II 

Calendar No. 444 

113TH CONGRESS 

2D SESSION S. 2449 

To reauthorize certain provisions of the Public Health Service Act relating 

to autism, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 9, 2014 

Mr. MENENDEZ (for himself, Mr. ENZI, Mr. KIRK, Mr. FRANKEN, Ms. KLOBUCHAR, Mr. BURR, Mr. SCHUMER, Mr. BLUNT, Mr. HARKIN, Mr. 

MORAN, and Mr. COONS) introduced the following bill; which was read 

twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

JUNE 26, 2014 

Reported by Mr. HARKIN, with an amendment 

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

A BILL 

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 indi8 vidual with’’ and inserting ‘‘grants or contracts, 

9 which may include grants or contracts to research 

10 centers or networks, to determine the evidence-based 

11 practices for interventions to improve the physical 

12 and 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 Federal departments 

8 and agencies, including coordination of Federal ac9 tivities with respect to autism spectrum disorder;’’; 

10 (D) in paragraph (3), by striking ‘‘rec11 ommendations to the Director of NIH’’; 

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

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

14 by which public feedback can be better inte15 grated into such decisions’’; and 

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

17 inserting the following: 

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

19 and support for, autism spectrum disorder research 

20 and services and supports for individuals with an au21 tism spectrum disorder and the families of such indi22 viduals, which shall include— 

23 ‘‘(A) proposed budgetary requirements; 

24 and 


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1 ‘‘(B) recommendations to ensure that au2 tism spectrum disorder research, services, and 

3 support activities of the Department of Health 

4 and Human Services and of other Federal de5 partments and agencies are not unnecessarily 

6 duplicative; and 

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

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

9 advances described in paragraph (2); and 

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

11 plan described in paragraph (5), including any 

12 progress made in achieving the goals outlined in 

13 such strategic plan.’’; 

14 (2) in subsection (c)— 

15 (A) in paragraph (1)— 

16 (i) by striking the paragraph heading 

17 and matter preceding subparagraph (A) 

18 and inserting the following: 

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

20 shall be composed of the following Federal mem21 bers—’’; 

22 (ii) in subparagraph (C)— 

23 (I) by inserting ‘‘, such as the 

24 Administration for Community Living, 

25 Administration for Children and FamVerDate Mar 15 2010 22:53 Jun 26, 2014 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6401 E:\BILLS\S2449.RS S2449

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1 ilies, the Centers for Medicare & Med2 icaid Services, the Food and Drug Ad3 ministration, and the Health Re4 sources and Services Administration’’ 

5 before the semicolon at the end; and 

6 (II) by adding at the end ‘‘and’’; 

7 (iii) in subparagraph (D)— 

8 (I) by inserting ‘‘and the Depart9 ment of Defense’’ after ‘‘Department 

10 of Education’’; and 

11 (II) by striking at the end ‘‘; 

12 and’’ and inserting a period; and 

13 (iv) by striking subparagraph (E); 

14 (B) in paragraph (2)— 

15 (i) in the paragraph heading, by strik16 ing ‘‘ADDITIONAL’’ and inserting ‘‘NON17 FEDERAL’’; 

18 (ii) in the matter preceding subpara19 graph (A), by striking ‘‘Not fewer than 6 

members of the Committee, or 1 20 ⁄3 of the 

21 total membership of the Committee, which22 ever is greater’’ and inserting ‘‘Not more 

than 1⁄2, but not fewer than 1 23 ⁄3, of the total 

24 membership of the Committee’’; 


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

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

3 and inserting ‘‘two such members shall be 

4 individuals’’; 

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

6 ‘‘one such member shall be a parent or 

7 legal guardian’’ and inserting ‘‘two such 

8 members shall be parents or legal guard9 ians’’; and 

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

11 ‘‘one such member shall be a representa12 tive’’ and inserting ‘‘two such members 

13 shall be representatives’’; and 

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

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

16 ‘‘(A) PERIOD OF APPOINTMENT FOR NON17 FEDERAL MEMBERS.—Non-Federal members 

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

19 reappointed for one or more additional 4-year 

20 term. 

21 ‘‘(B) VACANCIES.—A vacancy on the Com22 mittee shall be filled in the manner in which the 

23 original appointment was made and shall not 

24 affect the powers or duties of the Committee. 

25 Any member appointed to fill a vacancy for an 


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1 unexpired term shall be appointed for the re2 mainder of such term. A member may serve 

3 after the expiration of the member’s term until 

4 a successor has been appointed.’’; 

5 (3) in subsection (d)— 

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

7 (B) by redesignating paragraphs (3) and 

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

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

10 inserting ‘‘2019’’. 

11 SEC. 6. REPORTS. 

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

13 U.S.C. 280i–3) is amended— 

14 (1) in the section heading, by striking ‘‘RE15 PORT’’ and inserting ‘‘REPORTS’’; 

16 (2) in subsection (b), by redesignating para17 graphs (1) through (9) as subparagraphs (A) 

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

19 accordingly; 

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

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

22 the margins accordingly; 

23 (4) by inserting after the section heading the 

24 following: 

25 ‘‘(a) PROGRESS REPORT.—’’; 


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

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

3 enactment of the Combating Autism Reauthor4 ization Act of 2011’’ and inserting ‘‘4 years 

5 after the date of enactment of the Autism 

6 CARES Act of 2014’’; 

7 (B) by inserting ‘‘and the Secretary of De8 fense’’ after ‘‘the Secretary of Education’’; and 

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

10 available, including through posting on the 

11 Internet Web site of the Department of Health 

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

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

14 (A) in subparagraph (A), (as so redesig15 nated), by striking ‘‘Combating Autism Act of 

16 2006’’ and inserting ‘‘the Autism CARES Act 

17 of 2014’’; 

18 (B) in subparagraph (B) (as so redesig19 nated), by striking ‘‘particular provision of 

20 Combating Autism Act of 2006’’ and inserting 

21 ‘‘amendments made by the Autism CARES Act 

22 of 2014’’; 

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

24 redesignated), and inserting the following: 


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1 ‘‘(C) information on the incidence and 

2 prevalence of autism spectrum disorder, includ3 ing available information on the prevalence of 

4 autism spectrum disorder among children and 

5 adults, and identification of any changes over 

6 time with respect to the incidence and preva7 lence of autism spectrum disorder;’’; 

8 (D) in subparagraph (D) (as so redesig9 nated), by striking ‘‘6-year period beginning on 

10 the date of enactment of the Combating Autism 

11 Act of 2006’’ and inserting ‘‘4-year period be12 ginning on the date of enactment of the Autism 

13 CARES Act of 2014 and, as appropriate, how 

14 this age varies across populations subgroups’’; 

15 (E) in subparagraph (E) (as so redesig16 nated), by striking ‘‘6-year period beginning on 

17 the date of enactment of the Combating Autism 

18 Act of 2006’’ and inserting ‘‘4-year period be19 ginning on the date of enactment of the Autism 

20 CARES Act of 2014 and, as appropriate, how 

21 this age varies across populations subgroups’’; 

22 (F) in subparagraph (F) (as so redesig23 nated), by inserting ‘‘and, as appropriate, how 

24 this average time varies across populations sub25 groups’’ after ‘‘disabilities’’; 


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1 (G) in subparagraph (G) (as so redesig2 nated)— 

3 (i) by striking ‘‘including by various 

4 subtypes,’’ and inserting ‘‘including by se5 verity level as practicable,’’; and 

6 (ii) by striking ‘‘child may’’ and in7 serting ‘‘child or other factors, such as de8 mographic characteristics, may’’; and 

9 (H) by striking subparagraph (I) (as so re10 designated), and inserting the following: 

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

12 implement and the progress made on implemen13 tation of the strategic plan developed by the 

14 Interagency Autism Coordinating Committee.’’; 

15 and 

16 (7) by adding at the end the following new sub17 section: 

18 ‘‘(b) REPORT ON YOUNG ADULTS AND

19 TRANSITIONING YOUTH.— 

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

21 after the date of enactment of the Autism CARES 

22 Act of 2014, the Secretary of Health and Human 

23 Services, in coordination with the Secretary of Edu24 cation and in collaboration with the Secretary of 

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1 retary of Housing and Urban Development, and the 

2 Attorney General, shall prepare and submit to the 

3 Committee on Health, Education, Labor, and Pen4 sions of the Senate and the Committee on Energy 

5 and Commerce of the House of Representatives, a 

6 report concerning young adults with autism spec7 trum disorder and the challenges related to the tran8 sition from existing school-based services to those 

9 services available during adulthood. 

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

11 paragraph (1) shall contain— 

12 ‘‘(A) an overview of policies and programs 

13 relevant to young adults with autism spectrum 

14 disorder relating to post-secondary school tran15 sitional services, including an identification of 

16 existing Federal laws, regulations, policies, re17 search, and programs; 

18 ‘‘(B) demographic characteristics of youth 

19 transitioning from school-based to community20 based supports; 

21 ‘‘(C) proposals on establishing best prac22 tices guidelines to ensure— 

23 ‘‘(i) interdisciplinary coordination be24 tween all relevant services providers receiv25 ing Federal funding; 


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1 ‘‘(ii) coordination with transitioning 

2 youth and the family of such transitioning 

3 youth; and 

4 ‘‘(iii) the inclusion of the transitioning 

5 youth’s Individualized Education Program 

6 as prescribed in section 614 of the Individ7 uals with Disabilities Education Act (20 

8 U.S.C. 1414); 

9 ‘‘(D) comprehensive approaches to 

10 transitioning from existing school-based services 

11 to services available during adulthood, includ12 ing— 

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

14 and improve integration and completion of, 

15 post-secondary education, peer support, vo16 cational training (as defined in section 103 

17 of the Rehabilitation Act of 1973 (29 

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

19 skills, and competitive, integrated employ20 ment; 

21 ‘‘(ii) community-based behavioral sup22 ports and interventions; 

23 ‘‘(iii) community-based integrated res24 idential services, housing, and transpor25 tation; 


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

2 recreational, and social activities; 

3 ‘‘(v) personal safety services for indi4 viduals with autism spectrum disorder re5 lated to public safety agencies or the crimi6 nal justice system; and 

7 ‘‘(vi) evidence-based approaches for 

8 coordination of resources and services once 

9 individuals have aged out of post-secondary 

10 education; and 

11 ‘‘(E) proposals that seek to improve out12 comes for adults with autism spectrum disorder 

13 making the transition from a school-based sup14 port system to adulthood by— 

15 ‘‘(i) increasing the effectiveness of 

16 programs that provide transition services; 

17 ‘‘(ii) increasing the ability of relevant 

18 service providers to provide supports and 

19 services to underserved populations and re20 gions; 

21 ‘‘(iii) increasing the efficiency of serv22 ice delivery to maximize resources and out23 comes, including with respect to the inte24 gration of and collaboration among services 

25 for transitioning youth; 


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1 ‘‘(iv) ensuring access to all services 

2 necessary to transitioning youth of all ca3 pabilities; and 

4 ‘‘(v) encouraging transitioning youth 

5 to utilize all available transition services to 

6 maximize independence, equal opportunity, 

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

8 SEC. 7. AUTHORIZATION OF APPROPRIATIONS. 

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

10 U.S.C. 280i–4) is amended— 

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

12 2012 through 2014’’ and inserting ‘‘fiscal years 

13 2015 through 2019’’; 

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

15 2011 through 2014’’ and inserting ‘‘fiscal years 

16 2015 through 2019’’; and 

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

18 for each of fiscal years 2011 through 2014’’ and in19 serting ‘‘$190,000,000 for each of fiscal years 2015 

20 through 2019’’. 

21 SECTION 1. SHORT TITLE. 

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

23 Accountability, Research, Education, and Support Act of 

24 2014’’ or the ‘‘Autism CARES Act of 2014’’. 


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1 SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER INITIA2 TIVE. 

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

4 Human Services shall designate an existing official within 

5 the Department of Health and Human Services to oversee, 

6 in consultation with the Secretaries of Defense and Edu7 cation, national autism spectrum disorder research, serv8 ices, and support activities. 

9 (b) DUTIES.—The official designated under subsection 

10 (a) shall— 

11 (1) implement autism spectrum disorder activi12 ties, taking into account the strategic plan developed 

13 by the Interagency Autism Coordinating Committee 

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

15 Act (42 U.S.C. 280i–2(b)); and 

16 (2) ensure that autism spectrum disorder activi17 ties of the Department of Health and Human Services 

18 and of other Federal departments and agencies are 

19 not unnecessarily duplicative. 

20 SEC. 3. RESEARCH PROGRAM. 

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

22 U.S.C. 280i) is amended— 

23 (1) in subsection (a)(1), by inserting ‘‘for chil24 dren and adults’’ after ‘‘reporting of State epidemio25 logical data’’; 

26 (2) in subsection (b)(1)— 


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1 (A) by striking ‘‘establishment of regional 

2 centers of excellence’’ and inserting ‘‘establish3 ment or support of regional centers of excel4 lence’’; and 

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

6 before the period at the end; 

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

8 established’’ and inserting ‘‘center to be established or 

9 supported’’; and 

10 (4) in subsection (e), by striking ‘‘2014’’ and in11 serting ‘‘2019’’. 

12 SEC. 4. AUTISM INTERVENTION. 

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

14 U.S.C. 280i–1) is amended— 

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

16 competent’’ after ‘‘provide’’; 

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

18 ‘‘(which may include respite care for caregivers of in19 dividuals with an autism spectrum disorder)’’ after 

20 ‘‘services and supports’’; 

21 (3) in subsection (e)(1)(B)(v), by inserting before 

22 the semicolon the following: ‘‘, which may include col23 laborating with research centers or networks to pro24 vide training for providers of respite care (as defined 

25 in section 2901)’’; 


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1 (4) in subsection (f), by striking ‘‘grants or con2 tracts’’ and all that follows through ‘‘for individuals 

3 with’’ and inserting ‘‘grants or contracts, which may 

4 include grants or contracts to research centers or net5 works, to determine the evidence-based practices for 

6 interventions to improve the physical and behavioral 

7 health of individuals with’’; and 

8 (5) in subsection (g), by striking ‘‘2014’’ and in9 serting ‘‘2019’’. 

10 SEC. 5. INTERAGENCY AUTISM COORDINATING COMMITTEE. 

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

12 U.S.C. 280i–2) is amended— 

13 (1) in subsection (b)— 

14 (A) in paragraph (1)— 

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

16 and 

17 (ii) by striking ‘‘intervention’’ and in18 serting ‘‘interventions, including school and 

19 community-based interventions’’; 

20 (B) by striking paragraph (2); 

21 (C) by redesignating paragraph (1) as 

22 paragraph (2), and inserting before such redesig23 nated paragraph the following: 

24 ‘‘(1) monitor autism spectrum disorder research, 

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1 tivities, across all relevant Federal departments and 

2 agencies, including coordination of Federal activities 

3 with respect to autism spectrum disorder;’’; 

4 (D) in paragraph (3), by striking ‘‘rec5 ommendations to the Director of NIH’’; 

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

7 the semicolon the following: ‘‘, and the process by 

8 which public feedback can be better integrated 

9 into such decisions’’; and 

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

11 inserting the following: 

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

13 and support for, autism spectrum disorder research, 

14 including as practicable for services and supports for 

15 individuals with an autism spectrum disorder and 

16 the families of such individuals, which shall in17 clude— 

18 ‘‘(A) proposed budgetary requirements; and 

19 ‘‘(B) recommendations to ensure that au20 tism spectrum disorder research, and services 

21 and support activities to the extent practicable, 

22 of the Department of Health and Human Serv23 ices and of other Federal departments and agen24 cies are not unnecessarily duplicative; and 

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


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

2 advances described in paragraph (2); and 

3 ‘‘(B) an annual update to the strategic plan 

4 described in paragraph (5), including any 

5 progress made in achieving the goals outlined in 

6 such strategic plan.’’; 

7 (2) in subsection (c)— 

8 (A) in paragraph (1)— 

9 (i) by striking the paragraph designa10 tion, the heading, and the matter preceding 

11 subparagraph (A) and inserting the fol12 lowing: 

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

14 shall be composed of the following Federal members— 

15 ’’; 

16 (ii) in subparagraph (C)— 

17 (I) by inserting ‘‘, such as the Ad18 ministration for Community Living, 

19 Administration for Children and Fam20 ilies, the Centers for Medicare & Med21 icaid Services, the Food and Drug Ad22 ministration, and the Health Resources 

23 and Services Administration’’ before 

24 the semicolon at the end; and 

25 (II) by adding at the end ‘‘and’’; 


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1 (iii) in subparagraph (D)— 

2 (I) by inserting ‘‘and the Depart3 ment of Defense’’ after ‘‘Department of 

4 Education’’; and 

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

6 and inserting a period; and 

7 (iv) by striking subparagraph (E); 

8 (B) in paragraph (2)— 

9 (i) in the paragraph heading, by strik10 ing ‘‘ADDITIONAL’’ and inserting ‘‘NON11 FEDERAL’’; 

12 (ii) in the matter preceding subpara13 graph (A), by striking ‘‘Not fewer than 6 

14 members of the Committee, or 1/3 of the 

15 total membership of the Committee, which16 ever is greater’’ and inserting ‘‘Not more 

than 1 17 ⁄2, but not fewer than 1/3, of the total 

18 membership of the Committee’’; 

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

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

21 and inserting ‘‘two such members shall be 

22 individuals’’; 

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

24 ‘‘one such member shall be a parent or legal 

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1 bers shall be parents or legal guardians’’; 

2 and 

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

4 ‘‘one such member shall be a representative’’ 

5 and inserting ‘‘two such members shall be 

6 representatives’’; and 

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

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

9 ‘‘(A) PERIOD OF APPOINTMENT FOR NON10 FEDERAL MEMBERS.—Non-Federal members 

11 shall serve for a term of 4 years, and may be re12 appointed for one or more additional 4-year 

13 terms. 

14 ‘‘(B) VACANCIES.—A vacancy on the Com15 mittee shall be filled in the manner in which the 

16 original appointment was made and shall not 

17 affect the powers or duties of the Committee. Any 

18 member appointed to fill a vacancy for an unex19 pired term shall be appointed for the remainder 

20 of such term. A member may serve after the expi21 ration of the member’s term until a successor has 

22 been appointed.’’; 

23 (3) in subsection (d)— 

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


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1 (B) by redesignating paragraphs (3) and 

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

3 (4) in subsection (f), by striking ‘‘2014’’ and in4 serting ‘‘2019’’. 

5 SEC. 6. REPORTS. 

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

7 U.S.C. 280i–3) is amended— 

8 (1) in the section heading, by striking ‘‘RE9 PORT’’ and inserting ‘‘REPORTS’’; 

10 (2) in subsection (b), by redesignating para11 graphs (1) through (9) as subparagraphs (A) through 

12 (I), respectively, and realigning the margins accord13 ingly; 

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

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

16 the margins accordingly; 

17 (4) by inserting after the section heading the fol18 lowing: 

19 ‘‘(a) PROGRESS REPORT.—’’; 

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

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

22 enactment of the Combating Autism Reauthor23 ization Act of 2011’’ and inserting ‘‘4 years after 

24 the date of enactment of the Autism CARES Act 

25 of 2014’’; 


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1 (B) by inserting ‘‘and the Secretary of De2 fense’’ after ‘‘the Secretary of Education’’; and 

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

4 available, including through posting on the 

5 Internet Web site of the Department of Health 

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

7 and 

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

9 (A) in subparagraph (A), (as so redesig10 nated), by striking ‘‘Combating Autism Act of 

11 2006’’ and inserting ‘‘Autism CARES Act of 

12 2014’’; 

13 (B) in subparagraph (B) (as so redesig14 nated), by striking ‘‘particular provisions of 

15 Combating Autism Act of 2006’’ and inserting 

16 ‘‘amendments made by the Autism CARES Act 

17 of 2014’’; 

18 (C) by striking subparagraph (C) (as so re19 designated), and inserting the following: 

20 ‘‘(C) information on the incidence and 

21 prevalence of autism spectrum disorder, includ22 ing available information on the prevalence of 

23 autism spectrum disorder among children and 

24 adults, and identification of any changes over 


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1 time with respect to the incidence and prevalence 

2 of autism spectrum disorder;’’; 

3 (D) in subparagraph (D) (as so redesig4 nated), by striking ‘‘6-year period beginning on 

5 the date of enactment of the Combating Autism 

6 Act of 2006’’ and inserting ‘‘4-year period begin7 ning on the date of enactment of the Autism 

8 CARES Act of 2014 and, as appropriate, how 

9 this age varies across population subgroups’’; 

10 (E) in subparagraph (E) (as so redesig11 nated), by striking ‘‘6-year period beginning on 

12 the date of enactment of the Combating Autism 

13 Act of 2006’’ and inserting ‘‘4-year period begin14 ning on the date of enactment of the Autism 

15 CARES Act of 2014 and, as appropriate, how 

16 this age varies across population subgroups’’; 

17 (F) in subparagraph (F) (as so redesig18 nated), by inserting ‘‘and, as appropriate, how 

19 such average time varies across population sub20 groups’’ before the semicolon at the end; 

21 (G) in subparagraph (G) (as so redesig22 nated)— 

23 (i) by striking ‘‘including by various 

24 subtypes,’’ and inserting ‘‘including by se25 verity level as practicable,’’; and 


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1 (ii) by striking ‘‘child may’’ and in2 serting ‘‘child or other factors, such as de3 mographic characteristics, may’’; and 

4 (H) by striking subparagraph (I) (as so re5 designated), and inserting the following: 

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

7 implement and the progress made on implemen8 tation of the strategic plan developed by the 

9 Interagency Autism Coordinating Committee 

10 under section 399CC(b).’’; and 

11 (7) by adding at the end the following new sub12 section: 

13 ‘‘(b) REPORT ON YOUNG ADULTS AND TRANSITIONING

14 YOUTH.— 

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

16 the date of enactment of the Autism CARES Act of 

17 2014, the Secretary of Health and Human Services, 

18 in coordination with the Secretary of Education and 

19 in collaboration with the Secretary of Transportation, 

20 the Secretary of Labor, the Secretary of Housing and 

21 Urban Development, and the Attorney General, shall 

22 prepare and submit to the Committee on Health, 

23 Education, Labor, and Pensions of the Senate and the 

24 Committee on Energy and Commerce of the House of 

25 Representatives, a report concerning young adults 


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1 with autism spectrum disorder and the challenges re2 lated to the transition from existing school-based serv3 ices to those services available during adulthood. 

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

5 paragraph (1) shall contain— 

6 ‘‘(A) demographic characteristics of youth 

7 transitioning from school-based to community8 based supports; 

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

10 relevant to young adults with autism spectrum 

11 disorder relating to post-secondary school transi12 tional services, including an identification of ex13 isting Federal laws, regulations, policies, re14 search, and programs; 

15 ‘‘(C) proposals on establishing best practices 

16 guidelines to ensure— 

17 ‘‘(i) interdisciplinary coordination be18 tween all relevant service providers receiv19 ing Federal funding; 

20 ‘‘(ii) coordination with transitioning 

21 youth and the family of such transitioning 

22 youth; and 

23 ‘‘(iii) inclusion of the individualized 

24 education program for the transitioning 

25 youth, as prescribed in section 614 of the 


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1 Individuals with Disabilities Education Act 

2 (20 U.S.C. 1414); 

3 ‘‘(D) comprehensive approaches to 

4 transitioning from existing school-based services 

5 to services available during adulthood, includ6 ing— 

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

8 and improve integration and completion of, 

9 post-secondary education, peer support, vo10 cational training (as defined in section 103 

11 of the Rehabilitation Act of 1973 (29 U.S.C. 

12 723)), rehabilitation, self-advocacy skills, 

13 and competitive, integrated employment; 

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

16 ‘‘(iii) community-based integrated resi17 dential services, housing, and transpor18 tation; 

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

20 recreational, and social activities; 

21 ‘‘(v) personal safety services for indi22 viduals with autism spectrum disorder re23 lated to public safety agencies or the crimi24 nal justice system; and 


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1 ‘‘(vi) evidence-based approaches for co2 ordination of resources and services once in3 dividuals have aged out of post-secondary 

4 education; and 

5 ‘‘(E) proposals that seek to improve out6 comes for adults with autism spectrum disorder 

7 making the transition from a school-based sup8 port system to adulthood by— 

9 ‘‘(i) increasing the effectiveness of pro10 grams that provide transition services; 

11 ‘‘(ii) increasing the ability of the rel12 evant service providers described in sub13 paragraph (C) to provide supports and 

14 services to underserved populations and re15 gions; 

16 ‘‘(iii) increasing the efficiency of serv17 ice delivery to maximize resources and out18 comes, including with respect to the integra19 tion of and collaboration among services for 

20 transitioning youth; 

21 ‘‘(iv) ensuring access to all services 

22 necessary to transitioning youth of all capa23 bilities; and 

24 ‘‘(v) encouraging transitioning youth 

25 to utilize all available transition services to 


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1 maximize independence, equal opportunity, 

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

3 SEC. 7. AUTHORIZATION OF APPROPRIATIONS. 

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

5 U.S.C. 280i–4) is amended— 

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

7 2012 through 2014’’ and inserting ‘‘fiscal years 2015 

8 through 2019’’; 

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

10 2011 through 2014’’ and inserting ‘‘fiscal years 2015 

11 through 2019’’; and 

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

13 for each of fiscal years 2011 through 2014’’ and in14 serting ‘‘$190,000,000 for each of fiscal years 2015 

15 through 2019’’. 


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Calendar No. 444 

113TH CONGRESS 

2D SESSION S. 2449 

A BILL 

To reauthorize certain provisions of the Public 

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

JUNE 26, 2014 

Reported with an amendment 


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