II 

113TH CONGRESS 

2D SESSION H. R. 4631 

IN THE SENATE OF THE UNITED STATES 

JUNE 25, 2014 

Received 

AN ACT 

To reauthorize certain provisions of the Public Health 

Service Act 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 2014’’ or the ‘‘Autism CARES Act of 2014’’. 

5 SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER INITIA6 TIVE. 

7 (a) IN GENERAL.—The Secretary of Health and 

8 Human Services shall designate an existing official within 

9 the Department of Health and Human Services to oversee, 

10 in consultation with the Secretaries of Defense and Edu11 cation, national autism spectrum disorder research, serv12 ices, and support activities. 

13 (b) DUTIES.—The official designated under sub14 section (a) shall— 

15 (1) implement autism spectrum disorder activi16 ties, taking into account the strategic plan developed 

17 by the Interagency Autism Coordinating Committee 

18 under section 399CC(b) of the Public Health Service 

19 Act (42 U.S.C. 280i–2(b)); and 

20 (2) ensure that autism spectrum disorder activi21 ties of the Department of Health and Human Serv22 ices and of other Federal departments and agencies 

23 are not unnecessarily duplicative. 

24 SEC. 3. RESEARCH PROGRAM. 

25 Section 399AA of the Public Health Service Act (42 

26 U.S.C. 280i) is amended— 


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1 (1) in subsection (a)(1), by inserting ‘‘for chil2 dren and adults’’ after ‘‘reporting of State epidemio3 logical data’’; 

4 (2) in subsection (b)(1)— 

5 (A) by striking ‘‘establishment of regional 

6 centers of excellence’’ and inserting ‘‘establish7 ment or support of regional centers of excel8 lence’’; and 

9 (B) by inserting ‘‘for children and adults’’ 

10 before the period at the end; 

11 (3) in subsection (b)(2), by striking ‘‘center to 

12 be established’’ and inserting ‘‘center to be estab13 lished or supported’’; and 

14 (4) in subsection (e), by striking ‘‘2014’’ and 

15 inserting ‘‘2019’’. 

16 SEC. 4. AUTISM INTERVENTION. 

17 Section 399BB of the Public Health Service Act (42 

18 U.S.C. 280i–1) is amended— 

19 (1) in subsection (b)(1), by inserting ‘‘culturally 

20 competent’’ after ‘‘provide’’; 

21 (2) in subsection (c)(2)(A)(ii), by inserting 

22 ‘‘(which may include respite care for caregivers of 

23 individuals with an autism spectrum disorder)’’ after 

24 ‘‘services and supports’’; 


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1 (3) in subsection (e)(1)(B)(v), by inserting be2 fore the semicolon the following: ‘‘, which may in3 clude collaborating with research centers or networks 

4 to provide training for providers of respite care (as 

5 defined in section 2901)’’; 

6 (4) in subsection (f), by striking ‘‘grants or 

7 contracts’’ and all that follows through ‘‘for individ8 uals with’’ and inserting ‘‘grants or contracts, which 

9 may include grants or contracts to research centers 

10 or networks, to determine the evidence-based prac11 tices for interventions to improve the physical and 

12 behavioral health of individuals with’’; and 

13 (5) in subsection (g), by striking ‘‘2014’’ and 

14 inserting ‘‘2019’’. 

15 SEC. 5. INTERAGENCY AUTISM COORDINATING COM16 MITTEE. 

17 Section 399CC of the Public Health Service Act (42 

18 U.S.C. 280i–2) is amended— 

19 (1) in subsection (b)— 

20 (A) in paragraph (1)— 

21 (i) by striking ‘‘and annually update’’; 

22 and 

23 (ii) by striking ‘‘intervention’’ and in24 serting ‘‘interventions, including school and 

25 community-based interventions’’; 


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1 (B) by striking paragraph (2); 

2 (C) by redesignating paragraph (1) as 

3 paragraph (2), and inserting before such redes4 ignated paragraph the following: 

5 ‘‘(1) monitor autism spectrum disorder re6 search, and to the extent practicable services and 

7 support activities, across all relevant Federal depart8 ments and agencies, including coordination of Fed9 eral activities with respect to autism spectrum dis10 order;’’; 

11 (D) in paragraph (3), by striking ‘‘rec12 ommendations to the Director of NIH’’; 

13 (E) in paragraph (4), by inserting before 

14 the semicolon the following: ‘‘, and the process 

15 by which public feedback can be better inte16 grated into such decisions’’; and 

17 (F) by striking paragraphs (5) and (6) and 

18 inserting the following: 

19 ‘‘(5) develop a strategic plan for the conduct of, 

20 and support for, autism spectrum disorder research, 

21 including as practicable for services and supports, 

22 for individuals with an autism spectrum disorder 

23 and the families of such individuals, which shall in24 clude— 


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1 ‘‘(A) proposed budgetary requirements; 

2 and 

3 ‘‘(B) recommendations to ensure that au4 tism spectrum disorder research, and services 

5 and support activities to the extent practicable, 

6 of the Department of Health and Human Serv7 ices and of other Federal departments and 

8 agencies are not unnecessarily duplicative; and 

9 ‘‘(6) submit to Congress and the President— 

10 ‘‘(A) an annual update on the summary of 

11 advances described in paragraph (2); and 

12 ‘‘(B) an annual update to the strategic 

13 plan described in paragraph (5), including any 

14 progress made in achieving the goals outlined in 

15 such strategic plan.’’; 

16 (2) in subsection (c)— 

17 (A) in paragraph (1)— 

18 (i) by striking the paragraph designa19 tion, the heading, and the matter pre20 ceding subparagraph (A) and inserting the 

21 following: 

22 ‘‘(1) FEDERAL MEMBERSHIP.—The Committee 

23 shall be composed of the following Federal mem24 bers—’’; 

25 (ii) in subparagraph (C)— 


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1 (I) by inserting ‘‘, such as the 

2 Administration for Community Living, 

3 Administration for Children and Fam4 ilies, the Centers for Medicare & Med5 icaid Services, the Food and Drug Ad6 ministration, and the Health Re7 sources and Services Administration’’ 

8 before the semicolon at the end; and 

9 (II) by adding at the end ‘‘and’’; 

10 (iii) in subparagraph (D)— 

11 (I) by inserting ‘‘and the Depart12 ment of Defense’’ after ‘‘Department 

13 of Education’’; and 

14 (II) by striking at the end ‘‘; 

15 and’’ and inserting a period; and 

16 (iv) by striking subparagraph (E); 

17 (B) in paragraph (2)— 

18 (i) in the paragraph heading, by strik19 ing ‘‘ADDITIONAL’’ and inserting ‘‘NON20 FEDERAL’’; 

21 (ii) in the matter preceding subpara22 graph (A), by striking ‘‘Not fewer than 6 

members of the Committee, or 1 23 ⁄3 of the 

24 total membership of the Committee, which25 ever is greater’’ and inserting ‘‘Not more 


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than 1⁄2, but not fewer than 1 1 ⁄3, of the total 

2 membership of the Committee’’; 

3 (iii) in subparagraph (A), by striking 

4 ‘‘one such member shall be an individual’’ 

5 and inserting ‘‘two such members shall be 

6 individuals’’; 

7 (iv) in subparagraph (B), by striking 

8 ‘‘one such member shall be a parent or 

9 legal guardian’’ and inserting ‘‘two such 

10 members shall be parents or legal guard11 ians’’; and 

12 (v) in subparagraph (C), by striking 

13 ‘‘one such member shall be a representa14 tive’’ and inserting ‘‘two such members 

15 shall be representatives’’; and 

16 (C) by adding at the end the following: 

17 ‘‘(3) PERIOD OF APPOINTMENT; VACANCIES.— 

18 ‘‘(A) PERIOD OF APPOINTMENT FOR NON19 FEDERAL MEMBERS.—Non-Federal members 

20 shall serve for a term of 4 years, and may be 

21 reappointed for one or more additional 4-year 

22 terms. 

23 ‘‘(B) VACANCIES.—A vacancy on the Com24 mittee shall be filled in the manner in which the 

25 original appointment was made and shall not 


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1 affect the powers or duties of the Committee. 

2 Any member appointed to fill a vacancy for an 

3 unexpired term shall be appointed for the re4 mainder of such term. A member may serve 

5 after the expiration of the member’s term until 

6 a successor has been appointed.’’; 

7 (3) in subsection (d)— 

8 (A) by striking paragraph (2); and 

9 (B) by redesignating paragraphs (3) and 

10 (4) as paragraphs (2) and (3), respectively; and 

11 (4) in subsection (f), by striking ‘‘2014’’ and 

12 inserting ‘‘2019’’. 

13 SEC. 6. REPORTS. 

14 Section 399DD of the Public Health Service Act (42 

15 U.S.C. 280i–3) is amended— 

16 (1) in the section heading, by striking ‘‘RE17 PORT’’ and inserting ‘‘REPORTS’’; 

18 (2) in subsection (b), by redesignating para19 graphs (1) through (9) as subparagraphs (A) 

20 through (I), respectively, and realigning the margins 

21 accordingly; 

22 (3) by redesignating subsections (a) and (b) as 

23 paragraphs (1) and (2), respectively, and realigning 

24 the margins accordingly; 


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1 (4) by inserting after the section heading the 

2 following: 

3 ‘‘(a) PROGRESS REPORT.—’’; 

4 (5) in subsection (a)(1) (as so redesignated)— 

5 (A) by striking ‘‘2 years after the date of 

6 enactment of the Combating Autism Reauthor7 ization Act of 2011’’ and inserting ‘‘4 years 

8 after the date of enactment of the Autism 

9 CARES Act of 2014’’; 

10 (B) by inserting ‘‘and the Secretary of De11 fense’’ after ‘‘the Secretary of Education’’; and 

12 (C) by inserting ‘‘, and make publicly 

13 available, including through posting on the 

14 Internet Web site of the Department of Health 

15 and Human Services,’’ after ‘‘Representatives’’; 

16 and 

17 (6) in subsection (a)(2) (as so redesignated)— 

18 (A) in subparagraph (A), (as so redesig19 nated), by striking ‘‘Combating Autism Act of 

20 2006’’ and inserting ‘‘Autism CARES Act of 

21 2014’’; 

22 (B) in subparagraph (B) (as so redesig23 nated), by striking ‘‘particular provisions of 

24 Combating Autism Act of 2006’’ and inserting 


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1 ‘‘amendments made by the Autism CARES Act 

2 of 2014’’; 

3 (C) by striking subparagraph (C) (as so 

4 redesignated), and inserting the following: 

5 ‘‘(C) information on the incidence and 

6 prevalence of autism spectrum disorder, includ7 ing available information on the prevalence of 

8 autism spectrum disorder among children and 

9 adults, and identification of any changes over 

10 time with respect to the incidence and preva11 lence of autism spectrum disorder;’’; 

12 (D) in subparagraph (D) (as so redesig13 nated), by striking ‘‘6-year period beginning on 

14 the date of enactment of the Combating Autism 

15 Act of 2006’’ and inserting ‘‘4-year period be16 ginning on the date of enactment of the Autism 

17 CARES Act of 2014 and, as appropriate, how 

18 this age varies across population subgroups’’; 

19 (E) in subparagraph (E) (as so redesig20 nated), by striking ‘‘6-year period beginning on 

21 the date of enactment of the Combating Autism 

22 Act of 2006’’ and inserting ‘‘4-year period be23 ginning on the date of enactment of the Autism 

24 CARES Act of 2014 and, as appropriate, how 

25 this age varies across population subgroups’’; 


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1 (F) in subparagraph (F) (as so redesig2 nated), by inserting ‘‘and, as appropriate, on 

3 how such average time varies across population 

4 subgroups’’ before the semicolon at the end; 

5 (G) in subparagraph (G) (as so redesig6 nated)— 

7 (i) by striking ‘‘including by various 

8 subtypes,’’ and inserting ‘‘including by se9 verity level as practicable,’’; and 

10 (ii) by striking ‘‘child may’’ and in11 serting ‘‘child or other factors, such as de12 mographic characteristics, may’’; and 

13 (H) by striking subparagraph (I) (as so re14 designated), and inserting the following: 

15 ‘‘(I) a description of the actions taken to 

16 implement and the progress made on implemen17 tation of the strategic plan developed by the 

18 Interagency Autism Coordinating Committee 

19 under section 399CC(b).’’; and 

20 (7) by adding at the end the following new sub21 section: 

22 ‘‘(b) REPORT ON YOUNG ADULTS AND

23 TRANSITIONING YOUTH.— 

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

25 after the date of enactment of the Autism CARES 


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1 Act of 2014, the Secretary of Health and Human 

2 Services, in coordination with the Secretary of Edu3 cation and in collaboration with the Secretary of 

4 Transportation, the Secretary of Labor, the Sec5 retary of Housing and Urban Development, and the 

6 Attorney General, shall prepare and submit to the 

7 Committee on Health, Education, Labor, and Pen8 sions of the Senate and the Committee on Energy 

9 and Commerce of the House of Representatives, a 

10 report concerning young adults with autism spec11 trum disorder and the challenges related to the tran12 sition from existing school-based services to those 

13 services available during adulthood. 

14 ‘‘(2) CONTENTS.—The report submitted under 

15 paragraph (1) shall contain— 

16 ‘‘(A) demographic characteristics of youth 

17 transitioning from school-based to community18 based supports; 

19 ‘‘(B) an overview of policies and programs 

20 relevant to young adults with autism spectrum 

21 disorder relating to post-secondary school tran22 sitional services, including an identification of 

23 existing Federal laws, regulations, policies, re24 search, and programs; 


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1 ‘‘(C) proposals on establishing best prac2 tices guidelines to ensure— 

3 ‘‘(i) interdisciplinary coordination be4 tween all relevant service providers receiv5 ing Federal funding; 

6 ‘‘(ii) coordination with transitioning 

7 youth and the family of such transitioning 

8 youth; and 

9 ‘‘(iii) inclusion of the individualized 

10 education program for the transitioning 

11 youth, as prescribed in section 614 of the 

12 Individuals with Disabilities Education Act 

13 (20 U.S.C. 1414); 

14 ‘‘(D) comprehensive approaches to 

15 transitioning from existing school-based services 

16 to those services available during adulthood, in17 cluding— 

18 ‘‘(i) services that increase access to, 

19 and improve integration and completion of, 

20 post-secondary education, peer support, vo21 cational training (as defined in section 103 

22 of the Rehabilitation Act of 1973 (29 

23 U.S.C. 723)), rehabilitation, self-advocacy 

24 skills, and competitive, integrated employ25 ment; 


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1 ‘‘(ii) community-based behavioral sup2 ports and interventions; 

3 ‘‘(iii) community-based integrated res4 idential services, housing, and transpor5 tation; 

6 ‘‘(iv) nutrition, health and wellness, 

7 recreational, and social activities; 

8 ‘‘(v) personal safety services for indi9 viduals with autism spectrum disorder re10 lated to public safety agencies or the crimi11 nal justice system; and 

12 ‘‘(vi) evidence-based approaches for 

13 coordination of resources and services once 

14 individuals have aged out of post-secondary 

15 education; and 

16 ‘‘(E) proposals that seek to improve out17 comes for adults with autism spectrum disorder 

18 making the transition from a school-based sup19 port system to adulthood by— 

20 ‘‘(i) increasing the effectiveness of 

21 programs that provide transition services; 

22 ‘‘(ii) increasing the ability of the rel23 evant service providers described in sub24 paragraph (C) to provide supports and 


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1 services to underserved populations and re2 gions; 

3 ‘‘(iii) increasing the efficiency of serv4 ice delivery to maximize resources and out5 comes, including with respect to the inte6 gration of and collaboration among services 

7 for transitioning youth; 

8 ‘‘(iv) ensuring access to all services 

9 necessary to transitioning youth of all ca10 pabilities; and 

11 ‘‘(v) encouraging transitioning youth 

12 to utilize all available transition services to 

13 maximize independence, equal opportunity, 

14 full participation, and self-sufficiency.’’. 

15 SEC. 7. AUTHORIZATION OF APPROPRIATIONS. 

16 Section 399EE of the Public Health Service Act (42 

17 U.S.C. 280i–4) is amended— 

18 (1) in subsection (a), by striking ‘‘fiscal years 

19 2012 through 2014’’ and inserting ‘‘fiscal years 

20 2015 through 2019’’; 

21 (2) in subsection (b), by striking ‘‘fiscal years 

22 2011 through 2014’’ and inserting ‘‘fiscal years 

23 2015 through 2019’’; and 

24 (3) in subsection (c), by striking ‘‘$161,000,000 

25 for each of fiscal years 2011 through 2014’’ and inVerDate Mar 15 2010 23:43 Aug 01, 2014 Jkt 039200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H4631.RDS H4631

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1 serting ‘‘$190,000,000 for each of fiscal years 2015 

2 through 2019’’. 

Passed the House of Representatives June 24, 2014. 

Attest: KAREN L. HAAS, 

Clerk. 


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