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<dc:title>119 HR 4086 IH: Autism Family Caregivers Act of 2025</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2025-06-23</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 4086</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20250623">June 23, 2025</action-date><action-desc><sponsor name-id="M001241">Mr. Min</sponsor> (for himself, <cosponsor name-id="M001188">Ms. Meng</cosponsor>, <cosponsor name-id="F000466">Mr. Fitzpatrick</cosponsor>, <cosponsor name-id="C001063">Mr. Cuellar</cosponsor>, <cosponsor name-id="B001298">Mr. Bacon</cosponsor>, <cosponsor name-id="S000168">Ms. Salazar</cosponsor>, <cosponsor name-id="C001110">Mr. Correa</cosponsor>, <cosponsor name-id="V000129">Mr. Valadao</cosponsor>, <cosponsor name-id="K000391">Mr. Krishnamoorthi</cosponsor>, <cosponsor name-id="G000583">Mr. Gottheimer</cosponsor>, <cosponsor name-id="M000317">Ms. Malliotakis</cosponsor>, <cosponsor name-id="N000147">Ms. Norton</cosponsor>, <cosponsor name-id="M001229">Mrs. McIver</cosponsor>, <cosponsor name-id="C001068">Mr. Cohen</cosponsor>, <cosponsor name-id="H001081">Mrs. Hayes</cosponsor>, <cosponsor name-id="M001231">Mr. Mannion</cosponsor>, <cosponsor name-id="K000402">Mr. Kennedy of New York</cosponsor>, <cosponsor name-id="T000469">Mr. Tonko</cosponsor>, <cosponsor name-id="K000389">Mr. Khanna</cosponsor>, <cosponsor name-id="M001238">Ms. McBride</cosponsor>, <cosponsor name-id="R000606">Mr. Raskin</cosponsor>, <cosponsor name-id="B001315">Ms. Budzinski</cosponsor>, and <cosponsor name-id="G000598">Mr. Garcia of California</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">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.</official-title></form><legis-body id="H851B84D8ED7C445385AA6B3B730AC809" style="OLC"> 
<section id="HC361BF6A4DD3498C8140FA2C9BB812DA" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Autism Family Caregivers Act of 2025</short-title></quote>.</text></section> <section id="H4D45E6428E48441DAE40B23CC371D1AD"><enum>2.</enum><header>Caregiver skills training pilot program</header> <subsection id="H7DFB8C515F6F4D628BA5D4F0612D71B8"> <enum>(a)</enum> <header>Authorization</header> <text>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 <quote>Secretary</quote>), 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—</text>
                <paragraph id="HF9C8AD474EE645E592A4675E1374428F">
                    <enum>(1)</enum>
 <text display-inline="yes-display-inline">improving the well-being of children with autism spectrum disorder or another developmental disability or developmental delay and their caregivers; and</text>
                </paragraph>
                <paragraph id="HDEF81DDBF1EA4FDE8C9A3A131BA5B419">
                    <enum>(2)</enum>
 <text>teaching family caregivers evidenced-based intervention strategies to promote—</text>
                    <subparagraph id="H1A302382BD894B42978D2AAA8E0EF43D">
                        <enum>(A)</enum>
 <text>improvement in the well-being of such children and their caregivers; and</text>
                    </subparagraph>
                    <subparagraph id="H20AB8B9F2AFB4532ABA17BA289F839E5">
                        <enum>(B)</enum>
 <text>the greater inclusion of such children in family and community life.</text>
                    </subparagraph>
                </paragraph>
            </subsection> 
<subsection id="HA870C03537A04A0CA0FED10894317757"><enum>(b)</enum><header>Application</header><text>To seek a grant under this section, an eligible entity shall submit to the Secretary an application that includes—</text> <paragraph id="HE8DBB3D838284C49BDD2E42D6C14F322"><enum>(1)</enum><text>a description of—</text> 
<subparagraph id="H28B2245F5F844F43AE2B03BCF7019E65"><enum>(A)</enum><text>the applicant’s experience delivering evidence-based caregiver skills training to family caregivers;</text></subparagraph> <subparagraph id="HC2C79C9F6B464685AD668417602ED62B"><enum>(B)</enum><text>the activities that the applicant proposes to carry out through the grant; and</text></subparagraph> 
<subparagraph id="H1F6C3864E646402D99F5EC26CD6087E3"><enum>(C)</enum><text>how such activities will achieve the purposes described in subsection (a); and</text></subparagraph></paragraph> <paragraph id="H7A621E261D214D2EAE651749948E89DF"><enum>(2)</enum><text>a plan for—</text> 
<subparagraph id="H71000A17773F4A2A8404456E24039F65"><enum>(A)</enum><text>coordination with—</text> <clause id="HEC9D3591F8C740D5BAB4162E85024B48"><enum>(i)</enum><text>community-based organizations;</text></clause>
<clause id="HE7624C073FE940D380479AD41C66F9DA"><enum>(ii)</enum><text>State and local early intervention providers;</text></clause> <clause id="H25AE5BD16A744C5AA38E1EF43DC9126F"><enum>(iii)</enum><text>State plans (or waivers of such plans) under the Medicaid program under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>);</text></clause>
<clause id="H989106168ABB49048F52ACC2245BF206"><enum>(iv)</enum><text display-inline="yes-display-inline">State Directors of Head Start Collaboration (as described in section 642B of the Head Start Act (<external-xref legal-doc="usc" parsable-cite="usc/42/9837b">42 U.S.C. 9837b</external-xref>));</text></clause> <clause id="H1AB5B377BC664D189F98EABC1F044ACC"><enum>(v)</enum><text>schools; and</text></clause>
<clause id="HC10F89609EE846C5AA0C164FEDA5191B"><enum>(vi)</enum><text>other providers of early intervening services;</text></clause></subparagraph> <subparagraph id="HA2E3399E929A4C0B94390317A71F2FE2"><enum>(B)</enum><text>collaboration with health care payors (including public and private insurance), State departments of insurance, health plans, and other relevant payors;</text></subparagraph> 
<subparagraph id="H11FEDD8E0A2145538D61D1DE088B654B"><enum>(C)</enum><text>expanding the skills training program proposed to be carried out through the grant;</text></subparagraph> <subparagraph id="H528D519A94A34D2B9FF05AF30A90F6F9"><enum>(D)</enum><text>achieving sustainability of such program; and</text></subparagraph> 
<subparagraph id="HBF5151F9A0904FDDAC7EE675CBDB85C2"><enum>(E)</enum><text>establishing and maintaining a stakeholder implementation committee under subsection (e).</text></subparagraph></paragraph></subsection> <subsection id="HC9B2749E8427462B857C2CCBBD1DAF1F"><enum>(c)</enum><header>Reducing disparities</header><text display-inline="yes-display-inline">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.</text></subsection> 
<subsection id="H84CF09B5141B40CA8CEEC00E01801239"><enum>(d)</enum><header>Use of funds</header><text>The recipient of a grant under this section shall use funds received through the grant—</text> <paragraph id="HAEE1E060317644F8A8EF9ABDB6DD02FB"><enum>(1)</enum><text>to provide, at no cost to participants—</text> 
<subparagraph id="H641EE58DB5814759B7D01F97E21301D4"><enum>(A)</enum><text display-inline="yes-display-inline">evidence-based caregiver skills training to family caregivers; and</text></subparagraph> <subparagraph id="H3656A58662EB4929BD62B3D81B19BF35"><enum>(B)</enum><text>such training in areas related to children’s learning and development, including—</text> 
<clause id="HFE4CDAF38E4B4F68BE99457E39F6C7C8"><enum>(i)</enum><text>communication skills;</text></clause> <clause id="H076120B537B34EB7878B4245254D3636"><enum>(ii)</enum><text>social engagement;</text></clause> 
<clause id="H09F3392AC09145BF882075493AD4844E"><enum>(iii)</enum><text>daily living skills;</text></clause> <clause id="HCC7270A286E147B6AB13EF8B6CBCF518"><enum>(iv)</enum><text>caregiver response strategies to challenging behaviors; and</text></clause>
<clause id="HD4F0E2B4A218468F8A53D7C3772A7C9B"><enum>(v)</enum><text display-inline="yes-display-inline">coping and self-care strategies for family caregivers; and</text></clause></subparagraph></paragraph> <paragraph id="HB44B9814CB5243C19E84BF6913CEC123"><enum>(2)</enum><text>to establish and maintain a stakeholder implementation committee under subsection (e).</text></paragraph></subsection> 
<subsection id="H94A7F2AD21FC4B948635DD116DF440D0"><enum>(e)</enum><header>Stakeholder implementation committee</header> 
<paragraph id="H61CE17AF22254B909473FDB9EF9BC11B"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H122DD7C5F07C4AA89D54A265D2D09389"><enum>(2)</enum><header>Composition</header><text>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:</text> 
<subparagraph id="HD33F08E0405D4B36A5D11E073029F41E"><enum>(A)</enum><text>Family caregivers, including autistic caregivers and other caregivers with disabilities.</text></subparagraph> <subparagraph id="H982A89C638364559BC905644EECB59A1"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> 
<subparagraph id="H6C9B0B910C864B01948721058A399AE5">
                        <enum>(C)</enum>
 <text display-inline="yes-display-inline">Educators or related service professionals, including child care providers, with experience serving children with autism spectrum disorder or other developmental disabilities and delays.</text>
                    </subparagraph> 
<subparagraph id="HAB0421CD7DBC4D2C8C54037D1F6C1099"><enum>(D)</enum><text>Representatives of local organizations familiar with the cultural values and priorities of individuals in the local community.</text></subparagraph> <subparagraph id="H14CA329820EB4507B60200222334B113"><enum>(E)</enum><text>Local government officials.</text></subparagraph></paragraph></subsection> 
<subsection id="HB0CCAD8EF1124E028AC2A760639C1BF3"><enum>(f)</enum><header>Requirements</header> 
<paragraph id="HF253E5B4237141AB907DDFA9F20C0FD1"><enum>(1)</enum><header>Number of recipients and states</header><text>The Secretary shall award grants under subsection (a) to not fewer than 25 eligible entities in not fewer than 15 States.</text></paragraph> <paragraph id="H7E71BA02C39241C382E03B72D9D70A34"><enum>(2)</enum><header>Amount</header><text>The total amount of each grant awarded under subsection (a) shall be not less than $500,000 over a 5-year period.</text></paragraph></subsection> 
<subsection id="H90639790EEC041308FFD8A91C64119CF"><enum>(g)</enum><header>Supplement not supplant</header><text>Amounts received through a grant under this section shall be used to supplement, not supplant, other amounts received to provide—</text> <paragraph id="H1151D24930B84F3682A4299B4EDCA18E"> <enum>(1)</enum> <text>behavioral, medical, habilitative, and other services covered by the Medicaid program under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) or private health insurance;</text>
                </paragraph> 
<paragraph id="HDEC7B4D704A34305AB331598AA62DF41"><enum>(2)</enum><text>services provided under the Individuals with Disabilities Education Act (<external-xref legal-doc="usc" parsable-cite="usc/20/1400">20 U.S.C. 1400 et seq.</external-xref>); or</text></paragraph> <paragraph id="H3B97EE62AE6E4CBD83373D41EF6D5D0B"><enum>(3)</enum><text>adaptations of a training program using evidence-based approaches to serve children of different ages, communities, and underrepresented groups.</text></paragraph></subsection> 
<subsection id="H4BAEBBC6752A4FFB889DF9C061FCABD8"><enum>(h)</enum><header>Activities of the secretary</header><text>The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall—</text> <paragraph id="H5A0D9E0F54894D99AF7BF363C4E18279"><enum>(1)</enum><text>assist recipients of grants under subsection (a) in—</text> 
<subparagraph id="H32C6CC56045A4061A7CBF54307F7CC16"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H38C246D56B584CB98ECEA03D3CCEE613"> <enum>(B)</enum> <text display-inline="yes-display-inline">ensuring the programs of the recipients assist medically underserved communities (as defined in section 799B(6) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/295p">42 U.S.C. 295p(6)</external-xref>)), when possible; and</text>
                    </subparagraph> 
<subparagraph id="HF1B5181CAEAE4749B7DB3834C058C048"><enum>(C)</enum><text>developing plans for achieving sustainability of the programs of the recipients;</text></subparagraph></paragraph> <paragraph id="H7A8CDA0D55DC448CA01DB83BFA20F06F"><enum>(2)</enum><text display-inline="yes-display-inline">conduct an annual evaluation of activities funded through grants under subsection (a), in consultation with the grant recipients, including evaluation of the effectiveness of—</text>
<subparagraph id="HFFDFB82238EF4CD9A9C6E8D4EF57AE50"><enum>(A)</enum><text display-inline="yes-display-inline">the communication, social engagement, and daily living skills of children with autism spectrum disorder or other developmental disabilities and delays; and</text></subparagraph> <subparagraph id="HA7260157CB8E46B68B9218FD9E3A8AA8"><enum>(B)</enum><text display-inline="yes-display-inline">the extent to which family caregivers see improvements in the communication, social engagement, and daily living skills of such children; and</text></subparagraph></paragraph> 
<paragraph id="HB60704F5606346A2BEC987F483EBFE9F"><enum>(3)</enum><text>convene at least one national or regional meeting of such grant recipients to discuss best practices.</text></paragraph></subsection> <subsection id="H2BC98BCB0B1F4265B6DE5E3D2E05A94E"><enum>(i)</enum><header>Reports</header> <paragraph id="HD293730FA0E94C23AE6D86597BD761B3"><enum>(1)</enum><header>Initial report</header><text display-inline="yes-display-inline">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—</text> 
<subparagraph id="HFAD6CD206E4549BCACB78FBED2CB49E3"><enum>(A)</enum><text>how many grants have been awarded;</text></subparagraph> <subparagraph id="H223ADA89B6BA4DF491C88F628F72E998"><enum>(B)</enum><text>the name and location of the grant recipients;</text></subparagraph> 
<subparagraph id="H0F22DC76C0E546E29D3336E968C9A690"><enum>(C)</enum><text>the communities served by the grants;</text></subparagraph> <subparagraph id="H68EB61D0291144AC8F2833896868C324"><enum>(D)</enum><text>a description of the kind of activities to be carried out with the grants;</text></subparagraph> 
<subparagraph id="HD3694D64F5764F27A6E50C7D9EE940D8"><enum>(E)</enum><text>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—</text> <clause id="H5544050AFF974E85A31F04391A7FED76"><enum>(i)</enum><text>the communication, social engagement, and daily living skills of children with autism spectrum disorder or other developmental disabilities and delays; and</text></clause>
<clause id="HAFF93B3FE2F347DCBE095ABA6187939B"><enum>(ii)</enum><text display-inline="yes-display-inline">the extent to which family caregivers see improvements in the communication, social engagement, and daily living skills of such children; and</text></clause></subparagraph> <subparagraph id="HA29C9194A99C435A9EFB5AD68D33CE43"><enum>(F)</enum><text>best practices to increase access to caregiver skills training programs described in subsection (a) in medically underserved communities.</text></subparagraph></paragraph> 
<paragraph id="H6F0E4FE1A076472498BB0B379601E082"><enum>(2)</enum><header>Final report</header><text display-inline="yes-display-inline">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—</text> <subparagraph id="HE86F41DCAC074C279917C05C6621E335"><enum>(A)</enum><text>the information, analysis, and best practices listed in subparagraphs (A) through (F) of paragraph (1); and</text></subparagraph> 
<subparagraph id="H4C60D954BDED488D9851BD63BF2213CD"><enum>(B)</enum><text>recommendations on how to expand and extend the program under this section.</text></subparagraph></paragraph></subsection> <subsection id="H52322B9359DD4A1094B7C721DF7748BE"><enum>(j)</enum><header>Definitions</header><text>In this section:</text> 
<paragraph id="H4E54E991E9FE41C3844003FBB325D834">
                    <enum>(1)</enum>
                    <header>Developmental delay</header>
 <text display-inline="yes-display-inline">The term <quote>developmental delay</quote> has the meaning given such term in section 632(3) of the Individuals with Disabilities Education Act (<external-xref legal-doc="usc" parsable-cite="usc/20/1432">20 U.S.C. 1432(3)</external-xref>).</text>
                </paragraph> 
<paragraph id="H17A1BA95275142F48D3BBFFCC337901B"><enum>(2)</enum><header>Developmental disability</header><text display-inline="yes-display-inline">The term <quote>developmental disability</quote> has the meaning given such term in section 102(8)(A) of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (<external-xref legal-doc="usc" parsable-cite="usc/42/15002">42 U.S.C. 15002</external-xref>).</text></paragraph> <paragraph id="H4BD75EEDB4B84CD9A695FB9B3D74BD6A"><enum>(3)</enum><header>Eligible entity</header><text display-inline="yes-display-inline">The term <quote>eligible entity</quote> means an entity that—</text> 
<subparagraph id="H5999C9EE8E7848A8B111624B63EEA955" display-inline="no-display-inline"><enum>(A)</enum><text>is—</text> <clause id="H61A39648DDB94984AE15A93F9662FAE0"><enum>(i)</enum><text>a nonprofit or other community-based organization;</text></clause> 
<clause id="H8D20AE64A2EA4946993D04A70E1AA2C2"><enum>(ii)</enum><text>a Federally qualified health center;</text></clause> <clause id="HE7C26BC7883544B0AF80F73533A8BAE3"><enum>(iii)</enum><text>an accredited academic medical center;</text></clause> 
<clause id="HBF8AB1DD093A4A74AB7A07B48A6478DC"><enum>(iv)</enum><text>a health system; or</text></clause> <clause id="H8AA8138D70954D1B8691015B00098FA5"><enum>(v)</enum><text>a collaboration or consortium of 2 or more entities listed in clauses (i) through (iv);</text></clause></subparagraph> 
<subparagraph id="H6CA131F939E24D4F9B4FD893E5C9C2C1"><enum>(B)</enum><text>has at least 3 years of demonstrated experience—</text> <clause id="HC92668004544424AB6373683B6AA34C7"><enum>(i)</enum><text>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;</text></clause> 
<clause id="H1DE26577B1E24B639D5C0113A00A3762"><enum>(ii)</enum><text display-inline="yes-display-inline">providing services to such children, as well as collaborating directly with their families;</text></clause> <clause id="H0162537FDCCD475C9B41CC045065F34F"><enum>(iii)</enum><text display-inline="yes-display-inline">providing individual caregiver coaching to caregivers of such children; and</text></clause> 
<clause id="H1D7CD10197CF4E69840DC88CA016EB26"><enum>(iv)</enum><text display-inline="yes-display-inline">working with self-advocates or adults with autism spectrum disorder or other developmental disabilities or developmental delays;</text></clause></subparagraph> <subparagraph id="H25760940120F411B9F3780D200A9EB8B" display-inline="no-display-inline"><enum>(C)</enum><text display-inline="yes-display-inline">can demonstrate the ability to access resources from and collaborate with—</text> 
<clause id="H227952F5E2BB49108EBD1A57B4B6E5F0"><enum>(i)</enum><text>health care providers;</text></clause> <clause id="HE449CCFA56F64D7EBB2A6EA54EABA39F"><enum>(ii)</enum><text>allied health professionals;</text></clause> 
<clause id="HD9DF5578C07E4AE897FA4E3C623BAA44"><enum>(iii)</enum><text display-inline="yes-display-inline">educators, including childcare providers;</text></clause> <clause id="H089F77BBB50C4E2CA28869CAF4994637"><enum>(iv)</enum><text>social workers; and</text></clause> 
<clause id="HC5F3926FBE96495B8DE58D248A195713"><enum>(v)</enum><text display-inline="yes-display-inline">direct care professionals; and</text></clause></subparagraph> <subparagraph id="H1AE61B3B2AE74EE9A59D08C066E9E410"><enum>(D)</enum><text display-inline="yes-display-inline">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)</text></subparagraph></paragraph> 
<paragraph id="H1ED0150B162F46228AAC6E32F0316A6A"><enum>(4)</enum><header>Family caregiver</header><text display-inline="yes-display-inline">The term <quote>family caregiver</quote> 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.</text></paragraph> <paragraph id="H72BC12F25DE94C888FD0431EA4DDE756"><enum>(5)</enum><header>Federally qualified health center</header><text>The term <quote>Federally qualified health center</quote> has the meaning given the term in section 1861(aa) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)</external-xref>).</text></paragraph></subsection> 
<subsection id="H0C8F2C119E4E4F5EA2BA21C339D1CEFA"><enum>(k)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section> </legis-body></bill>

