I 119th CONGRESS 1st Session H. R. 4086 IN THE HOUSE OF REPRESENTATIVES June 23, 2025 Mr. Min (for himself, Ms. Meng , Mr. Fitzpatrick , Mr. Cuellar , Mr. Bacon , Ms. Salazar , Mr. Correa , Mr. Valadao , Mr. Krishnamoorthi , Mr. Gottheimer , Ms. Malliotakis , Ms. Norton , Mrs. McIver , Mr. Cohen , Mrs. Hayes , Mr. Mannion , Mr. Kennedy of New York , Mr. Tonko , Mr. Khanna , Ms. McBride , Mr. Raskin , Ms. Budzinski , and Mr. Garcia of California ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To authorize the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, to award grants for providing evidence-based caregiver skills training to family caregivers of children with autism spectrum disorder or other developmental disabilities or delays, and for other purposes.

1. Short title This Act may be cited as the Autism Family Caregivers Act of 2025 . 2. Caregiver skills training pilot program (a) Authorization The Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration (referred to in this Act as the Secretary ), shall carry out a program, to be known as the Caregiver Skills Training Pilot Program, under which the Secretary shall award grants to eligible entities to provide evidence-based caregiver skills training to family caregivers, for the purposes of— (1) improving the well-being of children with autism spectrum disorder or another developmental disability or developmental delay and their caregivers; and (2) teaching family caregivers evidenced-based intervention strategies to promote— (A) improvement in the well-being of such children and their caregivers; and (B) the greater inclusion of such children in family and community life. (b) Application To seek a grant under this section, an eligible entity shall submit to the Secretary an application that includes— (1) a description of— (A) the applicant’s experience delivering evidence-based caregiver skills training to family caregivers; (B) the activities that the applicant proposes to carry out through the grant; and (C) how such activities will achieve the purposes described in subsection (a); and (2) a plan for— (A) coordination with— (i) community-based organizations; (ii) State and local early intervention providers; (iii) State plans (or waivers of such plans) under the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ); (iv) State Directors of Head Start Collaboration (as described in section 642B of the Head Start Act ( 42 U.S.C. 9837b )); (v) schools; and (vi) other providers of early intervening services; (B) collaboration with health care payors (including public and private insurance), State departments of insurance, health plans, and other relevant payors; (C) expanding the skills training program proposed to be carried out through the grant; (D) achieving sustainability of such program; and (E) establishing and maintaining a stakeholder implementation committee under subsection (e). (c) Reducing disparities In awarding grants under this section, the Secretary may consider the extent to which an eligible entity can deliver evidence-based, culturally competent and linguistically appropriate information to family caregivers from diverse racial, ethnic, geographic, or linguistic backgrounds. (d) Use of funds The recipient of a grant under this section shall use funds received through the grant— (1) to provide, at no cost to participants— (A) evidence-based caregiver skills training to family caregivers; and (B) such training in areas related to children’s learning and development, including— (i) communication skills; (ii) social engagement; (iii) daily living skills; (iv) caregiver response strategies to challenging behaviors; and (v) coping and self-care strategies for family caregivers; and (2) to establish and maintain a stakeholder implementation committee under subsection (e). (e) Stakeholder implementation committee (1) In general An eligible entity shall establish and maintain a stakeholder implementation committee referred to in subsection (d)(2) to advise on ensuring that the training provided pursuant to the grant is accessible and culturally appropriate and linguistically appropriate. (2) Composition The members of the stakeholder implementation committee shall all be from the local community served pursuant to the grant (or the relevant metropolitan statistical area) and shall include, at a minimum, the following: (A) Family caregivers, including autistic caregivers and other caregivers with disabilities. (B) Pediatric health care and early intervention providers, including developmental behavioral pediatricians, with expertise providing services to children with autism spectrum disorder or other developmental disabilities and delays. (C) Educators or related service professionals, including child care providers, with experience serving children with autism spectrum disorder or other developmental disabilities and delays. (D) Representatives of local organizations familiar with the cultural values and priorities of individuals in the local community. (E) Local government officials. (f) Requirements (1) Number of recipients and states The Secretary shall award grants under subsection (a) to not fewer than 25 eligible entities in not fewer than 15 States. (2) Amount The total amount of each grant awarded under subsection (a) shall be not less than $500,000 over a 5-year period. (g) Supplement not supplant Amounts received through a grant under this section shall be used to supplement, not supplant, other amounts received to provide— (1) behavioral, medical, habilitative, and other services covered by the Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) or private health insurance; (2) services provided under the Individuals with Disabilities Education Act ( 20 U.S.C. 1400 et seq. ); or (3) adaptations of a training program using evidence-based approaches to serve children of different ages, communities, and underrepresented groups. (h) Activities of the secretary The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall— (1) assist recipients of grants under subsection (a) in— (A) the implementation of caregiver skills training programs using lessons learned from other evidenced-based activities or caregiver programs conducted or supported by the Health Resources and Services Administration; (B) ensuring the programs of the recipients assist medically underserved communities (as defined in section 799B(6) of the Public Health Service Act ( 42 U.S.C. 295p(6) )), when possible; and (C) developing plans for achieving sustainability of the programs of the recipients; (2) conduct an annual evaluation of activities funded through grants under subsection (a), in consultation with the grant recipients, including evaluation of the effectiveness of— (A) the communication, social engagement, and daily living skills of children with autism spectrum disorder or other developmental disabilities and delays; and (B) the extent to which family caregivers see improvements in the communication, social engagement, and daily living skills of such children; and (3) convene at least one national or regional meeting of such grant recipients to discuss best practices. (i) Reports (1) Initial report Not later than 6 months after awarding the first grant under subsection (a), the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, a report on the implementation of this section. Such report shall include— (A) how many grants have been awarded; (B) the name and location of the grant recipients; (C) the communities served by the grants; (D) a description of the kind of activities to be carried out with the grants; (E) an analysis, conducted by the Administrator of the Health Resources and Services Administration, based on the evaluation under subsection (h)(2), of the effectiveness of such grants with respect to— (i) the communication, social engagement, and daily living skills of children with autism spectrum disorder or other developmental disabilities and delays; and (ii) the extent to which family caregivers see improvements in the communication, social engagement, and daily living skills of such children; and (F) best practices to increase access to caregiver skills training programs described in subsection (a) in medically underserved communities. (2) Final report Not later than the end of fiscal year 2027, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, a final report on the implementation of this section, including— (A) the information, analysis, and best practices listed in subparagraphs (A) through (F) of paragraph (1); and (B) recommendations on how to expand and extend the program under this section. (j) Definitions In this section: (1) Developmental delay The term developmental delay has the meaning given such term in section 632(3) of the Individuals with Disabilities Education Act ( 20 U.S.C. 1432(3) ). (2) Developmental disability The term developmental disability has the meaning given such term in section 102(8)(A) of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 ( 42 U.S.C. 15002 ). (3) Eligible entity The term eligible entity means an entity that— (A) is— (i) a nonprofit or other community-based organization; (ii) a Federally qualified health center; (iii) an accredited academic medical center; (iv) a health system; or (v) a collaboration or consortium of 2 or more entities listed in clauses (i) through (iv); (B) has at least 3 years of demonstrated experience— (i) delivering culturally appropriate and linguistically appropriate services for children with autism spectrum disorder or other developmental disabilities or developmental delays, as well as collaborating directly with their families, including in medically underserved communities; (ii) providing services to such children, as well as collaborating directly with their families; (iii) providing individual caregiver coaching to caregivers of such children; and (iv) working with self-advocates or adults with autism spectrum disorder or other developmental disabilities or developmental delays; (C) can demonstrate the ability to access resources from and collaborate with— (i) health care providers; (ii) allied health professionals; (iii) educators, including childcare providers; (iv) social workers; and (v) direct care professionals; and (D) has prior demonstrated experience delivering mental health services that address both developmental disabilities and one or more cooccurring mental health conditions, including depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) (4) Family caregiver The term family caregiver means an adult family member or other individual who has a significant relationship with, and who provides a broad range of assistance to, a child between the ages of 0 and 9 diagnosed with autism spectrum disorder or another developmental disability or developmental delay. (5) Federally qualified health center The term Federally qualified health center has the meaning given the term in section 1861(aa) of the Social Security Act ( 42 U.S.C. 1395x(aa) ). (k) Authorization of appropriations To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2026 through 2030.