Mr. LAMB, Mr. THOMPSON
of Mississippi, Mr. LOEBSACK, Ms. 
DELAURO, Mr. RODNEY DAVIS of Illinois, Mr. GALLEGO, Mr. SHIMKUS, 
Ms. PRESSLEY, Ms. TITUS, Mr. JOYCE of Ohio, Mr. CHABOT, Miss 
GONZA´LEZ-COLO´N of Puerto Rico, Mr. LARSON of Connecticut, Mr. 
JOYCE of Pennsylvania, Ms. JACKSON LEE, Ms. CRAIG, Mr. HURD of 
Texas, Ms. FINKENAUER, Ms. CLARK of Massachusetts, Mrs. DINGELL, 
Mrs. KIRKPATRICK, Mr. LUJA´N, Ms. BLUNT
ROCHESTER, Mr. 
BUTTERFIELD, Mrs. MILLER, Mr. HECK, Mr. HARDER of California, Mr. 
ROUDA, Mrs. LAWRENCE, Mr. GREEN of Texas, Mr. COLLINS of New 
York, Mr. SCHWEIKERT, Mr. GIANFORTE, Mr. ENGEL, Mr. CA´RDENAS, 
Mr. TRONE, Mr. POSEY, Ms. LEE of California, Mrs. TRAHAN, Mr. 
RUSH, Mr. LATTA, Mr. UPTON, Mr. MCEACHIN, Mr. SOTO, Mr. SUOZZI, 
Mr. CARTER of Georgia, Mr. SPANO, Mr. TONKO, Mr. EMMER, Mr. 
LAWSON of Florida, Mr. CISNEROS, Mr. CARBAJAL, Mr. O’HALLERAN, 
Ms. OMAR, Mrs. BROOKS of Indiana, Mr. STEUBE, Mr. TED LIEU of 
California, Ms. ROYBAL-ALLARD, Mr. PHILLIPS, Ms. FUDGE, Ms. 
MCCOLLUM, Mr. GUTHRIE, Mr. PAPPAS, Mr. THOMPSON of Pennsyl-
vania, Ms. UNDERWOOD, Mr. HUFFMAN, Ms. KAPTUR, Mr. MARSHALL, 
Mr. BARR, Ms. WEXTON, Ms. WASSERMAN SCHULTZ, Ms. SCHAKOWSKY, 
Mr. WALDEN, Mr. JOHNSON of South Dakota, Mr. HIMES, Mrs. LOWEY, 
Mr. ZELDIN, Mr. VAN DREW, Mr. NEGUSE, Mr. HAGEDORN, Ms. HER-
RERA BEUTLER, Mr. QUIGLEY, Mr. SABLAN, Mr. GONZALEZ of Ohio, and 
Ms. KENDRA S. HORN of Oklahoma 
JULY 23, 2019 
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 7, 2019] 
A BILL 
To reauthorize certain provisions of the Public Health 
Service Act relating to autism, and for other purposes. 
VerDate Sep 11 2014 
20:11 Jul 24, 2019
Jkt 089200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6652
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
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 
2019’’ or the ‘‘Autism CARES Act of 2019’’. 
SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINA-
TION OF ACTIVITIES OF THE NIH WITH RE-
SPECT 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 inter-
ventions to maximize outcomes for individuals 
with autism spectrum disorder’’; and 
(B) by striking the second sentence and in-
serting the following: ‘‘Such research shall inves-
tigate the causes (including possible environ-
mental causes), diagnosis or ruling out, early 
and ongoing detection, prevention, services across 
the lifespan, supports, intervention, and treat-
ment of autism spectrum disorder, including dis-
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00003
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
semination 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 ‘‘dis-
order’’ and inserting ‘‘causes, diagnosis, 
early and ongoing detection, prevention, 
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, ge-
netics, genomics, psychopharmacology, de-
velopmental psychology, behavioral psy-
chology, and clinical psychology.’’; and 
(B) in paragraph (3), by adding at the end 
the following: 
‘‘(D) REDUCING DISPARITIES.—The Direc-
tor may consider, as appropriate, the extent to 
which a center can demonstrate availability and 
access to clinical services for youth and adults 
from diverse racial, ethnic, geographic, or lin-
guistic backgrounds in decisions about awarding 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00004
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
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 spectrum 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 officials’’; 
(B) by striking ‘‘or other developmental dis-
abilities’’ and inserting ‘‘and other develop-
mental disabilities’’; 
(3) in subsection (a)(3), by striking ‘‘a univer-
sity, or any other educational institution’’ and insert-
ing ‘‘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 disability researchers, and advocates 
for individuals with developmental disabilities’’ and 
inserting ‘‘State, local, and Tribal public health offi-
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00005
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
cials, private sector developmental disability research-
ers, advocates for individuals with autism spectrum 
disorder, and advocates for individuals with other de-
velopmental disabilities’’; 
(5) in subsection (d)— 
(A) by redesignating paragraphs (1) and 
(2) as paragraphs (2) and (3), respectively; and 
(B) by inserting before paragraph (2), as so 
redesignated, 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 in-
serting ‘‘2024’’. 
(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)(1)— 
(A) by striking ‘‘individuals with autism 
spectrum disorder or other developmental dis-
abilities’’ and inserting ‘‘individuals with au-
tism spectrum disorder and other developmental 
disabilities’’; and 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00006
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
(B) by striking ‘‘children with autism spec-
trum disorder’’ and all that follows through ‘‘dis-
abilities;’’ and inserting ‘‘individuals with au-
tism spectrum disorder and other developmental 
disabilities across their lifespan;’’; 
(2) in subsection (b)— 
(A) in paragraph (2), by inserting ‘‘indi-
viduals with’’ before ‘‘autism spectrum disorder’’; 
(B) 
by 
redesignating 
paragraphs 
(4) 
through (6) as paragraphs (5) through (7), re-
spectively; and 
(C) by inserting after paragraph (3) the fol-
lowing: 
‘‘(4) promote evidence-based screening techniques 
and interventions for individuals with autism spec-
trum disorder and other developmental disabilities 
across their lifespan;’’; 
(3) in subsection (c)— 
(A) in paragraph (1), in the matter pre-
ceding subparagraph (A), by striking ‘‘the needs 
of individuals with autism spectrum disorder or 
other developmental disabilities and their fami-
lies’’ and inserting ‘‘the needs of individuals 
with autism spectrum disorder and other devel-
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00007
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
opmental disabilities across their lifespan and 
the needs of their families’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (A)(ii), by strik-
ing ‘‘caregivers of individuals with an au-
tism spectrum disorder’’ and inserting 
‘‘caregivers of individuals with autism spec-
trum disorder or other developmental dis-
abilities’’; 
(ii) in subparagraph (B)(i)(II), by in-
serting ‘‘autism spectrum disorder and’’ 
after ‘‘individuals with’’; and 
(iii) in subparagraph (B)(ii), by in-
serting ‘‘autism spectrum disorder and’’ 
after ‘‘individuals with’’; 
(4) in subsection (e)— 
(A) in paragraph (1)— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘across their life-
span’’ before ‘‘and ensure’’; and 
(ii) in subparagraph (B)(iv), by in-
serting ‘‘across their lifespan’’ after ‘‘other 
developmental disabilities’’; 
(B) by redesignating paragraphs (2) and 
(3) as paragraphs (3) and (4), respectively; and 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00008
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
(C) by inserting after paragraph (1) the fol-
lowing: 
‘‘(2) DEVELOPMENTAL-BEHAVIORAL
PEDIATRI-
CIAN TRAINING PROGRAMS.— 
‘‘(A) IN
GENERAL.—In making awards 
under this 
subsection, 
the 
Secretary 
may 
prioritize awards to applicants that are develop-
mental-behavioral pediatrician training pro-
grams located in rural or underserved areas. 
‘‘(B) 
DEFINITION
OF
UNDERSERVED 
AREA.—In this paragraph, 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 des-
ignated by the Secretary as an area with a 
shortage of personal health services (as de-
scribed in section 330(b)(3)(A)).’’; 
(5) in subsection (f), by inserting ‘‘across the 
lifespan of such individuals’’ after ‘‘other develop-
mental disabilities’’; and 
(6) in subsection (g), by striking ‘‘2019’’ and in-
serting ‘‘2024’’. 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00009
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
(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 inserting ‘‘across 
the lifespan of such individuals’’ before the semi-
colon; and 
(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 Depart-
ment 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 additional 4-year terms’’ and inserting 
‘‘one additional 4-year term’’; and 
(3) in subsection (f), by striking ‘‘2019’’ and in-
serting ‘‘2024’’. 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00010
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
(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 insert-
ing ‘‘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 community-based services and other sup-
ports to ensure that individuals with autism 
spectrum disorder and other developmental dis-
abilities are living, working, and participating 
in their community.’’; and 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00011
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
(2) in subsection (b)— 
(A) in the heading, by striking ‘‘YOUNG 
ADULTS AND TRANSITIONING YOUTH’’ and in-
serting ‘‘THE HEALTH AND WELL-BEING OF IN-
DIVIDUALS WITH AUTISM SPECTRUM DISORDER 
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, Education, Labor, and Pen-
sions 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 follows: 
‘‘(A) demographic factors associated with 
the health and well-being of individuals with au-
tism spectrum disorder;’’; 
(ii) in subparagraph (B), by striking 
‘‘young adults’’ and all that follows through 
the semicolon and inserting ‘‘the health and 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00012
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
well-being of individuals with autism spec-
trum disorder, including an identification 
of existing Federal laws, regulations, poli-
cies, 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 pro-
viders receiving Federal funding; 
‘‘(D) comprehensive approaches to improv-
ing health outcomes and well-being for individ-
uals with autism spectrum disorder, including— 
‘‘(i) community-based behavioral sup-
ports and interventions; 
‘‘(ii) nutrition, recreational, and social 
activities; and 
‘‘(iii) personal safety services related to 
public safety agencies or the criminal jus-
tice system for such individuals; and 
‘‘(E) recommendations that seek to improve 
health outcomes for such individuals, including 
across their lifespan, by addressing— 
‘‘(i) screening and diagnosis of chil-
dren and adults; 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00013
Fmt 6652
Sfmt 6203
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
(3) in subsection (c), by striking ‘‘there is au-
thorized to be appropriated $190,000,000 for each of 
fiscal years 2015 through 2019’’ and inserting ‘‘there 
are authorized to be appropriated $296,000,000 for 
each of fiscal years 2020 through 2024’’. 
Amend the title so as to read: ‘‘A bill 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.’’. 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS
Union Calendar No. 137 
116TH CONGRESS 
1ST SESSION 
H. R. 1058 
[Report No. 116–177] 
A BILL 
To reauthorize certain provisions of the Public 
Health Service Act relating to autism, and for 
other purposes. 
JULY 23, 2019 
Reported with amendments, committed to the Committee 
of the Whole House on the State of the Union, and or-
dered to be printed 
VerDate Sep 11 2014 
01:46 Jul 24, 2019
Jkt 034408
PO 00000
Frm 00016
Fmt 6651
Sfmt 6651
E:\BILLS\H1058.RH
H1058
pbinns on DSK79D2C42PROD with BILLS