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[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 843 Enrolled Bill (ENR)]

        S.843

                       One Hundred Ninth Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

          Begun and held at the City of Washington on Tuesday,
             the third day of January, two thousand and six

                                 An Act

    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,

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) For 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).

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
```