IB 
Union Calendar No. 518 
118TH CONGRESS 
2D SESSION 
H. R. 7213 
[Report No. 118–620] 
To amend the Public Health Service Act to [enhance activities of the National 
Institutes of Health with respect to research on autism spectrum disorder 
and enhance programs relating to autism / reauthorize certain programs 
with respect to autism spectrum disorder?], and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 1, 2024 
Mr. SMITH of New Jersey (for himself and Mr. CUELLAR) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
JULY 30, 2024 
Additional sponsors: Mr. CARTER of Georgia, Mrs. DINGELL, Mr. MOLINARO, 
Ms. KUSTER, Mr. FITZPATRICK, Mr. MOULTON, Mr. KEAN of New Jer-
sey, Mr. SOTO, Mr. KILEY, Mr. GOTTHEIMER, Mr. DAVIS of North Caro-
lina, Ms. MATSUI, Mr. STAUBER, Ms. CLARKE of New York, Mr. BACON, 
Ms. SPANBERGER, Mr. HARDER of California, Ms. TLAIB, Mr. MOORE 
of Utah, Ms. SLOTKIN, Ms. OMAR, Mr. JOYCE of Pennsylvania, Mr. KIM 
of New Jersey, Ms. BLUNT ROCHESTER, Ms. KAPTUR, Ms. SALAZAR, Ms. 
TENNEY, Mr. HARRIS, Mr. VAN DREW, Mrs. MILLER of West Virginia, 
Mr. GRAVES of Louisiana, Mr. LARSON of Connecticut, Ms. WATERS, Ms. 
SEWELL, Mr. SUOZZI, Mr. PANETTA, Mrs. PELTOLA, Mr. RYAN, Mr. 
LAWLER, Mr. PAPPAS, Ms. ADAMS, Mr. KELLY of Pennsylvania, Mr. VAN 
ORDEN, Mr. NEGUSE, Ms. STEVENS, Ms. BUDZINSKI, Mr. BILIRAKIS, 
Ms. PINGREE, Ms. TOKUDA, Ms. PETTERSEN, Mr. COURTNEY, Mr. 
LANDSMAN, Mr. JACKSON of Illinois, Mr. THOMPSON of Pennsylvania, 
Mr. POCAN, Mr. SCHNEIDER, Ms. LEE of Nevada, Mr. WILLIAMS of New 
York, Mr. MEUSER, and Mr. CROW 
JULY 30, 2024 
Reported with amendments, committed to the Committee of the Whole House 
on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on February 1, 2024] 
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A BILL 
To amend the Public Health Service Act to [enhance activi-
ties of the National Institutes of Health with respect 
to research on autism spectrum disorder and enhance 
programs relating to autism / reauthorize certain pro-
grams with respect to autism spectrum disorder?], and 
for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Autism Collaboration, 
Accountability, Research, Education, and Support Act of 
2024’’ or the ‘‘Autism CARES Act of 2024’’. 
SEC. 2. NATIONAL INSTITUTES OF HEALTH ACTIVITIES. 
(a) EXPANSION OF ACTIVITIES.—Paragraph (1) of sec-
tion 409C(a) of the Public Health Service Act (42 U.S.C. 
284g(a)) is amended to read as follows: 
‘‘(1) EXPANSION OF ACTIVITIES.—The Director 
of NIH (in this section referred to as the ‘Director’), 
in coordination and consultation with the Adminis-
trator of the Administration for Community Living, 
and other agencies as appropriate, shall— 
‘‘(A) subject to the availability of appro-
priations, expand, intensify, and coordinate the 
activities of the National Institutes of Health 
with respect to research on autism spectrum dis-
order, including— 
‘‘(i) basic and clinical research in 
fields including pathology, developmental 
neurobiology, genetics, epigenetics, pharma-
cology, 
nutrition, 
immunology, 
neuroimmunology, neurobehavioral develop-
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ment, endocrinology, gastroenterology, toxi-
cology, 
speech, 
language 
and 
hearing 
science, psychiatry, psychology, develop-
mental behavioral pediatrics, and geron-
tology; and 
‘‘(ii) research on interventions to 
maximize outcomes for individuals with au-
tism spectrum disorder; and 
‘‘(B) ensure that research referred to in sub-
paragraph (A)— 
‘‘(i) investigates the causes (including 
possible environmental causes), diagnosis or 
ruling out, early and ongoing detection, 
prevention, intervention, services, supports 
across the lifespan for autistic individuals 
and caregivers, and treatment for autism 
spectrum disorder and co-occurring condi-
tions, including dissemination and imple-
mentation of clinical care, supports, inter-
ventions, and treatments; and 
‘‘(ii) reflects the entire population of 
individuals with autism spectrum disorder, 
including the full range of cognitive, com-
municative, behavioral, and adaptive func-
tioning, as well as co-occurring conditions 
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and needs for support and services, includ-
ing care necessary for physical safety.’’. 
(b) CENTERS OF EXCELLENCE.—Section 409C(b) of 
the Public Health Service Act (42 U.S.C. 284g(b)) is 
amended— 
(1) in paragraph (2)— 
(A) by striking ‘‘prevention, and treatment’’ 
and inserting ‘‘prevention, services, and treat-
ment’’; 
(B) by striking ‘‘including the fields’’ and 
inserting ‘‘including in the fields’’; and 
(C) by striking ‘‘behavioral psychology, and 
clinical psychology’’ and inserting ‘‘behavioral 
psychology, clinical psychology, and geron-
tology’’; 
(2) in paragraph (5)(A), by striking ‘‘not less 
than five centers’’ and inserting ‘‘not fewer than six 
centers’’; and 
(3) in paragraph (5)(B), by striking ‘‘period of 
not to exceed’’ and inserting ‘‘period not to exceed’’. 
(c) PUBLIC INPUT.—Section 409C(d) of the Public 
Health Service Act (42 U.S.C. 284g(d)) is amended to read 
as follows: 
‘‘(d) PUBLIC INPUT.— 
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‘‘(1) IN
GENERAL.—The Director shall under 
subsection (a)(1) provide for means through which the 
public can obtain information on the existing and 
planned programs and activities of the National In-
stitutes of Health with respect to autism spectrum 
disorder and through which the Director can receive 
comments from the public regarding such programs 
and activities. 
‘‘(2) OPPORTUNITIES.—Such public input oppor-
tunities may include encouraging the centers under 
subsection (b)(1) to establish an external advisory 
board or adopting a comprehensive plan to ensure in-
dividuals with various backgrounds and perspectives 
are represented, among other activities. Such opportu-
nities should consider including, as appropriate, indi-
viduals, family members, and caregivers of individ-
uals with autism spectrum disorder who represent the 
entire population of individuals with autism spec-
trum disorder, including the full range of cognitive, 
communicative, behavioral, and adaptive functioning, 
to better inform research findings and future stud-
ies.’’. 
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SEC. 3. PROGRAMS RELATING TO AUTISM. 
(a) DEVELOPMENTAL DISABILITIES SURVEILLANCE 
AND RESEARCH PROGRAM.—Section 399AA of the Public 
Health Service Act (42 U.S.C. 280i) is amended— 
(1) in subsection (b)(1), by striking ‘‘and causes’’ 
and inserting ‘‘causes, and life course’’; and 
(2) in subsection (e), by striking ‘‘2024’’ and in-
serting ‘‘2029’’. 
(b) AUTISM EDUCATION, EARLY DETECTION, AND 
INTERVENTION.—Section 399BB of the Public Health Serv-
ice Act (42 U.S.C. 280i–1) is amended— 
(1) in subsection (a)(2), by striking ‘‘subsequent 
interventions’’ and inserting ‘‘subsequent interven-
tions and services’’; 
(2) in subsection (b)(1), by striking ‘‘culturally 
competent information’’ and inserting ‘‘culturally 
and linguistically responsive information’’; 
(3) in subsection (b)(2)— 
(A) by striking ‘‘promote research’’ and in-
serting ‘‘promote research, which may include 
community-based participatory research,’’; and 
(B) by striking ‘‘screening tools’’ each place 
it appears and inserting ‘‘screening and diag-
nostic tools’’; 
(4) in subsection (b)(3), by striking ‘‘at higher 
risk’’ and inserting ‘‘at increased likelihood’’; 
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(5) in subsection (b)(4), by inserting ‘‘, which 
may include such individuals utilizing parents and 
guardians trained to provide interventions, services, 
and supports’’ before the semicolon at the end; 
(6) in subsection (c)(1), by striking ‘‘culturally 
competent information’’ and inserting ‘‘culturally 
and linguistically responsive information’’; 
(7) in subsection (c)(2)(A)(ii)— 
(A) by striking ‘‘advocates,’’ and inserting 
‘‘advocates, self-advocates,’’; and 
(B) by striking ‘‘culturally competent infor-
mation’’ and inserting ‘‘culturally and linguis-
tically responsive information’’; 
(8) by amending paragraph (1) of subsection (e) 
to read as follows: 
‘‘(1) TRAINING.—The Secretary, in coordination 
with activities conducted under title V of the Social 
Security Act, shall, subject to the availability of ap-
propriations, strengthen the capacity of existing 
training programs and expand existing interdiscipli-
nary training opportunities or opportunities to in-
crease the number of programs that address the health 
and well-being of individuals who have or are at in-
creased likelihood for autism spectrum disorder and 
other neurodevelopmental disabilities across their life-
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span. Activities under the preceding sentence shall in-
clude— 
‘‘(A) awarding competitive grants or coop-
erative agreements to public or nonprofit agen-
cies, including institutions of higher education, 
to expand existing or develop new maternal and 
child health interdisciplinary leadership edu-
cation in neurodevelopmental and related dis-
abilities programs (similar to the programs de-
veloped under section 501(a)(2) of the Social Se-
curity Act) in States that do not have such a 
program; 
‘‘(B) ensuring that trainees under such 
training programs— 
‘‘(i) receive an appropriate balance of 
academic, clinical, and community oppor-
tunities; 
‘‘(ii) are culturally and linguistically 
responsive; 
‘‘(iii) are from various backgrounds; 
‘‘(iv) demonstrate a capacity to evalu-
ate, diagnose or rule out, develop, and pro-
vide evidence-based interventions and pro-
grams to individuals with autism spectrum 
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disorder and other developmental disabil-
ities across their lifespan; and 
‘‘(v) demonstrate an ability to use a 
person- 
and 
family-centered 
approach, 
which may include collaborating with re-
search centers or networks to provide train-
ing for providers of respite care (as defined 
in section 2901); 
‘‘(C) ensuring that program sites provide 
culturally and linguistically responsive services; 
and 
‘‘(D) encouraging training programs to 
partner with appropriate entities to build com-
munity capacity.’’; 
(9) in subsection (e)(2), by adding at the end the 
following new subparagraph: 
‘‘(C) REPORT.—Not later than 2 years after 
September 30, 2024, the Comptroller General of 
the United States shall prepare and submit to 
the Committee on Energy and Commerce of the 
House of Representatives and the Committee on 
Health, Education, Labor, and Pensions of the 
Senate a report examining how to increase the 
number of developmental-behavioral pediatri-
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cians, including through the developmental be-
havioral pediatrician training program.’’; 
(10) in subsection (f)— 
(A) by striking ‘‘promote research’’ and in-
serting ‘‘promote research, including community- 
based participatory research,’’; 
(B) by striking ‘‘physical and behavioral 
health of individuals’’ and inserting ‘‘physical 
and behavioral health, and communication 
needs, of individuals’’; and 
(C) by striking ‘‘disseminate information 
related to such research and guidelines’’ and in-
serting ‘‘disseminate information relating to 
such research and guidelines to improve the 
quality of life and long-term outcomes’’; and 
(11) in subsection (g), by striking ‘‘2024’’ and 
inserting ‘‘2029’’. 
(c) INTERAGENCY
AUTISM
COORDINATING
COM-
MITTEE.—Section 399CC of the Public Health Service Act 
(42 U.S.C. 280i–2) is amended— 
(1) in subsection (b)— 
(A) in paragraph (2), by striking ‘‘develop 
a summary’’ and inserting ‘‘develop and update 
a summary’’; 
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(B) in paragraphs (3) and (4), by striking 
‘‘make recommendations’’ and inserting ‘‘make 
and update recommendations’’; and 
(C) by striking paragraphs (5) and (6) and 
inserting the following: 
‘‘(5) develop and update a strategic plan for the 
conduct of, and support for, autism spectrum disorder 
research, including as practicable for services and 
supports, for individuals with an autism spectrum 
disorder across the lifespan of such individuals and 
the families of such individuals, and across the entire 
population of individuals with autism spectrum dis-
order, including the full range of cognitive, commu-
nicative, behavioral, and adaptive functioning, as 
well as co-occurring conditions and needs for support 
and services, including care necessary for physical 
safety, which such plan shall include proposed budg-
etary requirements and recommendations to ensure 
that autism spectrum disorder research, and services 
and support activities to the extent practicable, of the 
Department of Health and Human Services and of 
other Federal departments and agencies are not un-
necessarily duplicative; and 
‘‘(6) submit to the Congress and President— 
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