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[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 843 Reported in Senate (RS)]

                                                       Calendar No. 578
109th CONGRESS
  2d Session
                                 S. 843

                          [Report No. 109-318]

    To amend the Public Health Service Act to combat autism through 
            research, screening, intervention and education.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             April 19, 2005

 Mr. Santorum (for himself, Mr. Dodd, Mr. Corzine, Mr. Lieberman, Mr. 
   Lautenberg, Ms. Cantwell, Mr. Pryor, Mr. Jeffords, Mr. Kerry, Mr. 
Coleman, Ms. Collins, Mr. Cochran, Mr. Akaka, Mr. Leahy, Mrs. Clinton, 
  Mr. Dayton, Ms. Landrieu, Mr. Johnson, Mr. Isakson, Mr. DeWine, Ms. 
Mikulski, Mr. Sarbanes, Mr. Inouye, Mr. Biden, Mrs. Boxer, Mr. Schumer, 
  Mr. Menendez, Mr. Hatch, Mr. Domenici, Mr. Bingaman, Mr. Reed, Mrs. 
 Murray, Mr. Sununu, Mr. Vitter, Mr. McCain, Mr. Bennett, Mr. Talent, 
   Mr. Nelson of Florida, Mr. Chafee, Mr. Salazar, Mr. Harkin, Mrs. 
 Hutchison, Mr. Cornyn, Mr. Enzi, Mr. Burr, Mr. Frist, Mr. Durbin, Mr. 
Chambliss, and Mr. Thune) introduced the following bill; which was read 
 twice and referred to the Committee on Health, Education, Labor, and 
                                Pensions

                             August 3, 2006

                Reported by Mr. Enzi, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
    To amend the Public Health Service Act to combat autism through 
            research, screening, intervention and education.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Combating Autism Act of 
2005''.</DELETED>

<DELETED>SEC. 2. ACTIVITIES TO IMPROVE AUTISM-RELATED RESEARCH AND 
              FUNDING.</DELETED>

<DELETED>    Title IV of the Public Health Service Act (42 U.S.C. 281 
et seq.) is amended by adding at the end the following:</DELETED>

         <DELETED>``PART J--AUTISM-RELATED ACTIVITIES</DELETED>

<DELETED>``SEC. 499A. AUTHORITY OF THE DIRECTOR OF THE NATIONAL 
              INSTITUTES OF HEALTH RELATING TO AUTISM.</DELETED>

<DELETED>    ``(a) Identifying Total Expenditures on Autism Spectrum 
Disorders.--The Director of NIH, in coordination with the National 
Institute of Mental Health and other institutes of the National 
Institutes of Health, shall identify the total amount of expenditures, 
both intramural and extramural, by the National Institutes of Health 
for autism spectrum disorders for fiscal year 2005.</DELETED>
<DELETED>    ``(b) Budget for Autism Research and Coordination of 
Activities and Programs.--The Director of NIH, based on the strategic 
plan developed under subsection (c), shall--</DELETED>
        <DELETED>    ``(1) develop and oversee the implementation of a 
        scientifically justified budget for research on autism spectrum 
        disorders at the National Institutes of Health;</DELETED>
        <DELETED>    ``(2) coordinate all research activities and 
        programs on autism spectrum disorders at the institutes, 
        centers, and divisions of the National Institutes of Health; 
        and</DELETED>
        <DELETED>    ``(3) evaluate all such activities and 
        programs.</DELETED>
<DELETED>    ``(c) Strategic Plan for Autism Research.--</DELETED>
        <DELETED>    ``(1) In general.--The Director of NIH shall 
        develop and oversee the implementation of a comprehensive, 
        long-range plan for the conduct and support of research on 
        autism spectrum disorders by the institutes, centers, and 
        divisions of the National Institutes of Health.</DELETED>
        <DELETED>    ``(2) Requirements.--The plan developed under 
        paragraph (1) shall--</DELETED>
                <DELETED>    ``(A) be updated on an annual 
                basis;</DELETED>
                <DELETED>    ``(B) be based on the research 
                recommendations contained in the Autism Research 
                Roadmap and Matrix of the Interagency Autism 
                Coordinating Committee;</DELETED>
                <DELETED>    ``(C) determine and establish priorities 
                among critical scientific questions related to autism 
                spectrum disorders;</DELETED>
                <DELETED>    ``(D) based on the priorities established 
                under subparagraph (C), specify the short and long-
                range objectives to be achieved, and estimate the 
                resources needed to achieve these objectives;</DELETED>
                <DELETED>    ``(E) evaluate the sufficiency of existing 
                research programs on autism spectrum disorders to meet 
                the objectives specified under subparagraph (D), and 
                establish objectives, timelines, and criteria for 
                evaluating future research programs; and</DELETED>
                <DELETED>    ``(F) make recommendations for changes to 
                existing research programs on autism spectrum 
                disorders.</DELETED>
<DELETED>    ``(d) Budgetary Authority.--</DELETED>
        <DELETED>    ``(1) In general.--The Director of NIH shall--
        </DELETED>
                <DELETED>    ``(A) in accordance with the strategic 
                plan developed under subsection (c), annually prepare 
                and submit to Congress a scientifically justified 
                budget estimate for research on autism spectrum 
                disorders to be conducted within the agencies of the 
                National Institutes of Health, which shall include the 
                amount of funds that will be required for--</DELETED>
                        <DELETED>    ``(i) the continued funding of 
                        ongoing discretionary program initiatives at 
                        the institutes, centers, and divisions of the 
                        National Institutes of Health; and</DELETED>
                        <DELETED>    ``(ii) the funding of new and 
                        complementary program initiatives.</DELETED>
                <DELETED>    ``(B) receive all research funds for 
                autism spectrum disorders described in subparagraph 
                (A), and allocate those funds to the institutes, 
                centers, and divisions of the National Institutes of 
                Health.</DELETED>
        <DELETED>    ``(2) Effective date.--Paragraph (1)(B) shall 
        become effective in the fiscal year following the submission of 
        the autism budget described in paragraph (1)(A).</DELETED>
<DELETED>    ``(e) Evaluation and Report.--</DELETED>
        <DELETED>    ``(1) Evaluation.--The Director of NIH shall 
        evaluate the effect of this section on the planning and 
        coordination of research programs on autism spectrum disorders 
        at the institutes, centers, and divisions of the National 
        Institutes of Health, and the extent to which funding mandated 
        under this section has followed the recommendation of the 
        strategic plan developed under subsection (c).</DELETED>
        <DELETED>    ``(2) Report.--Not later than 1 year after the 
        date of enactment of this section, the Director of NIH shall 
        prepare and submit to the Committee on Energy and Commerce and 
        the Committee on Appropriations of the House of 
        Representatives, and the Committee on Health, Education, Labor, 
        and Pensions and the Committee on Appropriations of the Senate, 
        a report based on the evaluation described in paragraph 
        (1).</DELETED>

<DELETED>``SEC. 499B. EXPANSION, INTENSIFICATION, AND COORDINATION OF 
              ACTIVITIES OF NATIONAL INSTITUTES OF HEALTH WITH RESPECT 
              TO RESEARCH ON AUTISM.</DELETED>

<DELETED>    ``(a) In General.--</DELETED>
        <DELETED>    ``(1) Expansion of activities.--The Director of 
        NIH shall expand, intensify, and coordinate the activities of 
        the National Institutes of Health with respect to research on 
        autism.</DELETED>
        <DELETED>    ``(2) Administration of program; coordination 
        among agencies.--The Director of NIH shall carry out this 
        section acting through the Director of the National Institute 
        of Mental Health and in collaboration with the National 
        Institute of Child Health and Human Development, the National 
        Institute of Neurological Disorders and Stroke, the National 
        Institute of Environmental Health Sciences, the National 
        Institute on Deafness and Other Communication Disorders, and 
        any other agencies that the Director determines 
        appropriate.</DELETED>
<DELETED>    ``(b) Centers of Excellence.--</DELETED>
        <DELETED>    ``(1) In general.--In carrying out subsection 
        (a)(1), the Director of NIH shall award grants and contracts to 
        public or nonprofit private entities to pay all or part of the 
        cost of planning, establishing, improving, and providing basic 
        operating support for centers of excellence regarding research 
        on autism.</DELETED>
        <DELETED>    ``(2) Research.--Each center of excellence that 
        receives funding under paragraph (1) shall conduct basic and 
        clinical research into autism. Such research--</DELETED>
                <DELETED>    ``(A) shall be conducted in the fields of 
                developmental neurobiology, genetics, and 
                psychopharmacology, and, beginning on July 1, 2008, 
                immunology, endocrinology, gastroenterology, and 
                toxicology; and</DELETED>
                <DELETED>    ``(B) should include--</DELETED>
                        <DELETED>    ``(i) investigations into the 
                        cause, diagnosis, early detection, prevention, 
                        control, treatment, and cure of autism; 
                        and</DELETED>
                        <DELETED>    ``(ii) research on high-risk 
                        infant siblings.</DELETED>
        <DELETED>    ``(3) Services for patients.--</DELETED>
                <DELETED>    ``(A) In general.--A center of excellence 
                that receives funding under paragraph (1) may expend 
                amounts provided under a grant or contract under such 
                paragraph to carry out a program to make individuals 
                aware of opportunities to participate as subjects in 
                research conducted by the centers.</DELETED>
                <DELETED>    ``(B) Referrals and costs.--A program 
                carried out under subparagraph (A) may, in accordance 
                with such criteria as the Director of NIH may 
                establish, provide to the subjects described in such 
                subparagraph, referrals for health and other services, 
                and such patient care costs as are required for 
                research.</DELETED>
                <DELETED>    ``(C) Availability and access.--The extent 
                to which a center of excellence that receives funding 
                under paragraph (1) can demonstrate availability and 
                access to clinical services shall be considered by the 
                Director of NIH in decisions about awarding grants or 
                contracts to applicants that meet the scientific 
                criteria for funding under this section.</DELETED>
        <DELETED>    ``(4) Coordination of centers of excellence.--
        </DELETED>
                <DELETED>    ``(A) In general.--The Director of NIH 
                shall, as appropriate, provide for the coordination of 
                information among centers of excellence that receive 
                funding under paragraph (1) and centers of excellence 
                that receive funding under section 463C, and ensure 
                regular communication between such centers.</DELETED>
                <DELETED>    ``(B) Periodic reports.--The Director of 
                NIH may require the periodic preparation of reports on 
                the activities of the centers described in subparagraph 
                (A) and the submission of such reports to the 
                Director.</DELETED>
                <DELETED>    ``(C) Collection and storage of data.--The 
                Director of NIH shall establish and fund mechanisms and 
                entities for collecting, storing, and coordinating data 
                collected by the centers referred to in subparagraph 
                (A) and data generated from public and private research 
                partnerships.</DELETED>
        <DELETED>    ``(5) Organization.--Each center of excellence 
        that receives funding under paragraph (1) shall use the 
        facilities of a single institution, or be formed from a 
        consortium of cooperating institutions, meeting such 
        requirements as may be prescribed by the Director of 
        NIH.</DELETED>
        <DELETED>    ``(6) Number and duration.--</DELETED>
                <DELETED>    ``(A) In general.--The Director shall 
                provide for the establishment of not less than 10 
                centers under paragraph (1).</DELETED>
                <DELETED>    ``(B) Duration.--A grant or contract 
                awarded under paragraph (1) shall not exceed a period 
                of 5 years. Such period may be extended for 1 or more 
                additional periods not exceeding 5 years if the 
                operations of the center of excellence involved have 
                been reviewed by an appropriate technical and 
                scientific peer review group established by the 
                Director of NIH and the group has recommended to the 
                Director that such period should be extended.</DELETED>
                <DELETED>    ``(C) Facilitation of research.--
                </DELETED>
                        <DELETED>    ``(i) Establishment of program.--
                        The Director of NIH shall establish a program 
                        under which samples of tissues and genetic and 
                        other biological materials that are of use in 
                        research on autism are donated, collected, 
                        preserved, and made available for such 
                        research.</DELETED>
                        <DELETED>    ``(ii) Accepted scientific 
                        standards.--The program established under 
                        clause (i) shall be carried out in accordance 
                        with accepted scientific and medical standards 
                        for the donation, collection, and preservation 
                        of such samples, and shall be conducted so that 
                        the tissues and other materials saved, as well 
                        as any database compiled from such tissues and 
                        materials, are available to researchers at a 
                        reasonable cost.</DELETED>
                <DELETED>    ``(D) Public input.--In carrying out this 
                section, the Director of NIH shall provide for a means 
                through which the public can obtain information on the 
                existing and planned programs and activities of the 
                National Institutes of Health with respect to autism 
                and through which the Director can receive comments 
                from the public regarding such programs and 
                activities.</DELETED>
<DELETED>    ``(c) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $30,000,000 
for each of fiscal years 2007 through 2011. Amounts appropriated under 
this subsection shall be in addition to any other amounts appropriated 
for such purpose.</DELETED>

<DELETED>``SEC. 499C. COLLABORATIVE PROGRAMS OF EXCELLENCE IN 
              AUTISM.</DELETED>

<DELETED>    ``(a) In General.--The Director of NIH, acting through the 
Director of the National Institute of Child Health and Human 
Development and the Director of the National Institute on Deafness and 
Other Disorders, shall award grants and contracts to public or 
nonprofit private entities to pay all or part of the cost of planning, 
establishing, improving, and providing basic operating support for the 
Collaborative Programs of Excellence in Autism.</DELETED>
<DELETED>    ``(b) Research.--Each program established under subsection 
(a) shall conduct basic and clinical research into autism. Such 
program--</DELETED>
        <DELETED>    ``(1) shall conduct research in the fields of 
        developmental neurobiology, genetics, and psychopharmacology, 
        and, beginning July 1, 2008, in the fields of immunology, 
        endocrinology, gastroenterology, and toxicology; and</DELETED>
        <DELETED>    ``(2) should conduct--</DELETED>
                <DELETED>    ``(A) investigations into the cause, 
                diagnosis, early detection, prevention, control, 
                treatment, and cure of autism; and</DELETED>
                <DELETED>    ``(B) research on high-risk infant 
                siblings.</DELETED>
<DELETED>    ``(c) Coordination of Programs.--</DELETED>
        <DELETED>    ``(1) In general.--The Director of NIH shall, as 
        appropriate, provide for the coordination of information among 
        programs established under subsection (a), and centers of 
        excellence that receive funding under section 463C and 499B, 
        and ensure regular communication between such 
        centers.</DELETED>
        <DELETED>    ``(2) Periodic reports.--The Director of NIH may 
        require the periodic preparation of reports on the activities 
        of the programs described in paragraph (1) and the submission 
        of such reports to the Director.</DELETED>
        <DELETED>    ``(3) Collection and storage of data.--The 
        Director of NIH shall establish and fund mechanisms and 
        entities for collecting, storing, and coordinating data 
        collected by the programs referred to in paragraph (1) and data 
        generated from public and private research 
        partnerships.</DELETED>
<DELETED>    ``(d) Organization.--Each program that receives funding 
under subsection (a) shall use the facilities of a single institution, 
or be formed from a consortium of cooperating institutions, meeting 
such requirements as may be prescribed by the Director of 
NIH.</DELETED>
<DELETED>    ``(e) Number and Duration.--</DELETED>
        <DELETED>    ``(1) In general.--The Director shall provide for 
        the establishment of not less than 10 programs under paragraph 
        (1).</DELETED>
        <DELETED>    ``(2) Duration.--A grant or contract awarded under 
        subsection (a) shall not exceed a period of 5 years. Such 
        period may be extended for 1 or more additional periods not 
        exceeding 5 years if the operations of the program involved 
        have been reviewed by an appropriate technical and scientific 
        peer review group established by the Director of NIH and the 
        group has recommended to the Director that such period should 
        be extended.</DELETED>
<DELETED>    ``(f) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $14,000,000 
for each of fiscal years 2007 through 2011. Amounts appropriated under 
this subsection shall be in addition to any other amounts appropriated 
for such purpose.''.</DELETED>

<DELETED>SEC. 3. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH 
              PROGRAM.</DELETED>

<DELETED>    Title III of the Public Health Service Act (42 U.S.C. 241 
et seq.) is amended by adding at the end thereof the 
following:</DELETED>

        <DELETED>``PART R--PROGRAMS RELATING TO AUTISM</DELETED>

<DELETED>``SEC. 399AA. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND 
              RESEARCH PROGRAM.</DELETED>

<DELETED>    ``(a) National Autism and Pervasive Developmental 
Disabilities Surveillance Program.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary, acting through 
        the Director of the Centers for Disease Control and Prevention, 
        may award grants and cooperative agreements to eligible 
        entities for the collection, analysis, and reporting of 
        epidemiological data on autism and pervasive developmental 
        disabilities. In making such awards, the Secretary may provide 
        direct technical assistance in lieu of cash.</DELETED>
        <DELETED>    ``(2) Eligibility.--To be eligible to receive a 
        grant or cooperative agreement under paragraph (1), an entity 
        shall be a public or nonprofit private entity (including a 
        health department of a State or political subdivisions of a 
        State, a university, or any other educational institution), and 
        submit to the Secretary an application at such time, in such 
        manner, and containing such information as the Secretary may 
        require.</DELETED>
<DELETED>    ``(b) Centers of Excellence in Autism and Pervasive 
Developmental Disabilities Epidemiology.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary, acting through 
        the Director of the Centers for Disease Control and Prevention, 
        shall establish not less than 6 regional centers of excellence 
        in autism and pervasive developmental disabilities epidemiology 
        for the purpose of collecting and analyzing information on the 
        number, incidence, incidence trend over time, correlates, and 
        causes of autism and related developmental 
        disabilities.</DELETED>
        <DELETED>    ``(2) Recipients of awards.--Each center of 
        excellence under paragraph (1) shall be established and 
        operated through the awarding of grants or cooperative 
        agreements to public or nonprofit private entities that conduct 
        research, including health departments of States and political 
        subdivisions of States, and universities and other educational 
        entities.</DELETED>
        <DELETED>    ``(3) Requirements.--To be eligible to receive a 
        grant or cooperative agreement under paragraph (2), an entity 
        shall submit to the Secretary an application containing such 
        agreements and information as the Secretary may require, 
        including an agreement that the center to be established shall 
        operate in accordance with the following:</DELETED>
                <DELETED>    ``(A) The center will collect, analyze, 
                and report autism and pervasive developmental 
                disabilities data according to guidelines prescribed by 
                the Director of the Centers for Disease Control and 
                Prevention, after consultation with relevant State and 
                local public health officials, private sector 
                developmental disability researchers, and advocates for 
                those with developmental disabilities.</DELETED>
                <DELETED>    ``(B) The center will assist with the 
                development and coordination of State autism and 
                pervasive developmental disabilities surveillance 
                efforts within a region.</DELETED>
                <DELETED>    ``(C) The center will identify eligible 
                cases and controls through its surveillance systems and 
                conduct research into factors which may cause or 
                increase the risk of autism and related developmental 
                disabilities.</DELETED>
                <DELETED>    ``(D) The center will develop or extend an 
                area of special research expertise (including genetics, 
                environmental exposure to contaminants, immunology, and 
                other relevant research specialty areas).</DELETED>
<DELETED>    ``(c) Clearinghouse.--The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, shall carry 
out the following:</DELETED>
        <DELETED>    ``(1) Establishment.--The Secretary shall 
        establish a clearinghouse within the Centers for Disease 
        Control and Prevention for the collection and storage of data 
        generated from the monitoring programs established under this 
        part and part J of title IV. Through the clearinghouse, such 
        Centers shall serve as the coordinating agency for autism and 
        pervasive developmental disabilities surveillance activities. 
        The functions of such clearinghouse shall include facilitating 
        the coordination of research and policy development relating to 
        the epidemiology of autism and other pervasive developmental 
        disabilities.</DELETED>
        <DELETED>    ``(2) Federal response.--The Secretary shall 
        coordinate the Federal response to requests for assistance from 
        State health department officials regarding potential or 
        alleged autism or developmental disability clusters.</DELETED>
        <DELETED>    ``(3) Facilitation of research.--The Secretary 
        shall provide for the establishment of a program under which 
        samples of tissues and genetic and other biological materials 
        that are of use in research on autism are donated, collected, 
        preserved, and made available for such research. Such program 
        shall be carried out in accordance with accepted scientific and 
        medical standards for the donation, collection, and 
        preservation of such samples, and shall be conducted so that 
        the tissues and other materials saved, as well as any database 
        compiled from such tissues and materials, are available to 
        researchers at a reasonable cost.</DELETED>
        <DELETED>    ``(4) Coordination.--The Centers for Disease 
        Control and Prevention shall coordinate research and 
        surveillance activities of such Centers with the National 
        Institutes of Health, other appropriate Federal agencies, and 
        interested nonprofit private entities, in a manner consistent 
        with the research recommendations contained in the Autism 
        Research Roadmap and Matrix of the Interagency Autism 
        Coordinating Committee, which shall be updated as determined 
        appropriate by the Secretary.</DELETED>
<DELETED>    ``(d) State.--In this part, the term `State' means each of 
the several States, the District of Columbia, the Commonwealth of 
Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern 
Mariana Islands, the Virgin Islands, and the Trust Territory of the 
Pacific Islands.</DELETED>
<DELETED>    ``(e) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $12,000,000 
for each of fiscal years 2007 through 2011.</DELETED>

<DELETED>``SEC. 399BB. INFORMATION AND EDUCATION RELATING TO 
              AUTISM.</DELETED>

<DELETED>    ``(a) In General.--The Secretary shall establish and 
implement a program to provide information and education on autism and 
its risk factors to health professionals and the general public, 
including information and education on advances in the diagnosis and 
treatment of autism and training and continuing education through 
programs for scientists, physicians, and other health professionals who 
provide care for patients with autism. The program shall place special 
emphasis on early identification of autism and those at risk for autism 
and prompt referral for appropriate services.</DELETED>
<DELETED>    ``(b) Stipends.--The Secretary may use amounts made 
available under this section to provide stipends for health 
professionals who are enrolled in training programs under this 
section.</DELETED>
<DELETED>    ``(c) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $10,000,000 
for each of fiscal years 2007 through 2011.</DELETED>

<DELETED>``SEC. 399CC. INTERAGENCY AUTISM COORDINATING 
              COMMITTEE.</DELETED>

<DELETED>    ``(a) Establishment.--The Secretary shall establish a 
committee to be known as the `Autism Coordinating Committee' (in this 
section referred to as the `Committee') to coordinate all efforts 
within the Department of Health and Human Services concerning autism, 
including activities carried out through the National Institutes of 
Health and the Centers for Disease Control and Prevention under the 
amendments made by the National Autism Research Act.</DELETED>
<DELETED>    ``(b) Membership.--</DELETED>
        <DELETED>    ``(1) In general.--The Committee shall be composed 
        of--</DELETED>
                <DELETED>    ``(A) the Director of the Centers for 
                Disease Control and Prevention;</DELETED>
                <DELETED>    ``(B) the Directors of such national 
                research institutes of the National Institutes of 
                Health as the Secretary determines 
                appropriate;</DELETED>
                <DELETED>    ``(C) the heads of such other agencies as 
                the Secretary determines appropriate; and</DELETED>
                <DELETED>    ``(D) the additional members appointed 
                under paragraph (2) (if any).</DELETED>
        <DELETED>    ``(2) Additional members.--If determined 
        appropriate by the Secretary, the Secretary may appoint to the 
        Committee--</DELETED>
                <DELETED>    ``(A) individuals with autism or other 
                pervasive developmental disorders;</DELETED>
                <DELETED>    ``(B) parents or legal guardians of 
                individuals with autism or other pervasive 
                developmental disorders;</DELETED>
                <DELETED>    ``(C) representatives of leading autism 
                research and service organizations; and</DELETED>
                <DELETED>    ``(D) representatives of other 
                governmental agencies that serve children with autism 
                such as the Department of Education.</DELETED>
<DELETED>    ``(c) Administrative Support; Terms of Services; Other 
Provisions.--The following shall apply with respect to the 
Committee:</DELETED>
        <DELETED>    ``(1) The Committee shall receive necessary and 
        appropriate administrative support from the 
        Secretary.</DELETED>
        <DELETED>    ``(2) Members of the Committee appointed under 
        subsection (b)(2)(A) shall serve for a term of 3 years, and may 
        serve for an unlimited number of terms if 
        reappointed.</DELETED>
        <DELETED>    ``(3) The Committee shall meet not less than 2 
        times each year.</DELETED>

<DELETED>``SEC. 399DD. SCREENING, DIAGNOSIS, AND TREATMENT OF AUTISM; 
              MEDICAL CARE FOR INDIVIDUALS WITH AUTISM.</DELETED>

<DELETED>    ``(a) Statewide Autism Screening, Diagnosis, and 
Intervention Programs and Systems.--</DELETED>
        <DELETED>    ``(1) In general.--The Secretary, acting through 
        the Administrator of the Health Resources and Services 
        Administration, shall award grants or cooperative agreements to 
        eligible entities to develop statewide autism screening, 
        diagnosis, and intervention programs and systems for the 
        purposes described in paragraph (2).</DELETED>
        <DELETED>    ``(2) Purposes.--The purposes described in this 
        paragraph are the following:</DELETED>
                <DELETED>    ``(A) To develop and monitor the efficacy 
                of statewide autism screening, diagnosis, and 
                intervention programs and systems, ensuring that all 
                children are screened for autism before their second 
                birthday, and that children at risk for autism receive 
                appropriate services as early as possible. Intervention 
                includes referral to schools and agencies, including 
                community, consumer, and parent-based agencies, and 
                organizations and other programs mandated by part C of 
                the Individuals with Disabilities Education Act, which 
                offer programs specifically designed to meet the unique 
                needs of children with autism.</DELETED>
                <DELETED>    ``(B) To collect data on statewide autism 
                screening, diagnosis, and intervention programs and 
                systems that can be used for applied research, program 
                evaluation, and policy development.</DELETED>
                <DELETED>    ``(C) To provide comprehensive medical 
                care for individuals with autism through evidence-based 
                practices, with specific attention to medical 
                conditions that may be associated with autism, and to 
                disseminate information on the medical care of 
                individuals with autism to health professionals and the 
                general public. In carrying out the program under this 
                paragraph, a grant shall be awarded to a national 
                organization that will establish and support regional 
                centers of clinical excellence to provide medical care 
                to individuals with autism and promote research aimed 
                at improving the treatment of such individuals, and 
                that will build a shared national medical database to 
                record the results of treatments and studies at the 
                regional centers.</DELETED>
        <DELETED>    ``(3) Set aside of funds.--From amounts 
        appropriated under subsection (e), the Secretary shall set-
        aside not less than $4,000,000 for each of fiscal years 2007 
        through 2011 to carry out activities described in paragraph 
        (2)(C).</DELETED>
<DELETED>    ``(b) Technical Assistance, Data Management, and Applied 
Research.--The Secretary, acting through the Director of the Centers 
for Disease Control and Prevention, shall award grants or cooperative 
agreements to provide technical assistance to State agencies to conduct 
applied research related to autism screening, diagnosis, and 
intervention programs and systems. In carrying out this section the 
Secretary shall develop standardized procedures for data management and 
program effectiveness and costs, including procedures--</DELETED>
        <DELETED>    ``(1) to ensure quality monitoring of autism 
        screening, diagnosis, and intervention programs and 
        systems;</DELETED>
        <DELETED>    ``(2) to provide technical assistance on data 
        collection and management;</DELETED>
        <DELETED>    ``(3) to study the costs and effectiveness of 
        autism screening, diagnosis, and intervention programs and 
        systems conducted by State-based programs in order to address 
        issues of importance to State and national 
        policymakers;</DELETED>
        <DELETED>    ``(4) to identify the causes and risk factors for 
        autism;</DELETED>
        <DELETED>    ``(5) to study the effectiveness of autism 
        screening, diagnosis, and intervention programs and systems by 
        assessing the intellectual and social development, cognitive 
        status, and language skills of children with autism at school 
        age; and</DELETED>
        <DELETED>    ``(6) to promote the sharing of data regarding 
        autism with State-based birth defects and developmental 
        disabilities monitoring programs and environmental discharge 
        monitoring programs of the Environmental Protection Agency for 
        the purpose of identifying previously unknown causes of and 
        risk factors for autism.</DELETED>
<DELETED>    ``(c) Coordination and Collaboration.--</DELETED>
        <DELETED>    ``(1) In general.--In carrying out programs under 
        this section, the Administrator of the Health Resources and 
        Services Administration, the Director of the Centers for 
        Disease Control and Prevention, and the Director of the 
        National Institutes of Health shall collaborate and consult 
        with--</DELETED>
                <DELETED>    ``(A) other Federal, State and local 
                agencies, including those responsible for early 
                intervention services pursuant to title XIX of the 
                Social Security Act (particularly the Medicaid Early 
                and Periodic Screening, Diagnosis and Treatment 
                Program), title XXI of the Social Security Act (State 
                Children's Health Insurance Program), title V of the 
                Social Security Act (Maternal and Child Health Block 
                Grant Program), and part C of the Individuals with 
                Disabilities Education Act;</DELETED>
                <DELETED>    ``(B) consumer groups of, and that serve, 
                individuals with autism and their families;</DELETED>
                <DELETED>    ``(C) appropriate national medical and 
                other health and education specialty 
                organizations;</DELETED>
                <DELETED>    ``(D) individuals with autism and their 
                families;</DELETED>
                <DELETED>    ``(E) other qualified personnel who 
                possess the specialized knowledge, skills, and 
                attributes needed to serve autistic children and their 
                families; and</DELETED>
                <DELETED>    ``(F) related commercial 
                industries.</DELETED>
        <DELETED>    ``(2) Policy development.--The Administrator of 
        the Health Resources and Services Administration, the Director 
        of the Centers for Disease Control and Prevention, and the 
        Director of the National Institutes of Health shall coordinate 
        and collaborate on recommendations for policy development at 
        the Federal and State levels and with the private sector, 
        including consumer, medical, and other health and education 
        professional-based organizations, with respect to autism 
        screening, diagnosis, and intervention programs and 
        systems.</DELETED>
        <DELETED>    ``(3) State early detection, diagnosis, and 
        intervention programs and systems.--The Administrator of the 
        Health Resources and Services Administration and the Director 
        of the Centers for Disease Control and Prevention shall 
        coordinate and collaborate in assisting States to establish 
        autism screening, diagnosis, and intervention programs and 
        systems under subsection (a) and to develop a data collection 
        system under subsection (b).</DELETED>
<DELETED>    ``(d) Physician Reimbursement for Development Screening.--
To make developmental screening more readily available, the Secretary, 
acting through the Administrator of the Centers for Medicare & Medicaid 
Services, shall assign a relative value unit to the diagnostic code for 
developmental screening.</DELETED>
<DELETED>    ``(e) Authorization of Appropriations.--There is 
authorized to be appropriated--</DELETED>
        <DELETED>    ``(1) to carry out subsection (a), $75,000,000 for 
        each of fiscal years 2007 through 2011; and</DELETED>
        <DELETED>    ``(2) to carry out subsection (b), $25,000,000 for 
        each of fiscal years 2007 through 2011.</DELETED>

<DELETED>``SEC. 399EE. ANNUAL REPORT ON AUTISM.</DELETED>

<DELETED>    ``(a) In General.--Not later than January 1, 2006, and 
each January 1 thereafter, the Secretary shall prepare and submit to 
the appropriate committees of Congress, a report concerning the 
implementation of this part and part J of title IV.</DELETED>
<DELETED>    ``(b) Contents.--The report, utilizing uniform reporting 
methods and procedures, shall--</DELETED>
        <DELETED>    ``(1) provide the dollar amount that each 
        institute of the National Institutes of Health expended on 
        autism research in the year for which the report was prepared; 
        and</DELETED>
        <DELETED>    ``(2) detail the progress and success of the 
        National Institutes of Health in implementing and funding the 
        recommendations contained in the Autism Research Roadmap and 
        Matrix of the Interagency Autism Coordinating 
        Committee.''.</DELETED>

<DELETED>SEC. 4. ENVIRONMENTAL HEALTH RESEARCH PROGRAMS.</DELETED>

<DELETED>    Subpart 12 of part C of title IV of the Public Health 
Service Act (42 U.S.C. 285l et seq.) is amended by adding at the end 
the following:</DELETED>

<DELETED>``SEC. 463C. ENVIRONMENTAL HEALTH RESEARCH PROGRAMS.</DELETED>

<DELETED>    ``(a) Centers of Excellence.--The Director of NIH, acting 
through the Director of the Institute, shall awards grants and 
contracts to public or nonprofit private entities to pay all or part of 
the cost of planning, establishing, improving, and providing basic 
operating support for centers of excellence regarding environmental 
health and autism.</DELETED>
<DELETED>    ``(b) Research.--Each center of excellence under 
subsection (a) shall conduct basic and clinical research into possible 
environmental causes of and risk factors for autism and the mechanisms 
by which they may lead to autism, and the developmental effects of 
environmental agents that may be associated with autism.</DELETED>
<DELETED>    ``(c) Coordination; Reports.--The Director of NIH shall, 
as appropriate, provide for the coordination of information among 
centers of excellence established under subsection (a) and section 499B 
and ensure regular communication between such centers. The Director may 
require the periodic preparation of reports on the activities of the 
centers and the submission of such reports to the Director. The 
Director shall establish and fund mechanisms and entities for 
collecting, storing, and coordinating data collected by the centers 
established under this section and data generated from public and 
private research partnerships.</DELETED>
<DELETED>    ``(d) Organization.--Each center of excellence under 
subsection (a) shall use the facilities of a single institution, or be 
formed from a consortium of cooperating institutions, meeting such 
requirements as may be prescribed by the Director of NIH.</DELETED>
<DELETED>    ``(e) Number of Centers; Duration.--</DELETED>
        <DELETED>    ``(1) In general.--The Director shall provide for 
        the establishment of not less than 3 centers under subsection 
        (a).</DELETED>
                <DELETED>    ``(A) Duration.--A grant or contract 
                awarded under subsection (a) shall not exceed a period 
                of 5 years. Such period may be extended for 1 or more 
                additional periods not exceeding 5 years if the 
                operations of the center of excellence involved have 
                been reviewed by an appropriate technical and 
                scientific peer review group established by the 
                Director of NIH and the group has recommended to the 
                Director that such period should be extended.</DELETED>
<DELETED>    ``(f) Authorization of Appropriations.--There is 
authorized to be appropriated to carry out this section, $6,000,000 for 
each of fiscal years 2007 through 2011.''.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Combating Autism Act of 2006''.

SEC. 2. ACTIVITIES TO IMPROVE AUTISM-RELATED RESEARCH.

    Section 409C of the Public Health Service Act (42 U.S.C. 284g) is 
amended to read as follows:

``SEC. 409C. AUTHORITY OF THE DIRECTOR OF THE NATIONAL INSTITUTES OF 
              HEALTH RELATING TO AUTISM.

    ``(a) Strategic Plan for Autism Research.--
            ``(1) In general.--The Secretary, acting through the 
        Director, shall develop and implement a strategic plan for the 
        conduct and support of research related to autism spectrum 
        disorder.
            ``(2) Requirements.--The strategic plan developed under 
        paragraph (1)--
                    ``(A) shall--
                            ``(i) be updated annually;
                            ``(ii) take into account the research 
                        recommendations of the Interagency Autism 
                        Coordinating Committee under section 399CC; and
                            ``(iii) using professional judgment, 
                        outline the proposed budgetary requirements of 
                        the strategic plan, including specific funding 
                        expectations for continued multi-year program 
                        activities, as well as new and complementary 
                        program activities, subject to the availability 
                        of appropriations; and
                    ``(B) may include investigator-initiated research.
            ``(3) Report.--Not later than April 1, 2008, and annually 
        thereafter, the Secretary, acting through the Director, shall 
        prepare and submit to the appropriate committees of Congress a 
        report that contains--
                    ``(A) the strategic plan under paragraph (1) that 
                will be applicable to the upcoming fiscal year; and
                    ``(B) a description of the actual dollar 
                expenditures for autism spectrum disorder during the 
                previous fiscal year.
    ``(b) Expansion, Intensification, and Coordination of Activities.--
The Secretary, acting through the Director, shall, subject to the 
availability of appropriations, expand, intensify, and coordinate the 
activities of the National Institutes of Health with respect to autism 
spectrum disorder.
    ``(c) Centers of Excellence.--
            ``(1) Autism centers of excellence.--
                    ``(A) In general.--The Secretary, acting through 
                the Director, shall, subject to the availability of 
                appropriations, award grants or contracts to public or 
                nonprofit private entities to assist such entities in 
                paying all or part of the costs of planning, 
                establishing, improving, and providing basic operating 
                support for centers of excellence concerning research 
                on autism spectrum disorder.
                    ``(B) Research activities.--A center of excellence 
                that receives funding under this paragraph shall 
                conduct basic and clinical research into autism 
                spectrum disorder. Such research shall--
                            ``(i) be conducted in the fields of 
                        developmental neurobiology, genetics, 
                        epigenetics, pharmacology, nutrition, 
                        immunology, neuroimmunology, neurobehavioral 
                        development, endocrinology, gastroenterology, 
                        psychopharmacology, or toxicology; and
                            ``(ii) include investigations into the 
                        causation, diagnosis or rule out, early 
                        detection, prevention, services, supports, or 
                        intervention of autism spectrum disorder.
                    ``(C) Services.--
                            ``(i) In general.--A center of excellence 
                        that receives funding under this paragraph may 
                        expend amounts provided under a grant or 
                        contract under such paragraph to carry out a 
                        program to make individuals aware of 
                        opportunities to participate as subjects in 
                        research conducted by the center.
                            ``(ii) Referrals and costs.--A program 
                        carried out under clause (i) may, in accordance 
                        with such criteria as the Director may 
                        establish, provide to the subjects described in 
                        such clause, referrals for health and other 
                        services and reimbursement of care for 
                        individuals as are required for such research.
                            ``(iii) Availability and access.--The 
                        extent to which a center of excellence that 
                        receives funding under this paragraph can 
                        demonstrate the availability of and access to 
                        clinical services shall be considered by the 
                        Director in making decisions concerning the 
                        awarding of grants or contracts to applicants 
                        that meet the scientific criteria for funding 
                        under this section.
                    ``(D) Coordination of centers of excellence.--The 
                Director shall provide for the appropriate coordination 
                of information among centers of excellence that receive 
                funding under this paragraph and ensure regular 
                communication between such centers.
                    ``(E) Organization.--A center of excellence that 
                receives funding under this paragraph shall use the 
                facilities of a single institution, or be formed 
                through a consortium of cooperating institutions, that 
                meets such requirements as may be required by the 
                Director.
                    ``(F) Duration.--The term of a grant or contract 
                awarded under this paragraph shall not exceed a period 
                of 5 years. Such period may be extended for 1 or more 
                additional periods not exceeding 5 years if the 
                operations of the center of excellence involved have 
                been reviewed by an appropriate technical and 
                scientific peer review group established by the 
                Director and the group has recommended to the Director 
                the extension of such period.
                    ``(G) Geographic diversity.--The Director shall 
                consider geographic diversity in awarding centers of 
                excellence.
            ``(2) Centers of excellence in environmental health and 
        autism.--
                    ``(A) In general.--The Director shall, subject to 
                the availability of appropriations, award grants or 
                contracts to public or nonprofit private entities to 
                pay all or part of the cost of planning, establishing, 
                improving, and providing basic operating support for 
                centers of excellence regarding environmental health 
                and autism spectrum disorder.
                    ``(B) Research.--A center of excellence established 
                under this paragraph shall conduct basic and clinical 
                research of a broad array of environmental factors that 
                may have a possible role in autism spectrum disorder.
                    ``(C) Coordination and organization.--The 
                Secretary, acting through the Director of NIH, shall 
                apply to the centers under this paragraph the same 
                requirements concerning coordination, reporting, and 
                organization as the requirements applied to the centers 
                of excellence under subparagraphs (D), (E), (F), and 
                (G) of paragraph (1).
    ``(d) Collection and Storage of Data.--
            ``(1) In general.--The Secretary, acting through the 
        Director and in coordination with the Director of the Centers 
        for Disease Control and Prevention, shall, subject to the 
        availability of appropriations, establish and provide funding 
        for mechanisms and entities that provide for the collection, 
        storage, coordination, and public availability of data that is 
        collected by the centers of excellence under this section, 
        under section 399AA(b), and under section 409C(c) and, to the 
        extent possible, data generated from public and private 
        research partnerships. In establishing such mechanisms and 
        entities, the Secretary--
                    ``(A) shall ensure that there is data sharing among 
                autism spectrum disorder researchers; and
                    ``(B) may utilize existing facilities.
            ``(2) Facilitation of research.--
                    ``(A) Establishment of program.--The Secretary 
                shall establish a program under which samples of 
                tissues and genetic and other biological materials that 
                are of use in research on autism spectrum disorder are 
                donated, collected, preserved, and made available for 
                such research.
                    ``(B) Accepted scientific standards.--The program 
                established under paragraph (1) shall be--
                            ``(i) carried out in accordance with 
                        accepted scientific and medical standards for 
                        the donation, collection, and preservation of 
                        such samples; and
                            ``(ii) conducted so that the tissues and 
                        other materials saved, as well as any database 
                        compiled from such tissues and materials, are 
                        available to researchers at a reasonable cost 
                        and on an expedited basis.
    ``(e) Consolidation.--The Secretary, acting through the Director, 
may consolidate program activities under this section if such 
consolidation would improve program efficiencies and outcomes.
    ``(f) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated--
                    ``(A) $68,000,000 for fiscal year 2007, $82,000,000 
                for fiscal year 2008, $96,000,000 for fiscal year 2009, 
                $120,000,000 for fiscal year 2010, and $134,000,000 for 
                fiscal year 2011, to carry out subsections (a), (b), 
                and (d);
                    ``(B) $26,000,000 for fiscal year 2007, $32,500,000 
                for fiscal year 2008, $39,000,000 for fiscal year 2009, 
                $45,500,000 for fiscal year 2010, and $52,000,000 for 
                fiscal year 2011, to carry out subsection (c)(1); and
                    ``(C) $6,000,000 for fiscal year 2007, $7,500,000 
                for fiscal year 2008, $9,000,000 for fiscal year 2009, 
                $10,500,000 for fiscal year 2010, and $12,000,000 for 
                fiscal year 2011, to carry out subsection (c)(2).
            ``(2) General usage.--Of the amounts appropriated under 
        subparagraphs (B) and (C) of paragraph (1), not to exceed 5 
        percent of such amounts may be utilized by the National 
        Institutes of Health for administrative and other expenses.
    ``(g) Sunset.--This section shall not apply after September 30, 
2011.''.

SEC. 3. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH PROGRAM.

    (a) In General.--Title III of the Public Health Service Act (42 
U.S.C. 241 et seq.) is amended by adding at the end the following:

                 ``PART R--PROGRAMS RELATING TO AUTISM

``SEC. 399AA. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH 
              PROGRAM.

    ``(a) Autism Spectrum Disorder and Other Developmental 
Disabilities.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, may 
        award grants or cooperative agreements to eligible entities for 
        the collection, analysis, and reporting of State 
        epidemiological data on autism spectrum disorder and other 
        developmental disabilities. An eligible entity shall assist 
        with the development and coordination of State autism spectrum 
        disorder and other developmental disability surveillance 
        efforts within a region. In making such awards, the Secretary 
        may provide direct technical assistance in lieu of cash.
            ``(2) Data standards.--In submitting epidemiological data 
        to the Secretary pursuant to subsection (a), an eligible entity 
        shall report data according to guidelines prescribed by the 
        Director of the Centers for Disease Control and Prevention, 
        after consultation with relevant State and local public health 
        officials, private sector developmental disability researchers, 
        and advocates for individuals with autism spectrum disorder or 
        other developmental disabilities.
            ``(3) Eligibility.--To be eligible to receive an award 
        under paragraph (1), an entity shall be a public or nonprofit 
        private entity (including a health department of a State or a 
        political subdivision of a State, a university, or any other 
        educational institution), and submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require.
    ``(b) Centers of Excellence in Autism Spectrum Disorder 
Epidemiology.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall, subject to the availability of appropriations, award 
        grants or cooperative agreements for the establishment of 
        regional centers of excellence in autism spectrum disorder and 
        other developmental disabilities epidemiology for the purpose 
        of collecting and analyzing information on the number, 
        incidence, correlates and causes of autism spectrum disorder 
        and other developmental disabilities.
            ``(2) Requirements.--To be eligible to receive a grant or 
        cooperative agreement under paragraph (1), an entity shall 
        submit to the Secretary an application containing such 
        agreements and information as the Secretary may require, 
        including an agreement that the center to be established under 
        the grant or cooperative agreement shall operate in accordance 
        with the following:
                    ``(A) The center will collect, analyze, and report 
                autism spectrum disorder and other developmental 
                disability data according to guidelines prescribed by 
                the Director of the Centers for Disease Control and 
                Prevention, after consultation with relevant State and 
                local public health officials, private sector 
                developmental disability researchers, and advocates for 
                individuals with developmental disabilities.
                    ``(B) The center will develop or extend an area of 
                special research expertise (including genetics, 
                epigenetics, epidemiological research related to 
                environmental exposures), immunology, and other 
                relevant research specialty areas.
                    ``(C) The center will identify eligible cases and 
                controls through its surveillance system and conduct 
                research into factors which may cause or increase the 
                risk of autism spectrum disorder and other 
                developmental disabilities.
    ``(c) Federal Response.--The Secretary shall coordinate the Federal 
response to requests for assistance from State health, mental health, 
and education department officials regarding potential or alleged 
autism spectrum disorder or developmental disability clusters.
    ``(d) Definitions.--In this part:
            ``(1) Other developmental disabilities.--The term `other 
        developmental disabilities' has the meaning given the term 
        `developmental disability' in section 102(8) of the 
        Developmental Disabilities Assistance and Bill of Rights Act of 
        2000 (42 U.S.C. 15002(8)).
            ``(2) State.--The term `State' means each of the several 
        States, the District of Columbia, the Commonwealth of Puerto 
        Rico, American Samoa, Guam, the Commonwealth of the Northern 
        Mariana Islands, the Virgin Islands, and the Trust Territory of 
        the Pacific Islands.
    ``(e) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated, $15,000,000 for fiscal year 
2007, and such sums as may be necessary for each of fiscal years 2008 
through 2011.
    ``(f) Sunset.--This section shall not apply after September 30, 
2011.

``SEC. 399BB. AUTISM EDUCATION, EARLY DETECTION, AND INTERVENTION .

    ``(a) Purpose.--It is the purpose of this section--
            ``(1) to increase awareness, reduce barriers to screening 
        and diagnosis, promote evidence-based interventions for 
        individuals with autism spectrum disorder or other 
        developmental disabilities, and train professionals to utilize 
        valid and reliable screening tools to diagnose or rule out and 
        provide evidence-based interventions for children with autism 
        spectrum disorder and other developmental disabilities; and
            ``(2) to conduct activities under this section with a focus 
        on an interdisciplinary approach (as defined in programs 
        developed under section 501(a)(2) of the Social Security Act) 
        that will also focus on specific issues for children who are 
        not receiving an early diagnosis and subsequent interventions.
    ``(b) In General.--The Secretary shall, subject to the availability 
of appropriations, establish and evaluate activities to--
            ``(1) provide information and education on autism spectrum 
        disorder and other developmental disabilities to increase 
        public awareness of developmental milestones;
            ``(2) promote research into the development and validation 
        of reliable screening tools for autism spectrum disorder and 
        other developmental disabilities and disseminate information 
        regarding those screening tools;
            ``(3) promote early screening of individuals at higher risk 
        for autism spectrum disorder and other developmental 
        disabilities as early as practicable, given evidence-based 
        screening techniques and interventions;
            ``(4) increase the number of individuals who are able to 
        confirm or rule out a diagnosis of autism spectrum disorder and 
        other developmental disabilities;
            ``(5) increase the number of individuals able to provide 
        evidence-based interventions for individuals diagnosed with 
        autism spectrum disorder or other developmental disabilities; 
        and
            ``(6) promote the use of evidence-based interventions for 
        individuals at higher risk for autism spectrum disorder and 
        other developmental disabilities as early as practicable.
    ``(c) Information and Education.--
            ``(1) In general.--In carrying out subsection (b)(1), the 
        Secretary, in collaboration with the Secretary of Education and 
        the Secretary of Agriculture, shall, subject to the 
        availability of appropriations, provide culturally competent 
        information regarding autism spectrum disorder and other 
        developmental disabilities, risk factors, characteristics, 
        identification, diagnosis or rule out, and evidence-based 
        interventions to meet the needs of individuals with autism 
        spectrum disorder or other developmental disabilities and their 
        families through--
                    ``(A) Federal programs, including--
                            ``(i) the Head Start program;
                            ``(ii) the Early Start program;
                            ``(iii) the Healthy Start program;
                            ``(iv) programs under the Child Care and 
                        Development Block Grant Act of 1990;
                            ``(v) programs under title XIX of the 
                        Social Security Act (particularly the Medicaid 
                        Early and Periodic Screening, Diagnosis and 
                        Treatment Program);
                            ``(vi) the program under title XXI of the 
                        Social Security Act (the State Children's 
                        Health Insurance Program);
                            ``(vii) the program under title V of the 
                        Social Security Act (Maternal and Child Health 
                        Block Grant Program);
                            ``(viii) the program under parts B and C of 
                        the Individuals with Disabilities Education 
                        Act;
                            ``(ix) the special supplemental nutrition 
                        program for women, infants, and children 
                        established under section 17 of the Child 
                        Nutrition Act of 1966 (42 U.S.C. 1786); and
                            ``(x) the State grant program under the 
                        Rehabilitation Act of 1973.
                    ``(B) State licensed child care facilities; and
                    ``(C) other community-based organizations or points 
                of entry for individuals with autism spectrum disorder 
                and other developmental disabilities to receive 
                services.
            ``(2) Lead agency.--
                    ``(A) Designation.--The governor of a State shall 
                designate a public agency as a lead agency to 
                coordinate the activities provided for under paragraph 
                (1) in the State at the State level.
                    ``(B) Information.--The Governor or a State, acting 
                through the lead agency under subparagraph (A), shall 
                make available to individuals and their family members, 
                guardians, advocates, or authorized representatives, 
                providers, and other appropriate individuals in the 
                State, comprehensive culturally competent information 
                about State and local resources regarding autism 
                spectrum disorder and other developmental disabilities, 
                risk factors, characteristics, identification, 
                diagnosis or rule out, available services and supports, 
                and evidence-based interventions. Such information 
                shall be provided through--
                            ``(i) toll-free telephone numbers;
                            ``(ii) Internet websites;
                            ``(iii) mailings; or
                            ``(iv) other means as the Governor may 
                        require.
                    ``(C) Requirements of agency.--In designating the 
                lead agency under subparagraph (A), the Governor 
                shall--
                            ``(i) select an agency that has 
                        demonstrated experience and expertise in--
                                    ``(I) autism spectrum disorder and 
                                other developmental disability issues; 
                                and
                                    ``(II) developing, implementing, 
                                conducting, and administering programs 
                                and delivering education, information, 
                                and referral services (including 
                                technology-based curriculum-development 
                                services) to individuals with 
                                developmental disabilities and their 
                                family members, guardians, advocates or 
                                authorized representatives, providers, 
                                and other appropriate individuals 
                                locally and across the State; and
                            ``(ii) consider input from individuals with 
                        developmental disabilities and their family 
                        members, guardians, advocates or authorized 
                        representatives, providers, and other 
                        appropriate individuals.
    ``(d) Tools.--
            ``(1) In general.--To promote the use of valid and reliable 
        screening tools for autism spectrum disorder and other 
        developmental disabilities, the Secretary shall develop a 
        curriculum for continuing education to assist individuals in 
        recognizing the need for valid and reliable screening tools and 
        the use of such tools.
            ``(2) Collection, storage, coordination, and 
        availability.--The Secretary, in collaboration with the 
        Secretary of Education, shall provide for the collection, 
        storage, coordination, and public availability of tools 
        described in paragraph (1), educational materials and other 
        products that are used by the Federal programs referred to in 
        subsection (c)(1)(A), as well as--
                    ``(A) programs authorized under the Developmental 
                Disabilities Assistance and Bill of Rights Act of 2000;
                    ``(B) early intervention programs or interagency 
                coordinating council's authorized under part C of the 
                Individuals with Disabilities Education Act; and
                    ``(C) children with special health care needs 
                programs authorized under title V of the Social 
                Security Act.
            ``(3) Required sharing.--In establishing mechanisms and 
        entities under this subsection, the Secretary, and the 
        Secretary of Education, shall ensure the sharing of tools, 
        materials, and products developed under this subsection among 
        entities receiving funding under this section.
    ``(e) Diagnosis.--
            ``(1) Training.--The Secretary, in coordination with 
        activities conducted under title V of the Social Security Act, 
        shall, subject to the availability of appropriations, expand 
        existing interdisciplinary training opportunities or 
        opportunities to increase the number of sites able to diagnose 
        or rule out individuals with autism spectrum disorder or other 
        developmental disabilities and ensure that--
                    ``(A) competitive grants or cooperative agreements 
                are awarded to public or non-profit agencies, including 
                institutions of higher education, to expanding existing 
                or develop new maternal and child health 
                interdisciplinary leadership education in 
                neurodevelopmental and related disabilities programs 
                (similar to the programs developed under section 
                501(a)(2) of the Social Security Act) in States that do 
                not have such a program;
                    ``(B) trainees under such training programs--
                            ``(i) receive an appropriate balance of 
                        academic, clinical, and community 
                        opportunities;
                            ``(ii) are culturally competent;
                            ``(iii) are ethnically diverse;
                            ``(iv) demonstrate a capacity to evaluate, 
                        diagnose or rule out, develop, and provide 
                        evidence-based interventions to individuals 
                        with autism spectrum disorder and other 
                        developmental disabilities; and
                            ``(v) demonstrate an ability to use a 
                        family-centered approach; and
                    ``(C) program sites provide culturally competent 
                services.
            ``(2) Technical assistance.--The Secretary may award one or 
        more grants under this section to provide technical assistance 
        to the network of interdisciplinary training programs.
            ``(3) Best practices.--The Secretary shall promote research 
        into additional valid and reliable tools for shortening the 
        time required to confirm or rule out a diagnosis of autism 
        spectrum disorder or other developmental disabilities and 
        detecting individuals with autism spectrum disorder or other 
        developmental disabilities at an earlier age.
    ``(f) Intervention.--The Secretary shall promote research, through 
grants or contracts, to determine the evidence-based practices for 
interventions for individuals with autism spectrum disorder or other 
developmental disabilities, develop guidelines for those interventions, 
and disseminate information related to such research and guidelines.
    ``(g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated, $32,000,000 for fiscal year 
2007, $37,000,000 for fiscal year 2008, $42,000,000 for fiscal year 
2009, $47,000,000 for fiscal year 2010, and $52,000,000 for fiscal year 
2011, of which--
            ``(1) $5,000,000 shall be made available in each fiscal 
        year for activities described in subsection (c); and
            ``(2) $3,000,000 shall be made available in fiscal year 
        2007, $6,000,000 in fiscal year 2008, $9,000,000 in fiscal year 
        2009, $12,000,000 in fiscal year 2010, and $15,000,000 in 
        fiscal year 2011, for activities described in subsection (f).
    ``(h) Sunset.--This section shall not apply after September 30, 
2011.

``SEC. 399CC. INTERAGENCY AUTISM COORDINATING COMMITTEE.

    ``(a) Establishment.--The Secretary shall establish a committee, to 
be known as the `Interagency Autism Coordinating Committee' (in this 
section referred to as the `Committee'), to coordinate all efforts 
within the Department of Health and Human Services concerning autism 
spectrum disorder.
    ``(b) Responsibilities.--In carrying out its duties under this 
section, the Committee shall--
            ``(1) make recommendations concerning the strategic plan 
        described in section 409C(a);
            ``(2) develop and annually update advances in autism 
        spectrum disorder research related to causes, early screening, 
        diagnosis or rule out, intervention, and access to services and 
        supports for individuals with autism spectrum disorder; and
            ``(3) make recommendations to the Secretary regarding the 
        public participation in decisions relating to autism spectrum 
        disorder.
    ``(c) Membership.--
            ``(1) In general.--The Committee shall be composed of--
                    ``(A) the Director of the Centers for Disease 
                Control and Prevention;
                    ``(B) the Director of the National Institutes of 
                Health, and the Directors of such national research 
                institutes of the National Institutes of Health as the 
                Secretary determines appropriate;
                    ``(C) the heads of such other agencies as the 
                Secretary determines appropriate;
                    ``(D) representatives of other Federal Governmental 
                agencies that serve individuals with autism spectrum 
                disorder such as the Department of Education; and
                    ``(E) the additional members appointed under 
                paragraph (2).
            ``(2) Additional members.--Not fewer than 6 members of the 
        Committee, or 1/3 of the total membership of the Committee, 
        whichever is greater, shall be composed of non-federal public 
        members to be appointed by the Secretary, of which--
                    ``(A) at least one such member shall be an 
                individual with a diagnosis of autism spectrum 
                disorder;
                    ``(B) at least one such member shall be a parent or 
                legal guardian of an individual with an autism spectrum 
                disorder; and
                    ``(C) at least one such member shall be a 
                representative of leading research, advocacy, and 
                service organizations for individuals with autism 
                spectrum disorder.
    ``(d) Administrative Support; Terms of Service; Other Provisions.--
The following provisions shall apply with respect to the Committee:
            ``(1) The Committee shall receive necessary and appropriate 
        administrative support from the Secretary.
            ``(2) Members of the Committee appointed under subsection 
        (c)(2) shall serve for a term of 4 years, and may be 
        reappointed for one or more additional 4 year term. 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 of the member's term until a successor has 
        taken office.
            ``(3) The Committee shall meet at the call of the 
        chairperson or upon the request of the Secretary. The Committee 
        shall meet not fewer than 2 times each year.
            ``(4) All meetings of the Committee shall be public and 
        shall include appropriate time periods for questions and 
        presentations by the public.
    ``(e) Compensation and Expenses.--Members of the Committee who are 
officers or employees of the Federal Government shall serve as members 
of the Committee without compensation in addition to that received in 
their regular government employment. Other members of the Committee 
shall receive compensation at rates not to exceed the daily equivalent 
of the annual rate in effect for grade GS-18 of the General Schedule 
for each day (including travel time) they are engaged in the 
performance of their duties as members of the Committee.
    ``(f) Subcommittees; Establishment and Membership.--In carrying out 
its functions, the Committee may establish subcommittees and convene 
workshops and conferences. Such subcommittees shall be composed of 
Committee members and may hold such meetings as are necessary to enable 
the subcommittees to carry out their duties.
    ``(g) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated, such sums as may be necessary 
for each of fiscal years 2007 through 2011.
    ``(h) Sunset.--This section shall not apply after September 30, 
2011 and the Committee shall be terminated on such date.

``SEC. 399DD. REPORT TO CONGRESS.

    ``(a) In General.--Not later than 4 years after the date of 
enactment of the Combating Autism Act of 2006, the Secretary, in 
coordination with the Secretary of Education, shall prepare and submit 
to the Health, Education, Labor, and Pensions Committee of the Senate 
and the Energy and Commerce Committee of the House of Representatives a 
progress report on activities related to autism spectrum disorder and 
other developmental disabilities.
    ``(b) Contents.--The report submitted under subsection (a) shall 
contain--
            ``(1) a description of the progress made in implementing 
        the provisions of the Combating Autism Act of 2006;
            ``(2) a description of the amounts expended on the 
        implementation of the particular provisions of Combating Autism 
        Act of 2006;
            ``(3) information on the incidence of autism spectrum 
        disorder and trend data of such incidence since the date of 
        enactment of the Combating Autism Act of 2006;
            ``(4) information on the average age of diagnosis for 
        children with autism spectrum disorder and other disabilities, 
        including how that age may have changed over the 4-year period 
        beginning on the date of enactment of this Act;
            ``(5) information on the average age for intervention for 
        individuals diagnosed with autism spectrum disorder and other 
        developmental disabilities, including how that age may have 
        changed over the 4-year period beginning on the date of 
        enactment of this Act;
            ``(6) information on the average time between initial 
        screening and then diagnosis or rule out for individuals with 
        autism spectrum disorder or other developmental disabilities, 
        as well as information on the average time between diagnosis 
        and evidence-based intervention for individuals with autism 
        spectrum disorder or other developmental disabilities;
            ``(7) information on the effectiveness and outcomes of 
        interventions for individuals diagnosed with autism spectrum 
        disorder, including by various subtypes, and other 
        developmental disabilities and how the age of the child may 
        affect such effectiveness;
            ``(8) information on the effectiveness and outcomes of 
        innovative and newly developed intervention strategies for 
        individuals with autism spectrum disorder or other 
        developmental disabilities; and
            ``(9) information on services and supports provided to 
        individuals with autism spectrum disorder and other 
        developmental disabilities who have reached the age of majority 
        (as defined for purposes of section 615(m) of the Individuals 
        with Disabilities Education Act (20 U.S.C. 1415(m)).''.
    (b) Repeals.--The following sections of the Children's Health Act 
of 2000 (Public Law 106-310) are repealed:
            (1) Section 101 (42 U.S.C. 247b-4a) relating to research 
        activities at the National Institutes of Health.
            (2) Section 102 (42 U.S.C. 247b-4b) relating to the 
        Developmental Disabilities Surveillance and Research Program.
            (3) Section 103 (42 U.S.C. 247b-4c) relating to information 
        and education.
            (4) Section 104 (42 U.S.C. 247b-4d) relating to the Inter-
        Agency Autism Coordinating Committee.
            (5) Section 105 (42 U.S.C. 247b-4e) relating to reports.
                                                       Calendar No. 578

109th CONGRESS

  2d Session

                                 S. 843

                          [Report No. 109-318]

_______________________________________________________________________

                                 A BILL

    To amend the Public Health Service Act to combat autism through 
            research, screening, intervention and education.

_______________________________________________________________________

                             August 3, 2006

                       Reported with an amendment
```