II Calendar No. 504 118th CONGRESS 2d Session S. 4762 IN THE SENATE OF THE UNITED STATES July 24, 2024 Mr. Luján (for himself and Ms. Collins ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions September 12, 2024 Reported by Mr. Sanders , with an amendment Strike out all after the enacting clause and insert the part printed in italic A BILL To amend the Public Health Service Act to reauthorize programs and research 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 2024 or the Autism CARES Act of 2024 . 2. 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)(3), by striking tribe, or a tribal and inserting Tribe, or a Tribal ; (2) in subsection (d)(1)— (A) in the paragraph heading, by striking tribe; tribal and inserting Tribe; Tribal ; (B) by striking tribe and inserting Tribe ; and (C) by striking tribal and inserting Tribal ; and (3) in subsection (e), by striking 2024 and inserting 2029 . (b) Autism education, early detection, and intervention Section 399BB of the Public Health Service Act ( 42 U.S.C. 280i–1 ) is amended— (1) in subsections (b)(1) and (c), by striking culturally competent each place it appears and inserting culturally and linguistically appropriate ; (2) in subsection (b)— (A) in paragraph (2), by striking screening each place it appears and inserting screening and diagnostic ; (B) in paragraph (3), by striking higher risk and inserting increased likelihood ; and (C) in paragraph (7), by striking higher risk and inserting increased likelihood ; (3) in subsection (e)(2), by adding at the end the following: (C) Report Not later than 2 years after the date of enactment of the Autism CARES Act of 2024 , the Secretary shall 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 that examines the need for developmental-behavioral pediatricians and the feasibility of expanding the developmental-behavioral pediatrician training programs described in subparagraph (A). ; (4) by amending subsection (f) to read as follows: (f) Intervention The Secretary shall promote research, through grants or contracts, which may include grants or contracts to research centers or networks, to— (1) develop and evaluate evidence-based practices and interventions to improve outcomes for individuals with autism spectrum disorder or other developmental disabilities by addressing physical and behavioral health and communication needs of such individuals across the lifespan; (2) develop guidelines for such evidence-based interventions; and (3) disseminate information related to such evidence-based practices and interventions and guidelines. ; and (5) in subsection (g), by striking 2024 and inserting 2029 . (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 striking develop a summary of and inserting summarize, on an annual basis, ; (B) in paragraph (5)(A), by striking proposed budgetary requirements and inserting a professional judgment of anticipated budgetary needs ; and (C) in paragraph (6)(B), by striking an annual and inserting a biennial ; and (2) in subsection (f), by striking 2024 and inserting 2029 . (d) Reports to Congress Section 399DD of the Public Health Service Act ( 42 U.S.C. 280i–3 ) is amended— (1) by striking 2019 each place it appears and inserting 2024 ; (2) in subsection (a)(1)— (A) in the paragraph heading, by striking In General and inserting In general ; (B) by striking Health, Education, Labor, and Pensions Committee of the Senate and the Energy and Commerce Committee and inserting Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce ; and (C) by striking Internet Web site and inserting website ; and (3) by adding at the end the following: (c) Update on young adults and youth transitioning to adulthood Not later than 2 years after the date of enactment of the Autism CARES Act of 2024 , the Secretary, in coordination with other Federal departments and agencies that serve individuals with autism spectrum disorder, 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 an update to the report required pursuant to subsection (b) of this section, as added by section 6 of the Autism CARES Act of 2014 and in effect before the date of enactment of the Autism CARES Act of 2019, concerning young adults with autism spectrum disorder and the challenges related to the transition from existing school-based services to services available during adulthood. . (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 $23,100,000 for each of fiscal years 2020 through 2024 and inserting $28,100,000 for each of fiscal years 2025 through 2029 ; (2) in subsection (b), by striking $50,599,000 for each of fiscal years 2020 through 2024 and inserting $56,344,000 for each of fiscal years 2025 through 2029 ; and (3) in subsection (c), by striking $296,000,000 for each of fiscal years 2020 through 2024 and inserting $306,000,000 for each of fiscal years 2025 through 2029 . 3. 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)— (A) in paragraph (1)— (i) by striking including pathology and inserting such as pathology ; and (ii) by inserting psychiatry, psychology, gerontology, developmental behavioral pediatrics, audiology, after toxicology, ; and (B) by adding at the end the following: (4) Considerations In carrying out this section, the Director shall take into consideration the various needs of individuals with autism spectrum disorder with respect to services and supports and addressing co-occurring conditions. ; and (2) in subsection (b)— (A) in paragraph (2), by inserting gerontology, after behavioral psychology, ; and (B) in paragraph (5)(B), by striking period of and inserting period . 4. Technical assistance to improve access to communication tools (a) In general The Secretary of Health and Human Services (referred to in this section as the Secretary ) may, at the request of a State, Indian Tribe or Tribal organization, locality, or territory, provide training and technical assistance to such jurisdiction on the manner in which Federal funding administered by the Secretary may be used to provide individuals with autism spectrum disorder and other developmental disabilities with access to evidence-based services, tools, and technologies that support communication needs. (b) Annual report The Secretary shall annually prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Education and the Workforce and the Committee on Energy and Commerce of the House of Representatives a report summarizing any technical assistance provided by the Secretary in the preceding fiscal year under subsection (a) and any advancements in the development or evaluation of such evidence-based services, tools, and technologies.

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 . 2. 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)(3), by striking tribe, or a tribal and inserting Tribe, or a Tribal ; (2) in subsection (d)(1)— (A) in the paragraph heading, by striking tribe; tribal and inserting Tribe; Tribal ; (B) by striking tribe and inserting Tribe ; and (C) by striking tribal and inserting Tribal ; and (3) in subsection (e), by striking 2024 and inserting 2029 . (b) Autism education, early detection, and intervention Section 399BB of the Public Health Service Act ( 42 U.S.C. 280i–1 ) is amended— (1) in subsections (b)(1) and (c), by striking culturally competent each place it appears and inserting culturally and linguistically appropriate ; (2) in subsection (b)— (A) in paragraph (2), by striking screening each place it appears and inserting screening and diagnostic ; (B) in paragraph (3), by striking higher risk and inserting increased likelihood ; and (C) in paragraph (7), by striking higher risk and inserting increased likelihood ; (3) in subsection (e)— (A) in paragraph (1)— (i) in the matter preceding subparagraph (A), by inserting and strengthen the capacity of after expand ; (ii) in subparagraph (A)— (I) by striking in States that do not have such a program; and inserting a semicolon; and (II) by striking expand existing or develop new and inserting expand and strengthen the capacity of existing, or, in States that do not have such a program, develop new, ; and (iii) in subparagraph (B)(v), by inserting or other providers, as applicable before the semicolon; and (iv) by amending subparagraph (C) to read as follows: (C) program sites— (i) provide culturally and linguistically appropriate services; (ii) take a multidisciplinary approach and have experience working with underserved populations; and (iii) identify opportunities to partner with community-based organizations to expand the capacity of communities to serve individuals with autism spectrum disorder or other developmental disabilities. ; and (B) in paragraph (2), by adding at the end the following: (C) Report Not later than 2 years after the date of enactment of the Autism CARES Act of 2024 , the Secretary shall 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 that examines the need for developmental-behavioral pediatricians and the feasibility of expanding the developmental-behavioral pediatrician training programs described in subparagraph (A). ; (4) by amending subsection (f) to read as follows: (f) Intervention The Secretary shall promote research, through grants or contracts, which may include grants or contracts to research centers or networks, to— (1) develop and evaluate evidence-based practices and interventions to improve outcomes for individuals with autism spectrum disorder or other developmental disabilities by addressing physical and behavioral health and communication needs of such individuals across the lifespan; (2) develop guidelines for such evidence-based interventions; and (3) disseminate information related to such evidence-based practices and interventions and guidelines. ; and (5) in subsection (g), by striking 2024 and inserting 2029 . (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 striking develop a summary of and inserting summarize, on an annual basis, ; and (B) in paragraph (6)(B), by striking an annual update to and inserting a biennial update on ; and (2) in subsection (f), by striking 2024 and inserting 2029 . (d) Reports to Congress Section 399DD of the Public Health Service Act ( 42 U.S.C. 280i–3 ) is amended— (1) by striking 2019 each place it appears and inserting 2024 ; (2) in subsection (a)(1)— (A) in the paragraph heading, by striking In General and inserting In general ; (B) by striking Health, Education, Labor, and Pensions Committee of the Senate and the Energy and Commerce Committee and inserting Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce ; and (C) by striking Internet Web site and inserting website ; (3) in subsection (b)— (A) in the subsection heading, by striking Health and Well-Being and inserting Mental Health Needs ; (B) in paragraph (1), by striking health and well-being and inserting mental health needs ; and (C) by amending paragraph (2) to read as follows: (2) Contents The report submitted under paragraph (1) shall contain— (A) an overview of policies and programs relevant to the mental health of individuals with autism spectrum disorder across their lifespan, including an identification of existing Federal laws, regulations, policies, research, and programs; and (B) recommendations to improve mental health outcomes and address related disparities in mental health care for individuals with autism spectrum disorder, including prevention, care coordination, and community-based services. ; and (4) by adding at the end the following: (c) Update on young adults and youth transitioning to adulthood Not later than 2 years after the date of enactment of the Autism CARES Act of 2024 , the Secretary, in coordination with other Federal departments and agencies that serve individuals with autism spectrum disorder, 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 an update to the report required pursuant to subsection (b) of this section, as added by section 6 of the Autism CARES Act of 2014 and in effect before the date of enactment of the Autism CARES Act of 2019, concerning young adults with autism spectrum disorder and the challenges related to the transition from existing school-based services to services available during adulthood. . (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 $23,100,000 for each of fiscal years 2020 through 2024 and inserting $28,100,000 for each of fiscal years 2025 through 2029 ; (2) in subsection (b), by striking $50,599,000 for each of fiscal years 2020 through 2024 and inserting $56,344,000 for each of fiscal years 2025 through 2029 ; and (3) in subsection (c), by striking $296,000,000 for each of fiscal years 2020 through 2024 and inserting $306,000,000 for each of fiscal years 2025 through 2029 . 3. 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)— (A) in paragraph (1)— (i) by striking including pathology and inserting such as pathology ; and (ii) by inserting psychiatry, psychology, gerontology, developmental behavioral pediatrics, audiology, after toxicology, ; and (B) by adding at the end the following: (4) Considerations In carrying out this section, the Director shall take into consideration the various needs of individuals with autism spectrum disorder with respect to services and supports and addressing co-occurring conditions. ; (2) in subsection (b)— (A) in paragraph (2)— (i) by striking including the fields of and inserting in fields such as ; and (ii) by inserting gerontology, after behavioral psychology, ; and (B) in paragraph (5)— (i) in subparagraph (A), by striking five and inserting 7 ; and (ii) in subparagraph (B), by striking period of and inserting period ; and (3) by adding at the end the following: (e) Budget estimate For each of fiscal years 2026 through 2029, the Director shall prepare and submit, directly to the President for review and transmittal to Congress, an annual budget estimate for the initiatives of the National Institutes of Health pursuant to the strategic plan developed under section 399CC(b)(5) and updated under section 399CC(b)(6)(B), after reasonable opportunity for comment (but without change) by the Secretary and the Interagency Autism Coordinating Committee established under section 399CC. . 4. Technical assistance to improve access to communication tools (a) In general The Secretary of Health and Human Services (referred to in this section as the Secretary ) may, at the request of a State, Indian Tribe or Tribal organization, locality, or territory, provide training and technical assistance to such jurisdiction on the manner in which Federal funding administered by the Secretary may be used to provide individuals with autism spectrum disorder and other developmental disabilities with access to evidence-based services, tools, and technologies that support communication needs. (b) Annual report The Secretary shall annually prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Education and the Workforce and the Committee on Energy and Commerce of the House of Representatives a report summarizing any technical assistance provided by the Secretary in the preceding fiscal year under subsection (a) and any advancements in the development or evaluation of the evidence-based services, tools, and technologies described in such subsection.

September 12, 2024 Reported with an amendment