IB 
Union Calendar No. 365 
113TH CONGRESS 
2D SESSION 
H. R. 4631 
[Report No. 113–490] 
To reauthorize certain provisions of the Public Health Service Act relating 
to autism, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 9, 2014 
Mr. SMITH of New Jersey (for himself, Mr. DOYLE, Mrs. MCMORRIS ROD-
GERS, Mr. VAN HOLLEN, Mr. SESSIONS, Mr. WOLF, Mr. STIVERS, Mr. 
MEEHAN, Mr. MORAN, Mrs. BLACKBURN, Mr. MILLER of Florida, Mrs. 
WALORSKI, Mr. LARSON of Connecticut, Ms. JACKSON LEE, Mr. HAR-
PER, Mr. LANCE, Mr. MEADOWS, Mr. MARINO, Mr. DEUTCH, Mr. ROO-
NEY, Mr. POMPEO, Mr. ADERHOLT, Mr. BACHUS, Mr. GIBSON, Mrs. 
MILLER of Michigan, Mr. YOUNG of Alaska, Mr. KING of New York, Ms. 
SHEA-PORTER, Ms. DELAURO, Mr. MURPHY of Pennsylvania, Mr. 
FITZPATRICK, Mr. TERRY, Mr. KELLY of Pennsylvania, Mr. YODER, and 
Mr. MATHESON) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
JUNE 23, 2014 
Additional sponsors: Mr. ROE of Tennessee, Ms. JENKINS, Mr. MCGOVERN, 
Mr. ISRAEL, Ms. SLAUGHTER, Mr. VARGAS, Mr. DAVID SCOTT of Geor-
gia, Mr. GRIMM, Mr. FORTENBERRY, Mr. BISHOP of Georgia, Ms. NOR-
TON, Ms. ROYBAL-ALLARD, Mr. ELLISON, Mr. CARSON of Indiana, Mr. 
SCHOCK, Mr. DAINES, Mr. QUIGLEY, Mrs. CAPITO, Mr. HUFFMAN, Mr. 
FATTAH, Mr. MCINTYRE, Mr. LIPINSKI, Mr. PETERSON, Mr. BILIRAKIS, 
Mr. SHIMKUS, Mr. ROSKAM, Mr. BURGESS, Mr. GERLACH, Ms. 
SCHWARTZ, Mr. HOLDING, Mrs. CAROLYN B. MALONEY of New York, 
Mr. BRALEY of Iowa, Mr. SCHIFF, Ms. KAPTUR, Mr. GRIFFIN of Arkan-
sas, Mr. HECK of Nevada, Mr. MCKEON, Mrs. MCCARTHY of New York, 
Mr. CARNEY, Mr. WELCH, Ms. ESTY, Ms. ESHOO, Mr. KENNEDY, Mr. 
SENSENBRENNER, Mr. JOYCE, Mr. KLINE, Mr. WALZ, Mrs. BUSTOS, Mr. 
HOLT, Mr. BARLETTA, Ms. BASS, and Ms. DUCKWORTH 
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JUNE 23, 2014 
Reported with an amendment, 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 May 9, 2014] 
A BILL 
To reauthorize certain provisions of the Public Health 
Service Act relating to autism, 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 
2014’’ or the ‘‘Autism CARES Act of 2014’’. 
SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER INITIA-
TIVE. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall designate an existing official within 
the Department of Health and Human Services to oversee, 
in consultation with the Secretaries of Defense and Edu-
cation, national autism spectrum disorder research, serv-
ices, and support activities. 
(b) DUTIES.—The official designated under subsection 
(a) shall— 
(1) implement autism spectrum disorder activi-
ties, taking into account the strategic plan developed 
by the Interagency Autism Coordinating Committee 
under section 399CC(b) of the Public Health Service 
Act (42 U.S.C. 280i–2(b)); and 
(2) ensure that autism spectrum disorder activi-
ties of the Department of Health and Human Services 
and of other Federal departments and agencies are 
not unnecessarily duplicative. 
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SEC. 3. RESEARCH PROGRAM. 
Section 399AA of the Public Health Service Act (42 
U.S.C. 280i) is amended— 
(1) in subsection (a)(1), by inserting ‘‘for chil-
dren and adults’’ after ‘‘reporting of State epidemio-
logical data’’; 
(2) in subsection (b)(1)— 
(A) by striking ‘‘establishment of regional 
centers of excellence’’ and inserting ‘‘establish-
ment or support of regional centers of excel-
lence’’; and 
(B) by inserting ‘‘for children and adults’’ 
before the period at the end; 
(3) in subsection (b)(2), by striking ‘‘center to be 
established’’ and inserting ‘‘center to be established or 
supported’’; and 
(4) in subsection (e), by striking ‘‘2014’’ and in-
serting ‘‘2019’’. 
SEC. 4. AUTISM INTERVENTION. 
Section 399BB of the Public Health Service Act (42 
U.S.C. 280i–1) is amended— 
(1) in subsection (b)(1), by inserting ‘‘culturally 
competent’’ after ‘‘provide’’; 
(2) in subsection (c)(2)(A)(ii), by inserting 
‘‘(which may include respite care for caregivers of in-
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dividuals with an autism spectrum disorder)’’ after 
‘‘services and supports’’; 
(3) in subsection (e)(1)(B)(v), by inserting before 
the semicolon the following: ‘‘, which may include col-
laborating with research centers or networks to pro-
vide training for providers of respite care (as defined 
in section 2901)’’; 
(4) in subsection (f), by striking ‘‘grants or con-
tracts’’ and all that follows through ‘‘for individuals 
with’’ and inserting ‘‘grants or contracts, which may 
include grants or contracts to research centers or net-
works, to determine the evidence-based practices for 
interventions to improve the physical and behavioral 
health of individuals with’’; and 
(5) in subsection (g), by striking ‘‘2014’’ and in-
serting ‘‘2019’’. 
SEC. 5. 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 (1)— 
(i) by striking ‘‘and annually update’’; 
and 
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(ii) by striking ‘‘intervention’’ and in-
serting ‘‘interventions, including school and 
community-based interventions’’; 
(B) by striking paragraph (2); 
(C) by redesignating paragraph (1) as 
paragraph (2), and inserting before such redesig-
nated paragraph the following: 
‘‘(1) monitor autism spectrum disorder research, 
and to the extent practicable services and support ac-
tivities, across all Federal departments and agencies, 
including coordination of Federal activities with re-
spect to autism spectrum disorder;’’; 
(D) in paragraph (3), by striking ‘‘rec-
ommendations to the Director of NIH’’; 
(E) in paragraph (4), by inserting before 
the semicolon the following: ‘‘, and the process by 
which public feedback can be better integrated 
into such decisions’’; and 
(F) by striking paragraphs (5) and (6) and 
inserting the following: 
‘‘(5) develop a strategic plan for the conduct of, 
and support for, autism spectrum disorder research 
and services and supports for individuals with an au-
tism spectrum disorder and the families of such indi-
viduals, which shall include— 
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‘‘(A) proposed budgetary requirements; and 
‘‘(B) recommendations to ensure that au-
tism spectrum disorder research, services, and 
support activities of the Department of Health 
and Human Services and of other Federal de-
partments and agencies are not unnecessarily 
duplicative; and 
‘‘(6) submit to Congress and the President— 
‘‘(A) an annual update on the summary of 
advances described in paragraph (2); and 
‘‘(B) an annual update to the strategic plan 
described in paragraph (5), including any 
progress made in achieving the goals outlined in 
such strategic plan.’’; 
(2) in subsection (c)— 
(A) in paragraph (1)— 
(i) by striking the paragraph designa-
tion, the heading, and the matter preceding 
subparagraph (A) and inserting the fol-
lowing: 
‘‘(1) FEDERAL
MEMBERSHIP.—The Committee 
shall be composed of the following Federal members— 
’’; 
(ii) in subparagraph (C)— 
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(I) by inserting ‘‘, such as the Ad-
ministration for Community Living, 
Administration for Children and Fam-
ilies, the Centers for Medicare & Med-
icaid Services, the Food and Drug Ad-
ministration, and the Health Resources 
and Services Administration’’ before 
the semicolon at the end; and 
(II) by adding at the end ‘‘and’’; 
(iii) in subparagraph (D)— 
(I) by inserting ‘‘and the Depart-
ment of Defense’’ after ‘‘Department of 
Education’’; and 
(II) by striking at the end ‘‘; and’’ 
and inserting a period; and 
(iv) by striking subparagraph (E); 
(B) in paragraph (2)— 
(i) in the paragraph heading, by strik-
ing ‘‘ADDITIONAL’’ and inserting ‘‘NON- 
FEDERAL’’; 
(ii) in the matter preceding subpara-
graph (A), by striking ‘‘Not fewer than 6 
members of the Committee, or 1/3 of the 
total membership of the Committee, which-
ever is greater’’ and inserting ‘‘Not more 
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than 1⁄2, but not fewer than 1/3, of the total 
membership of the Committee’’; 
(iii) in subparagraph (A), by striking 
‘‘one such member shall be an individual’’ 
and inserting ‘‘two such members shall be 
individuals’’; 
(iv) in subparagraph (B), by striking 
‘‘one such member shall be a parent or legal 
guardian’’ and inserting ‘‘two such mem-
bers shall be parents or legal guardians’’; 
and 
(v) in subparagraph (C), by striking 
‘‘one such member shall be a representative’’ 
and inserting ‘‘two such members shall be 
representatives’’; and 
(C) by adding at the end the following: 
‘‘(3) PERIOD OF APPOINTMENT; VACANCIES.— 
‘‘(A) PERIOD OF APPOINTMENT FOR NON- 
FEDERAL
MEMBERS.—Non-Federal 
members 
shall serve for a term of 4 years, and may be re-
appointed for one or more additional 4-year 
terms. 
‘‘(B) VACANCIES.—A vacancy on the Com-
mittee shall be filled in the manner in which the 
original appointment was made and shall not 
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affect the power or duties of the Committee. Any 
member appointed to fill a vacancy for an unex-
pired term shall be appointed for the remainder 
of such term. A member may serve after the expi-
ration of the member’s term until a successor has 
been appointed.’’; 
(3) in subsection (d)— 
(A) by striking paragraph (2); and 
(B) by redesignating paragraphs (3) and 
(4) as paragraphs (2) and (3), respectively; and 
(4) in subsection (f), by striking ‘‘2014’’ and in-
serting ‘‘2019’’. 
SEC. 6. REPORTS. 
Section 399DD of the Public Health Service Act (42 
U.S.C. 280i–3) is amended— 
(1) in the section heading, by striking ‘‘RE-
PORT’’ and inserting ‘‘REPORTS’’; 
(2) in subsection (b), by redesignating para-
graphs (1) through (9) as subparagraphs (A) through 
(I), respectively, and realigning the margins accord-
ingly; 
(3) by redesignating subsections (a) and (b) as 
paragraphs (1) and (2), respectively, and realigning 
the margins accordingly; 
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(4) by inserting after the section heading the fol-
lowing: 
‘‘(a) PROGRESS REPORT.—’’; 
(5) in subsection (a)(1) (as so redesignated)— 
(A) by striking ‘‘2 years after the date of 
enactment of the Combating Autism Reauthor-
ization Act of 2011’’ and inserting ‘‘4 years after 
the date of enactment of the Autism CARES Act 
of 2014’’; 
(B) by inserting ‘‘and the Secretary of De-
fense’’ after ‘‘the Secretary of Education’’; and 
(C) by inserting ‘‘, and make publicly 
available, including through posting on the 
Internet Web site of the Department of Health 
and Human Services,’’ after ‘‘Representatives’’; 
and 
(6) in subsection (a)(2) (as so redesignated)— 
(A) in subparagraph (A), (as so redesig-
nated), by striking ‘‘Combating Autism Act of 
2006’’ and inserting ‘‘Autism CARES Act of 
2014’’; 
(B) in subparagraph (B) (as so redesig-
nated), by striking ‘‘particular provisions of 
Combating Autism Act of 2006’’ and inserting 
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‘‘amendments made by the Autism CARES Act 
of 2014’’; 
(C) by striking subparagraph (C) (as so re-
designated), and inserting the following: 
‘‘(C) information on the incidence and 
prevalence of autism spectrum disorder, includ-
ing available information on the prevalence of 
autism spectrum disorder among children and 
adults, and identification of any changes over 
time with respect to the incidence and prevalence 
of autism spectrum disorder;’’; 
(D) in subparagraph (D) (as so redesig-
nated), by striking ‘‘6-year period beginning on 
the date of enactment of the Combating Autism 
Act of 2006’’ and inserting ‘‘4-year period begin-
ning on the date of enactment of the Autism 
CARES Act of 2014 and, as appropriate, how 
this age varies across populations subgroups’’; 
(E) in subparagraph (E) (as so redesig-
nated), by striking ‘‘6-year period beginning on 
the date of enactment of the Combating Autism 
Act of 2006’’ and inserting ‘‘4-year period begin-
ning on the date of enactment of the Autism 
CARES Act of 2014 and, as appropriate, how 
this age varies across populations subgroups’’; 
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(F) in subparagraph (F) (as so redesig-
nated), by inserting ‘‘and, as appropriate, on 
how such average time varies across populations 
subgroups’’ before the semicolon at the end; 
(G) in subparagraph (G) (as so redesig-
nated)— 
(i) by striking ‘‘including by various 
subtypes,’’ and inserting ‘‘including by se-
verity level as practicable,’’; and 
(ii) by striking ‘‘child may’’ and in-
serting ‘‘child or other factors, such as de-
mographic characteristics, may’’; and 
(H) by striking subparagraph (I) (as so re-
designated), and inserting the following: 
‘‘(I) a description of the actions taken to 
implement and the progress made on implemen-
tation of the strategic plan developed by the 
Interagency Autism Coordinating Committee 
under section 399CC(b).’’; and 
(7) by adding at the end the following new sub-
section: 
‘‘(b) REPORT ON YOUNG ADULTS AND TRANSITIONING 
YOUTH.— 
‘‘(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of the Autism CARES Act of 
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