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[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 843 Engrossed Amendment House (EAH)]

                In the House of Representatives, U. S.,

                                                      December 6, 2006.

    Resolved, That the bill from the Senate (S. 843) entitled ``An Act to amend 
the Public Health Service Act to combat autism through research, screening, 
intervention and education'', do pass with the following

                               AMENDMENT:

            Strike out all after the enacting clause and insert:

SECTION 1. SHORT TITLE.

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

SEC. 2. CENTERS OF EXCELLENCE; IMPROVING AUTISM-RELATED RESEARCH.

    (a) Centers of Excellence Regarding Research on Autism.--Section 
409C of the Public Health Service Act (42 U.S.C.284g) is amended--
            (1) in the section heading, by striking ``autism'' and 
        inserting ``autism spectrum disorder'';
            (2) by striking the term ``autism'' each place such term 
        appears (other than the section heading) and inserting ``autism 
        spectrum disorder''; and
            (3) in subsection (a)--
                    (A) by redesignating paragraph (2) as paragraph 
                (3); and
                    (B) by striking paragraph (1) and inserting the 
                following:
            ``(1) Expansion of activities.--The Director of NIH (in 
        this section referred to as the `Director') shall, subject to 
        the availability of appropriations, expand, intensify, and 
        coordinate the activities of the National Institutes of Health 
        with respect to research on autism spectrum disorder, including 
        basic and clinical research in fields including pathology, 
        developmental neurobiology, genetics, epigenetics, 
        pharmacology, nutrition, immunology, neuroimmunology, 
        neurobehavioral development, endocrinology, gastroenterology, 
        and toxicology. Such research shall investigate the cause 
        (including possible environmental causes), diagnosis or rule 
        out, early detection, prevention, services, supports, 
        intervention, and treatment of autism spectrum disorder.
            ``(2) Consolidation.--The Director may consolidate program 
        activities under this section if such consolidation would 
        improve program efficiencies and outcomes.''.
    (b) Centers of Excellence Generally.--Part A of title IV of the 
Public Health Service Act (42 U.S.C. 281 et seq.) is amended by adding 
at the end the following:

``SEC. 404H. REVIEW OF CENTERS OF EXCELLENCE.

    ``(a) In General.--Not later than April 1, 2008, and periodically 
thereafter, the Secretary, acting through the Director of NIH, shall 
conduct a review and submit a report to the appropriate committees of 
the Congress on the centers of excellence.
    ``(b) Report Contents.--Each report under subsection (a) shall 
include the following:
            ``(1) Evaluation of the performance and research outcomes 
        of each center of excellence.
            ``(2) Recommendations for promoting coordination of 
        information among centers of excellence.
            ``(3) Recommendations for improving the effectiveness, 
        efficiency, and outcomes of the centers of excellence.
    ``(c) Definition.--In this section, the term `center of excellence' 
means an entity receiving funding under this title in its capacity as a 
center of excellence.''.

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 paragraph (1), 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, and 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) 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 (the 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.--As a condition on the provision 
                of assistance or the conduct of activities under this 
                section with respect to a State, the Secretary may 
                require the Governor of the State--
                            ``(i) to designate a public agency as a 
                        lead agency to coordinate the activities 
                        provided for under paragraph (1) in the State 
                        at the State level; and
                            ``(ii) acting through such lead agency, to 
                        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.
                    ``(B) Requirements of agency.--In designating the 
                lead agency under subparagraph (A)(i), 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.
                    ``(C) Information.--Information under subparagraph 
                (A)(ii) shall be provided through--
                            ``(i) toll-free telephone numbers;
                            ``(ii) Internet websites;
                            ``(iii) mailings; or
                            ``(iv) such other means as the Governor may 
                        require.
    ``(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 councils 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 nonprofit agencies, including 
                institutions of higher education, to expand 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) 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) develop and annually update a summary of advances in 
        autism spectrum disorder research related to causes, 
        prevention, treatment, early screening, diagnosis or rule out, 
        intervention, and access to services and supports for 
        individuals with autism spectrum disorder;
            ``(2) monitor Federal activities with respect to autism 
        spectrum disorder;
            ``(3) make recommendations to the Secretary regarding any 
        appropriate changes to such activities, including 
        recommendations to the Director of NIH with respect to the 
        strategic plan developed under paragraph (5);
            ``(4) make recommendations to the Secretary regarding 
        public participation in decisions relating to autism spectrum 
        disorder;
            ``(5) develop and annually update a strategic plan for the 
        conduct of, and support for, autism spectrum disorder research, 
        including proposed budgetary requirements; and
            ``(6) submit to the Congress such strategic plan and any 
        updates to such plan.
    ``(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) 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.
    ``(f) 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 102 (42 U.S.C. 247b-4b), relating to the 
        Developmental Disabilities Surveillance and Research Program.
            (2) Section 103 (42 U.S.C. 247b-4c), relating to 
        information and education.
            (3) Section 104 (42 U.S.C. 247b-4d), relating to the Inter-
        Agency Autism Coordinating Committee.
            (4) Section 105 (42 U.S.C. 247b-4e), relating to reports.

SEC. 4. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--Part R of title III of the Public Health Service 
Act, as added by section 3, is amended by adding at the end the 
following:

``SEC. 399EE. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Developmental Disabilities Surveillance and Research 
Program.--To carry out section 399AA, there are authorized to be 
appropriated the following:
            ``(1) For fiscal year 2007, $15,000,000.
            ``(2) For fiscal year 2008, $16,500,000.
            ``(3) For fiscal year 2009, $18,000,000.
            ``(4) or fiscal year 2010, $19,500,000.
            ``(5) For fiscal year 2011, $21,000,000.
    ``(b) Autism Education, Early Detection, and Intervention.--To 
carry out section 399BB, there are authorized to be appropriated the 
following:
            ``(1) For fiscal year 2007, $32,000,000.
            ``(2) For fiscal year 2008, $37,000,000.
            ``(3) For fiscal year 2009, $42,000,000.
            ``(4) For fiscal year 2010, $47,000,000.
            ``(5) For fiscal year 2011, $52,000,000.
    ``(c) Interagency Autism Coordinating Committee; Certain Other 
Programs.--To carry out section 399CC, 409C, and section 404H, there 
are authorized to be appropriated the following:
            ``(1) For fiscal year 2007, $100,000,000.
            ``(2) For fiscal year 2008, $114,500,000.
            ``(3) For fiscal year 2009, $129,000,000.
            ``(4) For fiscal year 2010, $143,500,000.
            ``(5) For fiscal year 2011, $158,000,000.''.
    (b) Conforming Amendment.--Section 409C of the Public Health 
Service Act (42 U.S.C. 284g) is amended by striking subsection (e) 
(relating to funding).
            Attest:

                                                                          Clerk.
109th CONGRESS

  2d Session

                                 S. 843

_______________________________________________________________________

                               AMENDMENT
```