II 

118TH CONGRESS 

1ST SESSION S. 1333 

To authorize the Secretary of Health and Human Services, acting through 

the Administrator of the Health Resources and Services Administration, 

to award grants for providing evidence-based caregiver skills training 

to family caregivers of children with autism spectrum disorder or other 

developmental disabilities or delays, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 27, 2023 

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

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

A BILL 

To authorize the Secretary of Health and Human Services, 

acting through the Administrator of the Health Resources and Services Administration, to award grants 

for providing evidence-based caregiver skills training to 

family caregivers of children with autism spectrum disorder or other developmental disabilities or delays, 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 Family Care3 givers Act of 2023’’. 

4 SEC. 2. CAREGIVER SKILLS TRAINING PILOT PROGRAM. 

5 (a) AUTHORIZATION.—The Secretary shall carry out 

6 a program, to be known as the Caregiver Skills Training 

7 Pilot Program, under which the Secretary shall award 

8 grants to eligible entities to provide evidence-based care9 giver skills training to family caregivers of children with 

10 autism spectrum disorder or other developmental disabil11 ities or delays, for the purposes of— 

12 (1) improving the well-being of children and 

13 their caregivers; and 

14 (2) teaching caregivers of such children evi15 denced-based intervention strategies to promote— 

16 (A) improvement in the well-being of such 

17 children and their caregivers; and 

18 (B) the greater inclusion of such children 

19 in family and community life. 

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

21 under subsection (a), an entity shall be— 

22 (1) a nonprofit or other community-based orga23 nization; 

24 (2) a Federally qualified health center; 

25 (3) an academic health center; 

26 (4) a health system; or 


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1 (5) a collaboration or consortium of 2 or more 

2 entities listed in paragraphs (1) through (4). 

3 (c) APPLICATION.—To seek a grant under this sec4 tion, an eligible entity shall submit to the Secretary an 

5 application that includes— 

6 (1) a description of— 

7 (A) the applicant’s experience delivering 

8 evidence-based caregiver skills training to fam9 ily caregivers of children with autism spectrum 

10 disorder or other developmental disabilities or 

11 delays; 

12 (B) the activities that the applicant pro13 poses to carry out through the grant; and 

14 (C) how such activities will achieve the 

15 purposes described in subsection (a); and 

16 (2) a plan for— 

17 (A) coordination with community-based or18 ganizations, State and local early intervention 

19 providers, State Medicaid systems, schools, and 

20 other providers of early intervening services; 

21 (B) collaboration with health care payors 

22 (including public and private insurance), State 

23 departments of insurance, health plans, and 

24 other relevant payors; 


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1 (C) expanding the skills training program 

2 proposed to be carried out through the grant; 

3 (D) achieving sustainability of such pro4 gram; and 

5 (E) establishing and maintaining a stake6 holder implementation committee under sub7 section (f). 

8 (d) SELECTION OF GRANTEES.— 

9 (1) SELECTION CRITERIA.—In awarding a 

10 grant to an eligible entity or a collaboration or con11 sortium of 2 or more entities described in subsection 

12 (b), the Secretary shall require at least one of the 

13 recipients to— 

14 (A) have at least 3 years of demonstrated 

15 experience— 

16 (i) delivering culturally competent 

17 services for children with autism spectrum 

18 disorder or other developmental delays or 

19 disabilities, as well as collaborating directly 

20 with their families, including in medically 

21 underserved communities; 

22 (ii) providing services to children with 

23 autism spectrum disorder or other develop24 mental delays or disabilities, as well as col25 laborating directly with their families; 


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1 (iii) providing individual caregiver 

2 coaching to caregivers of children with au3 tism spectrum disorder or other develop4 mental delays or disabilities; and 

5 (iv) working with self-advocates or 

6 adults with autism spectrum disorder or 

7 other developmental delays or disabilities; 

8 and 

9 (B) demonstrate the ability to access re10 sources from and collaborate with— 

11 (i) health care providers; 

12 (ii) allied health professionals; 

13 (iii) educators; 

14 (iv) social workers; and 

15 (v) nonprofessional family caregivers 

16 who assist with daily living and develop17 mental activities, including for children 

18 with autism spectrum disorder or other de19 velopmental delays or disabilities. 

20 (2) REDUCING DISPARITIES.—In awarding 

21 grants under this section, the Secretary may con22 sider, as appropriate, the extent to which an eligible 

23 entity can deliver evidence-based, culturally com24 petent caregiver skills training programs for children 

25 with autism spectrum disorder or other developVerDate Sep 11 2014 01:17 May 06, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333

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1 mental delays or disabilities from diverse racial, eth2 nic, geographic, or linguistic backgrounds. 

3 (e) USE OF FUNDS.—The recipient of a grant under 

4 this section shall use the grant— 

5 (1) to provide, at no or minimal cost to partici6 pants— 

7 (A) evidence-based caregiver skills training 

8 to family caregivers of children with autism 

9 spectrum disorder or other developmental 

10 delays or disabilities; and 

11 (B) such training in areas related to chil12 dren’s learning and development, including— 

13 (i) communication skills; 

14 (ii) social engagement; 

15 (iii) daily living skills; and 

16 (iv) caregiver response strategies to 

17 severe and challenging behaviors; and 

18 (2) to establish and maintain a stakeholder im19 plementation committee under subsection (f). 

20 (f) STAKEHOLDER IMPLEMENTATION COMMITTEE.— 

21 (1) IN GENERAL.—As a condition on receipt of 

22 a grant under this section, an eligible entity shall 

23 agree to use the grant to establish and maintain a 

24 stakeholder implementation committee to advise on 


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1 ensuring that the training provided pursuant to the 

2 grant is accessible and culturally relevant. 

3 (2) COMPOSITION.—The members of the stake4 holder implementation committee shall all be from 

5 the local community served pursuant to the grant 

6 (or the relevant metropolitan statistical area) and 

7 shall include, at a minimum, the following: 

8 (A) Family caregivers of children with au9 tism or other developmental disabilities, includ10 ing autistic caregivers and other caregivers with 

11 disabilities. 

12 (B) Pediatric health care and early inter13 vention providers with experience providing 

14 services to children with autism or other devel15 opmental delays or disabilities. 

16 (C) Educators with experience working 

17 with children with autism or other develop18 mental delays or disabilities. 

19 (D) Representatives of local organizations 

20 familiar with the cultural values and priorities 

21 of individuals in the local community. 

22 (E) Local government officials. 

23 (g) REQUIREMENTS.— 

24 (1) NUMBER OF RECIPIENTS AND STATES.— 

25 The Secretary shall award grants under subsection 


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1 (a) to not fewer than 25 eligible entities in not fewer 

2 than 15 States. 

3 (2) AMOUNT.—The total amount of each grant 

4 awarded under subsection (a) shall be not less than 

5 $500,000 over a 5-year period. 

6 (h) SUPPLEMENT NOT SUPPLANT.—Amounts re7 ceived through a grant under this section shall be used 

8 to supplement, not supplant, other amounts received to 

9 provide— 

10 (1) behavioral, medical, habilitative, and other 

11 services covered by the Medicaid program or private 

12 health insurance; 

13 (2) services provided under the Individuals with 

14 Disabilities Education Act (20 U.S.C. 1400 et seq.); 

15 or 

16 (3) adaptations of a training program using evi17 dence-based approaches to serve children of different 

18 ages, communities, and underrepresented groups. 

19 (i) ACTIVITIES OF THE SECRETARY.—The Secretary 

20 shall— 

21 (1) assist recipients of grants under subsection 

22 (a) in— 

23 (A) the implementation of caregiver skills 

24 training programs using lessons learned from 

25 other evidenced-based activities or caregiver 


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1 programs conducted or supported by the Health 

2 Resources and Services Administration; 

3 (B) ensuring the programs of the recipi4 ents assist medically underserved communities, 

5 when possible; and 

6 (C) developing plans for achieving sustain7 ability of the programs of the recipients; 

8 (2) conduct an annual evaluation of activities 

9 funded through grants under subsection (a), in con10 sultation with the grant recipients, including evalua11 tion of the effectiveness of such grants at improving 

12 health outcomes and quality of life for children with 

13 autism spectrum disorder or other developmental 

14 delays or disabilities and their family caregivers; and 

15 (3) convene at least one national or regional 

16 meeting of such grant recipients to discuss best 

17 practices. 

18 (j) REPORTS.— 

19 (1) INITIAL REPORT.—Not later than 6 months 

20 after awarding the first grant under subsection (a), 

21 the Secretary shall submit to the Committees on Ap22 propriations of the House of Representatives and the 

23 Senate, and to other appropriate congressional com24 mittees, a report on the implementation of this sec25 tion. Such report shall include— 


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1 (A) how many grants have been awarded; 

2 (B) the name and location of the grant re3 cipients; 

4 (C) the communities impacted by the 

5 grants; 

6 (D) a description of the kind of activities 

7 to be carried out with the grants; 

8 (E) an analysis, conducted by the Sec9 retary, based on the evaluation under sub10 section (i)(2), of the effectiveness of such 

11 grants at improving health outcomes and qual12 ity of life for children with autism or other de13 velopmental delays or disabilities and their fam14 ily caregivers; and 

15 (F) best practices to increase access to 

16 caregiver skills training programs described in 

17 subsection (a) in medically underserved commu18 nities. 

19 (2) FINAL REPORT.—Not later than the end of 

20 fiscal year 2027, the Secretary shall submit to the 

21 Committees on Appropriations of the House of Rep22 resentatives and the Senate, and to other appro23 priate congressional committees, a final report on 

24 the implementation of this section, including— 


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1 (A) the information, analysis, and best 

2 practices listed in subparagraphs (A) through 

3 (F) of paragraph (1); and 

4 (B) recommendations on how to expand 

5 and extend the program under this section. 

6 (k) DEFINITIONS.—In this section: 

7 (1) The term ‘‘family caregiver’’ means an 

8 adult family member or other individual who has a 

9 significant relationship with, and who provides a 

10 broad range of assistance to, a child between the 

11 ages of 0 and 9 diagnosed with autism spectrum dis12 order or other developmental disabilities or delays. 

13 (2) The term ‘‘Federally qualified health cen14 ter’’ has the meaning given the term in section 

15 1861(aa) of the Social Security Act (42 U.S.C. 

16 1395x(aa)). 

17 (3) The term ‘‘Secretary’’ means the Secretary 

18 of Health and Human Services, acting through the 

19 Administrator of the Health Resources and Services 

20 Administration. 

21 (l) AUTHORIZATION OF APPROPRIATIONS.—To carry 

22 out this section, there is authorized to be appropriated 

23 $10,000,000 for each of fiscal years 2024 through 2028. 

Æ 


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