H. R. 1058 
One Hundred Sixteenth Congress 
of the 
United States of America 
AT THE FIRST SESSION 
Begun and held at the City of Washington on Thursday, 
the third day of January, two thousand and nineteen 
An Act 
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, and for other purposes. 
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 ‘‘Autism Collaboration, Account-
ability, Research, Education, and Support Act of 2019’’ or the 
‘‘Autism CARES Act of 2019’’. 
SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINATION OF 
ACTIVITIES OF THE NIH WITH RESPECT TO RESEARCH ON 
AUTISM SPECTRUM DISORDER. 
Section 409C of the Public Health Service Act (42 U.S.C. 284g) 
is amended— 
(1) in subsection (a)(1)— 
(A) in the first sentence, by striking ‘‘and toxicology’’ 
and inserting ‘‘toxicology, and interventions to maximize 
outcomes for individuals with autism spectrum disorder’’; 
and 
(B) by striking the second sentence and inserting the 
following: ‘‘Such research shall investigate the causes 
(including possible environmental causes), diagnosis or 
ruling out, early and ongoing detection, prevention, services 
across the lifespan, supports, intervention, and treatment 
of autism spectrum disorder, including dissemination and 
implementation of clinical care, supports, interventions, 
and treatments.’’; 
(2) in subsection (b)— 
(A) in paragraph (2)— 
(i) in the second sentence, by striking ‘‘cause’’ and 
all that follows through ‘‘disorder’’ and inserting 
‘‘causes, diagnosis, early and ongoing detection, preven-
tion, and treatment of autism spectrum disorder across 
the lifespan’’; and 
(ii) in the third sentence, by striking ‘‘neurobiology’’ 
and all that follows through the period and inserting 
‘‘neurobiology, 
genetics, 
genomics, 
psychopharmacology, 
developmental 
psychology, 
behavioral psychology, and clinical psychology.’’; and 
(B) in paragraph (3), by adding at the end the following: 
‘‘(D) REDUCING DISPARITIES.—The Director may con-
sider, as appropriate, the extent to which a center can
H. R. 1058—2 
demonstrate availability and access to clinical services for 
youth and adults from diverse racial, ethnic, geographic, 
or linguistic backgrounds in decisions about awarding 
grants to applicants which meet the scientific criteria for 
funding under this section.’’. 
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 (a)(1), by striking ‘‘adults on autism spec-
trum disorder’’ and inserting ‘‘adults with autism spectrum 
disorder’’; 
(2) in subsection (a)(2)— 
(A) by striking ‘‘State and local public health officials’’ 
and inserting ‘‘State, local, and Tribal public health offi-
cials’’; 
(B) by striking ‘‘or other developmental disabilities’’ 
and inserting ‘‘and other developmental disabilities’’; 
(3) in subsection (a)(3), by striking ‘‘a university, or any 
other educational institution’’ and inserting ‘‘a university, any 
other educational institution, an Indian tribe, or a tribal 
organization’’; 
(4) in subsection (b)(2)(A), by striking ‘‘relevant State and 
local public health officials, private sector developmental dis-
ability researchers, and advocates for individuals with develop-
mental disabilities’’ and inserting ‘‘State, local, and Tribal 
public health officials, private sector developmental disability 
researchers, advocates for individuals with autism spectrum 
disorder, and advocates for individuals with other develop-
mental disabilities’’; 
(5) in subsection (d)— 
(A) by redesignating paragraphs (1) and (2) as para-
graphs (2) and (3), respectively; and 
(B) by inserting before paragraph (2), as so redesig-
nated, the following new paragraph: 
‘‘(1) INDIAN
TRIBE; 
TRIBAL
ORGANIZATION.—The terms 
‘Indian tribe’ and ‘tribal organization’ have the meanings given 
such terms in section 4 of the Indian Health Care Improvement 
Act.’’; and 
(6) in subsection (e), by striking ‘‘2019’’ and inserting 
‘‘2024’’. 
(b) AUTISM EDUCATION, EARLY DETECTION, AND INTERVEN-
TION.—Section 399BB of the Public Health Service Act (42 U.S.C. 
280i–1) is amended— 
(1) in subsection (a)(1)— 
(A) by striking ‘‘individuals with autism spectrum dis-
order or other developmental disabilities’’ and inserting 
‘‘individuals with autism spectrum disorder and other 
developmental disabilities’’; and 
(B) by striking ‘‘children with autism spectrum dis-
order’’ and all that follows through ‘‘disabilities;’’ and 
inserting ‘‘individuals with autism spectrum disorder and 
other developmental disabilities across their lifespan;’’; 
(2) in subsection (b)— 
(A) in paragraph (2), by inserting ‘‘individuals with’’ 
before ‘‘autism spectrum disorder’’;
H. R. 1058—3 
(B) by redesignating paragraphs (4) through (6) as 
paragraphs (5) through (7), respectively; and 
(C) by inserting after paragraph (3) the following: 
‘‘(4) promote evidence-based screening techniques and inter-
ventions for individuals with autism spectrum disorder and 
other developmental disabilities across their lifespan;’’; 
(3) in subsection (c)— 
(A) in paragraph (1), in the matter preceding subpara-
graph (A), by striking ‘‘the needs of individuals with autism 
spectrum disorder or other developmental disabilities and 
their families’’ and inserting ‘‘the needs of individuals with 
autism spectrum disorder and other developmental disabil-
ities across their lifespan and the needs of their families’’; 
and 
(B) in paragraph (2)— 
(i) in subparagraph (A)(ii), by striking ‘‘caregivers 
of individuals with an autism spectrum disorder’’ and 
inserting ‘‘caregivers of individuals with autism spec-
trum disorder or other developmental disabilities’’; 
(ii) in subparagraph (B)(i)(II), by inserting ‘‘autism 
spectrum disorder and’’ after ‘‘individuals with’’; and 
(iii) in subparagraph (B)(ii), by inserting ‘‘autism 
spectrum disorder and’’ after ‘‘individuals with’’; 
(4) in subsection (e)— 
(A) in paragraph (1)— 
(i) in the matter preceding subparagraph (A), by 
inserting ‘‘across their lifespan’’ before ‘‘and ensure’’; 
and 
(ii) in subparagraph (B)(iv), by inserting ‘‘across 
their lifespan’’ after ‘‘other developmental disabilities’’; 
(B) by redesignating paragraphs (2) and (3) as para-
graphs (3) and (4), respectively; and 
(C) by inserting after paragraph (1) the following: 
‘‘(2) DEVELOPMENTAL-BEHAVIORAL
PEDIATRICIAN
TRAINING 
PROGRAMS.— 
‘‘(A) IN GENERAL.—In making awards under this sub-
section, the Secretary may prioritize awards to applicants 
that are developmental-behavioral pediatrician training 
programs located in rural or underserved areas. 
‘‘(B) DEFINITION OF UNDERSERVED AREA.—In this para-
graph, the term ‘underserved area’ means— 
‘‘(i) a health professional shortage area (as defined 
in section 332(a)(1)(A)); and 
‘‘(ii) an urban or rural area designated by the 
Secretary as an area with a shortage of personal health 
services (as described in section 330(b)(3)(A)).’’; 
(5) in subsection (f), by inserting ‘‘across the lifespan of 
such individuals’’ after ‘‘other developmental disabilities’’; and 
(6) in subsection (g), by striking ‘‘2019’’ and inserting 
‘‘2024’’. 
(c) INTERAGENCY AUTISM COORDINATING COMMITTEE.—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 inserting ‘‘across the lifespan 
of such individuals’’ before the semicolon; and
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(B) in paragraph (5), by inserting ‘‘across the lifespan 
of such individuals’’ before ‘‘and the families’’; 
(2) in subsection (c)— 
(A) in paragraph (1)(D), by inserting ‘‘, the Department 
of Labor, the Department of Justice, the Department of 
Veterans Affairs, the Department of Housing and Urban 
Development,’’ after ‘‘Department of Education’’; 
(B) in subparagraphs (A), (B), and (C) of paragraph 
(2), by striking ‘‘at least two such members’’ each place 
it appears and inserting ‘‘at least three such members’’; 
(C) in paragraph (3)(A), by striking ‘‘one or more addi-
tional 4-year terms’’ and inserting ‘‘one additional 4-year 
term’’; and 
(3) in subsection (f), by striking ‘‘2019’’ and inserting ‘‘2024’’. 
(d) REPORTS TO CONGRESS.—Section 399DD of the Public Health 
Service Act (42 U.S.C. 280i–3) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by striking ‘‘Autism CARES Act 
of 2014’’ and inserting ‘‘Autism CARES Act of 2019’’; and 
(B) in paragraph (2)— 
(i) in subparagraphs (A), (B), (D), and (E), by 
striking ‘‘Autism CARES Act of 2014’’ each place it 
appears and inserting ‘‘Autism CARES Act of 2019’’; 
(ii) in subparagraph (G), by striking ‘‘age of the 
child’’ and inserting ‘‘age of the individual’’; 
(iii) in subparagraph (H), by striking ‘‘; and’’ and 
inserting ‘‘;’’; 
(iv) in subparagraph (I), by striking the period 
and inserting ‘‘; and’’; and 
(v) by adding at the end the following: 
‘‘(J) information on how States use home- and commu-
nity-based services and other supports to ensure that 
individuals with autism spectrum disorder and other 
developmental disabilities are living, working, and partici-
pating in their community.’’; and 
(2) in subsection (b)— 
(A) in the heading, by striking ‘‘YOUNG ADULTS AND 
TRANSITIONING YOUTH’’ and inserting ‘‘THE HEALTH AND 
WELL-BEING OF INDIVIDUALS WITH AUTISM SPECTRUM DIS-
ORDER ACROSS THEIR LIFESPAN’’; 
(B) by amending paragraph (1) to read as follows: 
‘‘(1) IN GENERAL.—Not later than 2 years after the date 
of enactment of the Autism CARES Act of 2019, the Secretary 
shall prepare and submit, to the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Representatives, 
a report concerning the health and well-being of individuals 
with autism spectrum disorder.’’; and 
(C) in paragraph (2)— 
(i) by amending subparagraph (A) to read as fol-
lows: 
‘‘(A) demographic factors associated with the health 
and well-being of individuals with autism spectrum dis-
order;’’; 
(ii) in subparagraph (B), by striking ‘‘young adults’’ 
and all that follows through the semicolon and 
inserting ‘‘the health and well-being of individuals with
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autism spectrum disorder, including an identification 
of existing Federal laws, regulations, policies, research, 
and programs;’’; and 
(iii) by amending subparagraphs (C), (D), and (E) 
to read as follows: 
‘‘(C) recommendations on establishing best practices 
guidelines to ensure interdisciplinary coordination between 
all relevant service providers receiving Federal funding; 
‘‘(D) comprehensive approaches to improving health 
outcomes and well-being for individuals with autism spec-
trum disorder, including— 
‘‘(i) community-based behavioral supports and 
interventions; 
‘‘(ii) nutrition, recreational, and social activities; 
and 
‘‘(iii) personal safety services related to public 
safety agencies or the criminal justice system for such 
individuals; and 
‘‘(E) recommendations that seek to improve health out-
comes for such individuals, including across their lifespan, 
by addressing— 
‘‘(i) screening and diagnosis of children and adults; 
‘‘(ii) behavioral and other therapeutic approaches; 
‘‘(iii) primary and preventative care; 
‘‘(iv) communication challenges; 
‘‘(v) aggression, self-injury, elopement, and other 
behavioral issues; 
‘‘(vi) emergency room visits and acute care hos-
pitalization; 
‘‘(vii) treatment for co-occurring physical and 
mental health conditions; 
‘‘(viii) premature mortality; 
‘‘(ix) medical practitioner training; and 
‘‘(x) caregiver mental health.’’. 
(e) AUTHORIZATION OF APPROPRIATIONS.—Section 399EE of the 
Public Health Service Act (42 U.S.C. 280i–4) is amended— 
(1) in subsection (a), by striking ‘‘$22,000,000 for each 
of fiscal years 2015 through 2019’’ and inserting ‘‘$23,100,000 
for each of fiscal years 2020 through 2024’’; 
(2) in subsection (b), by striking ‘‘$48,000,000 for each 
of fiscal years 2015 through 2019’’ and inserting ‘‘$50,599,000 
for each of fiscal years 2020 through 2024’’; and 
(3) in subsection (c), by striking ‘‘there is authorized to 
be appropriated $190,000,000 for each of fiscal years 2015