II 

116TH CONGRESS 

1ST SESSION H. R. 1058 

IN THE SENATE OF THE UNITED STATES 

JULY 25, 2019 

Received 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

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

3 Accountability, Research, Education, and Support Act of 

4 2019’’ or the ‘‘Autism CARES Act of 2019’’. 

5 SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINA6 TION OF ACTIVITIES OF THE NIH WITH RE7 SPECT TO RESEARCH ON AUTISM SPECTRUM 

8 DISORDER. 

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

10 U.S.C. 284g) is amended— 

11 (1) in subsection (a)(1)— 

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

13 toxicology’’ and inserting ‘‘toxicology, and inter14 ventions to maximize outcomes for individuals 

15 with autism spectrum disorder’’; and 

16 (B) by striking the second sentence and in17 serting the following: ‘‘Such research shall in18 vestigate the causes (including possible environ19 mental causes), diagnosis or ruling out, early 

20 and ongoing detection, prevention, services 

21 across the lifespan, supports, intervention, and 

22 treatment of autism spectrum disorder, includ23 ing dissemination and implementation of clin24 ical care, supports, interventions, and treat25 ments.’’; 

26 (2) in subsection (b)— 


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1 (A) in paragraph (2)— 

2 (i) in the second sentence, by striking 

3 ‘‘cause’’ and all that follows through ‘‘dis4 order’’ and inserting ‘‘causes, diagnosis, 

5 early and ongoing detection, prevention, 

6 and treatment of autism spectrum disorder 

7 across the lifespan’’; and 

8 (ii) in the third sentence, by striking 

9 ‘‘neurobiology’’ and all that follows 

10 through the period and inserting 

11 ‘‘neurobiology, genetics, genomics, 

12 psychopharmacology, developmental psy13 chology, behavioral psychology, and clinical 

14 psychology.’’; and 

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

16 the following: 

17 ‘‘(D) REDUCING DISPARITIES.—The Direc18 tor may consider, as appropriate, the extent to 

19 which a center can demonstrate availability and 

20 access to clinical services for youth and adults 

21 from diverse racial, ethnic, geographic, or lin22 guistic backgrounds in decisions about awarding 

23 grants to applicants which meet the scientific 

24 criteria for funding under this section.’’. 


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1 SEC. 3. PROGRAMS RELATING TO AUTISM. 

2 (a) DEVELOPMENTAL DISABILITIES SURVEILLANCE

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

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

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

6 autism spectrum disorder’’ and inserting ‘‘adults 

7 with autism spectrum disorder’’; 

8 (2) in subsection (a)(2)— 

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

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

11 Tribal public health officials’’; 

12 (B) by striking ‘‘or other developmental 

13 disabilities’’ and inserting ‘‘and other develop14 mental disabilities’’; 

15 (3) in subsection (a)(3), by striking ‘‘a univer16 sity, or any other educational institution’’ and in17 serting ‘‘a university, any other educational institu18 tion, an Indian tribe, or a tribal organization’’; 

19 (4) in subsection (b)(2)(A), by striking ‘‘rel20 evant State and local public health officials, private 

21 sector developmental disability researchers, and ad22 vocates for individuals with developmental disabil23 ities’’ and inserting ‘‘State, local, and Tribal public 

24 health officials, private sector developmental dis25 ability researchers, advocates for individuals with 


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1 autism spectrum disorder, and advocates for individ2 uals with other developmental disabilities’’; 

3 (5) in subsection (d)— 

4 (A) by redesignating paragraphs (1) and 

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

6 (B) by inserting before paragraph (2), as 

7 so redesignated, the following new paragraph: 

8 ‘‘(1) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

9 The terms ‘Indian tribe’ and ‘tribal organization’ 

10 have the meanings given such terms in section 4 of 

11 the Indian Health Care Improvement Act.’’; and 

12 (6) in subsection (e), by striking ‘‘2019’’ and 

13 inserting ‘‘2024’’. 

14 (b) AUTISM EDUCATION, EARLY DETECTION, AND

15 INTERVENTION.—Section 399BB of the Public Health 

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

17 (1) in subsection (a)(1)— 

18 (A) by striking ‘‘individuals with autism 

19 spectrum disorder or other developmental dis20 abilities’’ and inserting ‘‘individuals with autism 

21 spectrum disorder and other developmental dis22 abilities’’; and 

23 (B) by striking ‘‘children with autism spec24 trum disorder’’ and all that follows through 

25 ‘‘disabilities;’’ and inserting ‘‘individuals with 


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1 autism spectrum disorder and other develop2 mental disabilities across their lifespan;’’; 

3 (2) in subsection (b)— 

4 (A) in paragraph (2), by inserting ‘‘indi5 viduals with’’ before ‘‘autism spectrum dis6 order’’; 

7 (B) by redesignating paragraphs (4) 

8 through (6) as paragraphs (5) through (7), re9 spectively; and 

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

11 following: 

12 ‘‘(4) promote evidence-based screening tech13 niques and interventions for individuals with autism 

14 spectrum disorder and other developmental disabil15 ities across their lifespan;’’; 

16 (3) in subsection (c)— 

17 (A) in paragraph (1), in the matter pre18 ceding subparagraph (A), by striking ‘‘the 

19 needs of individuals with autism spectrum dis20 order or other developmental disabilities and 

21 their families’’ and inserting ‘‘the needs of indi22 viduals with autism spectrum disorder and 

23 other developmental disabilities across their life24 span and the needs of their families’’; and 

25 (B) in paragraph (2)— 


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1 (i) in subparagraph (A)(ii), by strik2 ing ‘‘caregivers of individuals with an au3 tism spectrum disorder’’ and inserting 

4 ‘‘caregivers of individuals with autism 

5 spectrum disorder or other developmental 

6 disabilities’’; 

7 (ii) in subparagraph (B)(i)(II), by in8 serting ‘‘autism spectrum disorder and’’ 

9 after ‘‘individuals with’’; and 

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

12 after ‘‘individuals with’’; 

13 (4) in subsection (e)— 

14 (A) in paragraph (1)— 

15 (i) in the matter preceding subpara16 graph (A), by inserting ‘‘across their life17 span’’ before ‘‘and ensure’’; and 

18 (ii) in subparagraph (B)(iv), by in19 serting ‘‘across their lifespan’’ after ‘‘other 

20 developmental disabilities’’; 

21 (B) by redesignating paragraphs (2) and 

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

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

24 following: 


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1 ‘‘(2) DEVELOPMENTAL-BEHAVIORAL PEDIATRI2 CIAN TRAINING PROGRAMS.— 

3 ‘‘(A) IN GENERAL.—In making awards 

4 under this subsection, the Secretary may 

5 prioritize awards to applicants that are develop6 mental-behavioral pediatrician training pro7 grams located in rural or underserved areas. 

8 ‘‘(B) DEFINITION OF UNDERSERVED

9 AREA.—In this paragraph, the term ‘under10 served area’ means— 

11 ‘‘(i) a health professional shortage 

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

13 and 

14 ‘‘(ii) an urban or rural area des15 ignated by the Secretary as an area with 

16 a shortage of personal health services (as 

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

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

19 lifespan of such individuals’’ after ‘‘other develop20 mental disabilities’’; and 

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

22 inserting ‘‘2024’’. 

23 (c) INTERAGENCY AUTISM COORDINATING COM24 MITTEE.—Section 399CC of the Public Health Service Act 

25 (42 U.S.C. 280i–2) is amended— 


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1 (1) in subsection (b)— 

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

3 the lifespan of such individuals’’ before the 

4 semicolon; and 

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

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

7 the families’’; 

8 (2) in subsection (c)— 

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

10 the Department of Labor, the Department of 

11 Justice, the Department of Veterans Affairs, 

12 the Department of Housing and Urban Devel13 opment,’’ after ‘‘Department of Education’’; 

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

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

16 members’’ each place it appears and inserting 

17 ‘‘at least three such members’’; 

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

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

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

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

22 inserting ‘‘2024’’. 

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

24 Public Health Service Act (42 U.S.C. 280i–3) is amend25 ed— 


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1 (1) in subsection (a)— 

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

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

4 CARES Act of 2019’’; and 

5 (B) in paragraph (2)— 

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

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

8 of 2014’’ each place it appears and insert9 ing ‘‘Autism CARES Act of 2019’’; 

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

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

12 the individual’’; 

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

14 ‘‘; and’’ and inserting ‘‘;’’; 

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

16 the period and inserting ‘‘; and’’; and 

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

18 ‘‘(J) information on how States use home19 and community-based services and other sup20 ports to ensure that individuals with autism 

21 spectrum disorder and other developmental dis22 abilities are living, working, and participating in 

23 their community.’’; and 

24 (2) in subsection (b)— 


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

2 ADULTS AND TRANSITIONING YOUTH’’ and in3 serting ‘‘THE HEALTH AND WELL-BEING OF

4 INDIVIDUALS WITH AUTISM SPECTRUM DIS5 ORDER ACROSS THEIR LIFESPAN’’; 

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

7 follows: 

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

9 after the date of enactment of the Autism CARES 

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

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

12 Pensions of the Senate and the Committee on En13 ergy and Commerce of the House of Representa14 tives, a report concerning the health and well-being 

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

16 (C) in paragraph (2)— 

17 (i) by amending subparagraph (A) to 

18 read as follows: 

19 ‘‘(A) demographic factors associated with 

20 the health and well-being of individuals with au21 tism spectrum disorder;’’; 

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

23 ‘‘young adults’’ and all that follows 

24 through the semicolon and inserting ‘‘the 

25 health and well-being of individuals with 


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1 autism spectrum disorder, including an 

2 identification of existing Federal laws, reg3 ulations, policies, research, and pro4 grams;’’; 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 

19 to public safety agencies or the criminal 

20 justice system for such individuals; and 

21 ‘‘(E) recommendations that seek to im22 prove health outcomes for such individuals, in23 cluding 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, elope6 ment, 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 

3 of fiscal years 2015 through 2019’’ and inserting 

4 ‘‘there are authorized to be appropriated 

5 $296,000,000 for each of fiscal years 2020 through 

6 2024’’. 

Passed the House of Representatives July 24, 2019. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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