H. R. 4631 

One Hundred Thirteenth Congress 

of the 

United States of America 

AT THE SECOND SESSION 

Begun and held at the City of Washington on Friday, 

the third day of January, two thousand and fourteen 

An Act 

To reauthorize certain provisions of the Public Health Service Act relating to autism, 

and for other purposes. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Autism Collaboration, Accountability, Research, Education, and Support Act of 2014’’ or the 

‘‘Autism CARES Act of 2014’’. 

SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER INITIATIVE. 

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

shall designate an existing official within the Department of Health 

and Human Services to oversee, in consultation with the Secretaries 

of Defense and Education, national autism spectrum disorder 

research, services, and support activities. 

(b) DUTIES.—The official designated under subsection (a) shall— 

(1) implement autism spectrum disorder activities, taking 

into account the strategic plan developed by the Interagency 

Autism Coordinating Committee under section 399CC(b) of the 

Public Health Service Act (42 U.S.C. 280i–2(b)); and 

(2) ensure that autism spectrum disorder activities of the 

Department of Health and Human Services and of other Federal 

departments and agencies are not unnecessarily duplicative. 

SEC. 3. RESEARCH PROGRAM. 

Section 399AA of the Public Health Service Act (42 U.S.C. 

280i) is amended— 

(1) in subsection (a)(1), by inserting ‘‘for children and 

adults’’ after ‘‘reporting of State epidemiological data’’; 

(2) in subsection (b)(1)— 

(A) by striking ‘‘establishment of regional centers of 

excellence’’ and inserting ‘‘establishment or support of 

regional centers of excellence’’; and 

(B) by inserting ‘‘for children and adults’’ before the 

period at the end; 

(3) in subsection (b)(2), by striking ‘‘center to be established’’ and inserting ‘‘center to be established or supported’’; 

and 

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

‘‘2019’’. 

SEC. 4. AUTISM INTERVENTION. 

Section 399BB of the Public Health Service Act (42 U.S.C. 

280i–1) is amended— 
H. R. 4631—2 

(1) in subsection (b)(1), by inserting ‘‘culturally competent’’ 

after ‘‘provide’’; 

(2) in subsection (c)(2)(A)(ii), by inserting ‘‘(which may 

include respite care for caregivers of individuals with an autism 

spectrum disorder)’’ after ‘‘services and supports’’; 

(3) in subsection (e)(1)(B)(v), by inserting before the semicolon the following: ‘‘, which may include collaborating with 

research centers or networks to provide training for providers 

of respite care (as defined in section 2901)’’; 

(4) in subsection (f), by striking ‘‘grants or contracts’’ and 

all that follows through ‘‘for individuals with’’ and inserting 

‘‘grants or contracts, which may include grants or contracts 

to research centers or networks, to determine the evidencebased practices for interventions to improve the physical and 

behavioral health of individuals with’’; and 

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

‘‘2019’’. 

SEC. 5. INTERAGENCY AUTISM COORDINATING COMMITTEE. 

Section 399CC of the Public Health Service Act (42 U.S.C. 

280i–2) is amended— 

(1) in subsection (b)— 

(A) in paragraph (1)— 

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

(ii) by striking ‘‘intervention’’ and inserting ‘‘interventions, including school and community-based interventions’’; 

(B) by striking paragraph (2); 

(C) by redesignating paragraph (1) as paragraph (2), 

and inserting before such redesignated paragraph the following: 

‘‘(1) monitor autism spectrum disorder research, and to 

the extent practicable services and support activities, across 

all relevant Federal departments and agencies, including 

coordination of Federal activities with respect to autism spectrum disorder;’’; 

(D) in paragraph (3), by striking ‘‘recommendations 

to the Director of NIH’’; 

(E) in paragraph (4), by inserting before the semicolon 

the following: ‘‘, and the process by which public feedback 

can be better integrated into such decisions’’; and 

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

the following: 

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

for, autism spectrum disorder research, including as practicable 

for services and supports, for individuals with an autism spectrum disorder and the families of such individuals, which shall 

include— 

‘‘(A) proposed budgetary requirements; and 

‘‘(B) recommendations to ensure that autism spectrum 

disorder research, and services and support activities to 

the extent practicable, of the Department of Health and 

Human Services and of other Federal departments and 

agencies are not unnecessarily duplicative; and 

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

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

described in paragraph (2); and 
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‘‘(B) an annual update to the strategic plan described 

in paragraph (5), including any progress made in achieving 

the goals outlined in such strategic plan.’’; 

(2) in subsection (c)— 

(A) in paragraph (1)— 

(i) by striking the paragraph designation, the 

heading, and the matter preceding subparagraph (A) 

and inserting the following: 

‘‘(1) FEDERAL MEMBERSHIP.—The Committee shall be composed of the following Federal members—’’; 

(ii) in subparagraph (C)— 

(I) by inserting ‘‘, such as the Administration 

for Community Living, Administration for Children and Families, the Centers for Medicare & 

Medicaid Services, the Food and Drug Administration, and the Health Resources and Services 

Administration’’ before the semicolon at the end; 

and 

(II) by adding at the end ‘‘and’’; 

(iii) in subparagraph (D)— 

(I) by inserting ‘‘and the Department of 

Defense’’ after ‘‘Department of Education’’; and 

(II) by striking at the end ‘‘; and’’ and inserting 

a period; and 

(iv) by striking subparagraph (E); 

(B) in paragraph (2)— 

(i) in the paragraph heading, by striking ‘‘ADDITIONAL’’ and inserting ‘‘NON-FEDERAL’’; 

(ii) in the matter preceding subparagraph (A), by 

striking ‘‘Not fewer than 6 members of the Committee, 

or 1⁄3 of the total membership of the Committee, whichever is greater’’ and inserting ‘‘Not more than 1⁄2, but 

not fewer than 1⁄3, of the total membership of the 

Committee’’; 

(iii) in subparagraph (A), by striking ‘‘one such 

member shall be an individual’’ and inserting ‘‘two 

such members shall be individuals’’; 

(iv) in subparagraph (B), by striking ‘‘one such 

member shall be a parent or legal guardian’’ and 

inserting ‘‘two such members shall be parents or legal 

guardians’’; and 

(v) in subparagraph (C), by striking ‘‘one such 

member shall be a representative’’ and inserting ‘‘two 

such members shall be representatives’’; and 

(C) by adding at the end the following: 

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

‘‘(A) PERIOD OF APPOINTMENT FOR NON-FEDERAL MEMBERS.—Non-Federal members shall serve for a term of 4 

years, and may be reappointed for one or more additional 

4-year terms. 

‘‘(B) VACANCIES.—A vacancy on the Committee shall 

be filled in the manner in which the original appointment 

was made and shall not affect the powers or duties of 

the Committee. Any member appointed to fill a vacancy 

for an unexpired term shall be appointed for the remainder 

of such term. A member may serve after the expiration 
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of the member’s term until a successor has been 

appointed.’’; 

(3) in subsection (d)— 

(A) by striking paragraph (2); and 

(B) by redesignating paragraphs (3) and (4) as paragraphs (2) and (3), respectively; and 

(4) in subsection (f), by striking ‘‘2014’’ and inserting ‘‘2019’’. 

SEC. 6. REPORTS. 

Section 399DD of the Public Health Service Act (42 U.S.C. 

280i–3) is amended— 

(1) in the section heading, by striking ‘‘REPORT’’ and 

inserting ‘‘REPORTS’’; 

(2) in subsection (b), by redesignating paragraphs (1) 

through (9) as subparagraphs (A) through (I), respectively, and 

realigning the margins accordingly; 

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

(1) and (2), respectively, and realigning the margins accordingly; 

(4) by inserting after the section heading the following: 

‘‘(a) PROGRESS REPORT.—’’; 

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

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

of the Combating Autism Reauthorization Act of 2011’’ 

and inserting ‘‘4 years after the date of enactment of the 

Autism CARES Act of 2014’’; 

(B) by inserting ‘‘and the Secretary of Defense’’ after 

‘‘the Secretary of Education’’; and 

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

including through posting on the Internet Web site of the 

Department of Health and Human Services,’’ after ‘‘Representatives’’; and 

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

(A) in subparagraph (A), (as so redesignated), by 

striking ‘‘Combating Autism Act of 2006’’ and inserting 

‘‘Autism CARES Act of 2014’’; 

(B) in subparagraph (B) (as so redesignated), by 

striking ‘‘particular provisions of Combating Autism Act 

of 2006’’ and inserting ‘‘amendments made by the Autism 

CARES Act of 2014’’; 

(C) by striking subparagraph (C) (as so redesignated), 

and inserting the following: 

‘‘(C) information on the incidence and prevalence of 

autism spectrum disorder, including available information 

on the prevalence of autism spectrum disorder among children and adults, and identification of any changes over 

time with respect to the incidence and prevalence of autism 

spectrum disorder;’’; 

(D) in subparagraph (D) (as so redesignated), by 

striking ‘‘6-year period beginning on the date of enactment 

of the Combating Autism Act of 2006’’ and inserting ‘‘4- 

year period beginning on the date of enactment of the 

Autism CARES Act of 2014 and, as appropriate, how this 

age varies across population subgroups’’; 

(E) in subparagraph (E) (as so redesignated), by 

striking ‘‘6-year period beginning on the date of enactment 

of the Combating Autism Act of 2006’’ and inserting ‘‘4- 

year period beginning on the date of enactment of the 
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Autism CARES Act of 2014 and, as appropriate, how this 

age varies across population subgroups’’; 

(F) in subparagraph (F) (as so redesignated), by 

inserting ‘‘and, as appropriate, on how such average time 

varies across population subgroups’’ before the semicolon 

at the end; 

(G) in subparagraph (G) (as so redesignated)— 

(i) by striking ‘‘including by various subtypes,’’ and 

inserting ‘‘including by severity level as practicable,’’; 

and 

(ii) by striking ‘‘child may’’ and inserting ‘‘child 

or other factors, such as demographic characteristics, 

may’’; and 

(H) by striking subparagraph (I) (as so redesignated), 

and inserting the following: 

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

and the progress made on implementation of the strategic 

plan developed by the Interagency Autism Coordinating 

Committee under section 399CC(b).’’; and 

(7) by adding at the end the following new subsection: 

‘‘(b) REPORT ON YOUNG ADULTS AND TRANSITIONING YOUTH.— 

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

of enactment of the Autism CARES Act of 2014, the Secretary 

of Health and Human Services, in coordination with the Secretary of Education and in collaboration with the Secretary 

of Transportation, the Secretary of Labor, the Secretary of 

Housing and Urban Development, and the Attorney General, 

shall prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee 

on Energy and Commerce of the House of Representatives, 

a report concerning young adults with autism spectrum disorder 

and the challenges related to the transition from existing 

school-based services to those services available during adulthood. 

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

(1) shall contain— 

‘‘(A) demographic characteristics of youth transitioning 

from school-based to community-based supports; 

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

to young adults with autism spectrum disorder relating 

to post-secondary school transitional services, including an 

identification of existing Federal laws, regulations, policies, 

research, and programs; 

‘‘(C) proposals on establishing best practices guidelines 

to ensure— 

‘‘(i) interdisciplinary coordination between all relevant service providers receiving Federal funding; 

‘‘(ii) coordination with transitioning youth and the 

family of such transitioning youth; and 

‘‘(iii) inclusion of the individualized education program for the transitioning youth, as prescribed in section 614 of the Individuals with Disabilities Education 

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

‘‘(D) comprehensive approaches to transitioning from 

existing school-based services to those services available 

during adulthood, including— 
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‘‘(i) services that increase access to, and improve 

integration and completion of, post-secondary education, peer support, vocational training (as defined 

in section 103 of the Rehabilitation Act of 1973 (29 

U.S.C. 723)), rehabilitation, self-advocacy skills, and 

competitive, integrated employment; 

‘‘(ii) community-based behavioral supports and 

interventions; 

‘‘(iii) community-based integrated residential services, housing, and transportation; 

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

and social activities; 

‘‘(v) personal safety services for individuals with 

autism spectrum disorder related to public safety agencies or the criminal justice system; and 

‘‘(vi) evidence-based approaches for coordination of 

resources and services once individuals have aged out 

of post-secondary education; and 

‘‘(E) proposals that seek to improve outcomes for adults 

with autism spectrum disorder making the transition from 

a school-based support system to adulthood by— 

‘‘(i) increasing the effectiveness of programs that 

provide transition services; 

‘‘(ii) increasing the ability of the relevant service 

providers described in subparagraph (C) to provide 

supports and services to underserved populations and 

regions; 

‘‘(iii) increasing the efficiency of service delivery 

to maximize resources and outcomes, including with 

respect to the integration of and collaboration among 

services for transitioning youth; 

‘‘(iv) ensuring access to all services necessary to 

transitioning youth of all capabilities; and 

‘‘(v) encouraging transitioning youth to utilize all 

available transition services to maximize independence, 

equal opportunity, full participation, and self-sufficiency.’’. 

SEC. 7. AUTHORIZATION OF APPROPRIATIONS. 

Section 399EE of the Public Health Service Act (42 U.S.C. 

280i–4) is amended— 

(1) in subsection (a), by striking ‘‘fiscal years 2012 through 

2014’’ and inserting ‘‘fiscal years 2015 through 2019’’; 

(2) in subsection (b), by striking ‘‘fiscal years 2011 through 

2014’’ and inserting ‘‘fiscal years 2015 through 2019’’; and 
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(3) in subsection (c), by striking ‘‘$161,000,000 for each 

of fiscal years 2011 through 2014’’ and inserting ‘‘$190,000,000 

for each of fiscal years 2015 through 2019’’. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.