printed of the Whole House on the State of the Union, and orVerDate Sep 11 2014 01:46 Jul 24, 2019 Jkt 034408 PO 00000 Frm 00016 Fmt 6651 Sfmt 6651 E:\BILLS\H1058.RH H1058

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