I 116th CONGRESS 1st Session H. R. 1058 IN THE HOUSE OF REPRESENTATIVES February 7, 2019 Mr. Smith of New Jersey (for himself and Mr. Michael F. Doyle of Pennsylvania ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To reauthorize certain provisions of the Public Health Service Act relating to autism, and for other purposes.

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 . 2. Expansion, intensification, and coordination of activities of National Institutes of Health 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) by inserting after and toxicology the following: , and interventions to maximize outcomes for persons with autism spectrum disorder ; (B) by inserting after early the following: and ongoing ; and (C) by inserting after treatment of autism spectrum disorder the following: , including dissemination and implementation of clinical care, supports, intervention, and treatment ; and (2) in subsection (b)— (A) by amending paragraph (2) to read as follows: (2) Research Each center under paragraph (1) shall conduct basic and clinical research into autism spectrum disorder. Such research should include investigations into the causes, diagnosis, and early and ongoing detection, prevention, and treatment of autism spectrum disorder across the lifespan. The centers, as a group, shall conduct research including in the fields of developmental neurobiology, genetics, psychopharmacology, ge­nom­ics, and developmental, behavioral, and clinical psychology. ; and (B) in paragraph (3), by adding at the end the following new subparagraph: (D) Reducing disparities In awarding grants to applicants which meet the scientific criteria for funding under this section, the Director 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 linguistic backgrounds. . 3. Developmental disabilities surveillance and research program Section 399AA(e) of the Public Health Service Act ( 42 U.S.C. 280i(e) ) is amended by striking 2019 and inserting 2024 . 4. Autism education, early detection, and intervention Section 399BB of the Public Health Service Act ( 42 U.S.C. 280i–1 ) is amended— (1) in subsection (a)(1), by striking for children and inserting for individuals ; (2) in subsection (b)— (A) by redesignating paragraphs (4) through (6) as paragraphs (5) through (7), respectively; and (B) by inserting after paragraph (3) the following new paragraph: (4) promote evidence-based screening techniques and interventions for individuals with autism spectrum disorder across their lifespans; ; (3) in subsection (c)(1), in the matter preceding subparagraph (A), by inserting after needs of individuals with autism spectrum disorder or other developmental disabilities the following: across the lifespan of such individuals ; (4) in subsection (e), by adding at the end the following new paragraph: (4) Prioritization (A) In general In awarding grants and agreements under paragraphs (1) and (2), the Secretary may prioritize awards to training programs described in paragraph (1) that are developmental-behavioral pediatrician training programs located in rural areas or underserved areas. (B) Underserved area defined In this paragraph, the term underserved area means— (i) an area described in section 332(a)(1)(A); and (ii) a medically underserved population (as defined in section 330(b)(3)(A)). ; (5) in subsection (f), by inserting after individuals with autism spectrum disorder or other developmental disabilities the following: across the lifespan of such individuals ; and (6) in subsection (g), by striking 2019 and inserting 2024 . 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 (2), by inserting after services and supports for individuals with autism spectrum disorder the following: across the lifespan of such individuals ; and (B) in paragraph (5), by inserting after individuals with an autism spectrum disorder the following: across the lifespan of such individuals ; (2) in subsection (c)— (A) in paragraph (1)(D), by inserting after the Department of Education the following: , the Department of Labor, the Department of Justice, the Department of Housing and Urban Development, ; and (B) 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 inserting 2024 . 6. 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 of 2014 and inserting of 2019 ; and (B) in paragraph (2)— (i) by striking of 2014 each place it appears and inserting of 2019 ; (ii) in subparagraph (G), striking age of the child and inserting age of the individual ; (iii) in subparagraph (H), by striking and at the end; (iv) in subparagraph (I), by striking the period at the end and inserting ; and ; and (v) by adding at the end the following new subparagraph: (J) information on how States use home and community-based services and other supports to ensure that individuals with autism spectrum disorder or other developmental disabilities are living, working, and participating in the community. ; and (2) by amending subsection (b) to read as follows: (b) Report on health and well-Being of individuals with autism spectrum disorder (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 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. (2) Contents The report submitted under paragraph (1) shall contain— (A) demographic factors associated with the health and well-being of individuals with autism spectrum disorder; (B) an overview of policies and programs relevant to the health and well-being of individuals with autism spectrum disorder, including an identification of existing Federal laws, regulations, policies, research, and programs; (C) proposals 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 spectrum disorder, including— (i) community-based behavioral supports and interventions; (ii) nutrition, recreational, and social activities; and (iii) personal safety services for individuals with autism spectrum disorder related to public safety agencies or the criminal justice system; and (E) recommendations that seek to improve health outcomes for individuals with autism spectrum disorder by addressing— (i) screening and diagnosis of individuals of all ages; (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 hospitalization; (vii) treatment for co-occurring physical and mental health conditions; (viii) premature mortality; (ix) medical practitioner training; and (x) caregiver mental health. . 7. 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 through 2019 and inserting there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2020 through 2024 .