[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 4044 Introduced in Senate (IS)]

111th CONGRESS
  2d Session
                                S. 4044

To reauthorize and strengthen the Combating Austism Act of 2006 (Public 
  Law 109-416), to establish a National Institute of Autism Spectrum 
Disorders, to provide for the continuation of certain programs relating 
  to autism, to establish programs to provide services to individuals 
with autism and the families of such individuals and to increase public 
       education and awareness of autism, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 17, 2010

Mr. Dodd (for himself and Mr. Menendez) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To reauthorize and strengthen the Combating Austism Act of 2006 (Public 
  Law 109-416), to establish a National Institute of Autism Spectrum 
Disorders, to provide for the continuation of certain programs relating 
  to autism, to establish programs to provide services to individuals 
with autism and the families of such individuals and to increase public 
       education and awareness of autism, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Combating Autism Reauthorization Act 
of 2010''.

SEC. 2. FINDINGS.

    Congress finds as follows:
            (1) Autism is a general term used to describe a group of 
        complex developmental brain disorders known as pervasive 
        developmental disorders. To meet the criteria for autism 
        spectrum disorder there must be clinically significant and 
        persistent deficits in social behavior, communication, and 
        interactions, as well as restricted, repetitive patterns of 
        behavior, interests, and activities.
            (2) Autism is a neurodevelopmental disorder that results in 
        difficulties with communication and social interaction, as well 
        as repetitive behaviors. Autism affects individuals 
        differently, mildly affecting some and significantly disabling 
        others.
            (3) A variety of physical, medical, and mental health 
        issues may accompany autism, resulting in marked functional 
        impairment in all activities of daily living. Epilepsy occurs 
        in as many as 39 percent of individuals with autism. 
        Neurogenetic conditions such as Down syndrome and fragile X 
        syndrome can also co-occur with autism, as can gastrointestinal 
        problems, immune system disorders, sleep disturbance, sensory 
        integration dysfunction, and pica. Many individuals on the 
        autism spectrum face co-occurring mental health challenges, 
        including anxiety and depression.
            (4) A 2009 report from the Centers for Disease Control and 
        Prevention found that 1 out of 110 children, and 1 out of 70 
        boys, in the United States has an autism spectrum disorder. 
        This finding represents a 57 percent increase over the 
        prevalence rate previously reported by the Centers for Disease 
        Control and Prevention. With prevalence estimates increasing at 
        an alarming pace, autism is a national health emergency.
            (5) The United States should ensure that individuals on the 
        autism spectrum are provided equality of opportunity for full 
        participation in society, independent living, and economic 
        self-sufficiency.
            (6) Autism has high costs to United States society. 
        According to a report from the Harvard School of Public Health, 
        the incremental lifetime cost of caring for a person with 
        autism is $3,200,000; the cost of caring for all individuals 
        with autism in the United States is more than $35,000,000,000 
        annually.
            (7) Autism is a major public health concern that is taking 
        an enormous toll on millions of families who need answers that 
        can come only through further research. Meeting the education, 
        employment, and service-provision needs of individuals on the 
        autism spectrum is a clear and compelling public policy issue 
        that requires a rapid national response. Individuals and 
        families are desperate to access services that are, at this 
        point, grossly inadequate to meet the current and growing needs 
        of individuals with autism.
            (8) Several institutes at the National Institutes of Health 
        conduct or support autism research, but the challenges posed by 
        autism exceed the mission of any individual institute. A cross-
        agency institute with an aggressive, coordinated, and targeted 
        research agenda aimed at improving the lives of individuals 
        with autism is needed to accelerate research on the causes and 
        effective treatment of autism.
            (9) In searching for the causes of autism spectrum 
        disorders, all promising avenues of research should be pursued, 
        including research on the role of environmental exposures as 
        risk factors for autism.
            (10) The heterogeneity and complexity of autism and the 
        etiological and phenotypic subtypes of autism require increased 
        investment in large-scale biorepositories for DNA, brain 
        tissue, fibroblasts, and biosamples relevant to environmental 
        exposures. Such biorepositories will enable researchers to 
        discover the multiple environmental and genetic risk factors 
        for autism, and to identify biomarkers that will allow 
        treatments tailored to the individual.
            (11) Families of children with autism face barriers to 
        accessing appropriate medical care, including lack of training 
        for professionals, lack of evidence-based treatment guidelines, 
        inadequate dissemination of information, and lack of 
        comparative effectiveness research and other evidence-based 
        treatment research. Autism intervention research networks on 
        physical and behavioral health are needed to address these 
        barriers.
            (12) Meeting the needs of individuals with autism requires 
        a coordinated approach within Federal agencies and among 
        Federal departments. The approach should focus on both research 
        and services for affected individuals and the families of such 
        individuals.
            (13) Individuals with autism have the same rights as other 
        people to exert control and choice over their lives, to live 
        independently, and to participate fully in, and contribute to, 
        their communities and society through full integration and 
        inclusion in the economic, political, social, cultural, and 
        educational fabric of society. Individuals with autism have the 
        right to a life with dignity and purpose.
            (14) Individuals with autism often need assistance in the 
        areas of comprehensive early intervention, health, recreation, 
        job training, employment, housing, transportation, and early, 
        primary, and secondary education. With access to, and 
        assistance with, these types of services and supports, 
        individuals with autism can live rich, full, and productive 
        lives. Services for transitioning youth and adults with autism 
        are an especially pressing need, as are services that enhance 
        the safety of individuals with autism of any age.
            (15) Although autism has touched the lives of many, a 
        significant segment of the public lacks knowledge of the signs 
        of autism and the challenges that individuals with autism and 
        the families of such individuals face.
            (16) To meet the needs of individuals with autism, 
        training, continuing education, technical assistance, and 
        informational programs are needed for parents and 
        professionals.
            (17) There is a strong consensus that intensive treatment 
        as soon as possible following diagnosis can significantly 
        improve cognitive functioning, language, and adaptive behavior, 
        reduce the cost of lifetime care, and yield the most positive 
        life outcomes for children with autism.

SEC. 3. ESTABLISHMENT OF THE NATIONAL INSTITUTE OF AUTISM SPECTRUM 
              DISORDERS.

    (a) Establishment of the Institute.--Part C of title IV of the 
Public Health Service Act (42 U.S.C. 285 et seq.) is amended by adding 
at the end the following:

     ``Subpart 21--National Institute of Autism Spectrum Disorders

``SEC. 464Z-8. PURPOSE OF THE INSTITUTE.

    ``(a) In General.--The general purpose of the National Institute of 
Autism Spectrum Disorders (in this section referred to as the 
`Institute') is the conduct and support of research, training, the 
dissemination of health information, and other programs with respect to 
autism spectrum disorders. The principal goal of the Institute is to 
improve the lives of persons with autism spectrum disorders through 
research focused on prevention, treatment, services, and cures.
    ``(b) Duties.--The duties of the Director of the Institute shall 
include the following:
            ``(1) Interagency coordination of autism spectrum disorder 
        activities.--With respect to autism spectrum disorders, the 
        Director of the Institute shall plan and evaluate research and 
        other activities conducted or supported by the agencies of the 
        National Institutes of Health. In carrying out the preceding 
        sentence, the Director of the Institute shall evaluate the 
        activities of each of such agencies and shall provide for the 
        periodic reevaluation of such activities.
            ``(2) Consultations.--The Director of the Institute shall 
        carry out this section in consultation with the heads of the 
        agencies of the National Institutes of Health, with the 
        advisory councils of such agencies, and with the Interagency 
        Autism Coordinating Committee described in section 399CC.
            ``(3) Consolidation of autism programs.--The Director of 
        the Institute shall make recommendations to the Secretary and 
        the Director of the National Institutes of Health regarding the 
        consolidation of programs of the National Institutes of Health 
        for the express purpose of enhancing support of research on 
        autism spectrum disorders and the coordination of the 
        activities of the Institute with related activities of the 
        other agencies of the National Institutes of Health and with 
        related activities of other Federal agencies.
            ``(4) Coordination.--The Director of the Institute shall 
        act as the primary Federal official with responsibility for 
        overseeing all research on autism spectrum disorders conducted 
        or supported by the National Institutes of Health and shall 
        maintain communications with all relevant departments of the 
        Federal Government to ensure the timely transmission of 
        information concerning autism spectrum disorders. The 
        Interagency Autism Coordinating Committee shall function as the 
        primary advisory body for all such research coordination on 
        autism spectrum disorders.
    ``(c) Sunset.--The National Institute of Autism Spectrum Disorders 
established under this section shall be established for a 10-year 
period beginning on the date of enactment of the Combating Autism 
Reauthorization Act of 2010. On the date that is 10 years after the 
date of enactment of the Combating Autism Reauthorization Act of 2010, 
the authorities of the Director of the Institute under this section and 
section 464z-9 shall be transferred to the Director of NIH.''.
    (b) Activities of the National Institutes of Health With Respect to 
Research on Autism Spectrum Disorders.--
            (1) Transfer to the national institute of autism spectrum 
        disorders.--Section 409C of the Public Health Service Act (42 
        U.S.C. 284g) is--
                    (A) redesignated as section 464z-9; and
                    (B) transferred, as so redesignated, to appear 
                after section 464z-8 of the Public Health Service Act, 
                as added by subsection (a).
            (2) In general.--Section 464z-9 of the Public Health 
        Service Act, as so redesignated by paragraph (1), is amended--
                    (A) in subsection (a)--
                            (i) in paragraph (1), by striking ``basic 
                        and clinical research'' and inserting ``basic, 
                        clinical, and translational research''; and
                            (ii) in paragraph (3), by striking 
                        ``Director of the National Institute of Mental 
                        Health'' and inserting ``Director of the 
                        National Institute of Research on Autism 
                        Spectrum Disorders'';
                    (B) in subsection (b)--
                            (i) in paragraph (2)--
                                    (I) by striking ``basic and 
                                clinical research'' and inserting 
                                ``basic, clinical, and translational 
                                research''; and
                                    (II) by inserting ``, building upon 
                                the recommendations set forth in the 
                                most recent strategic plan for autism 
                                spectrum disorders of the Interagency 
                                Autism Coordinating Committee 
                                established under section 399CC'' 
                                before the period at the end of the 
                                second sentence;
                    (C) in subsection (c), by inserting ``, 
                biomaterials for induced pluripotent stem cells, 
                biosamples relevant to environmental exposures,'' after 
                ``tissues''; and
                    (D) by adding at the end the following:
            ``(6) Definition.--In this section, the term `translational 
        research' means research that emphasizes the development and 
        delivery of effective new therapies to patients.''.
    (c) Use of Existing Resources.--In providing for the establishment 
of the National Institute of Autism Spectrum Disorders (referred to in 
this subsection as the ``Institute'') pursuant to the amendment made by 
subsection (a), the Director of the National Institutes of Health 
(referred to in this subsection as the ``Director of NIH'')--
            (1) may transfer to the Institute such personnel of the 
        National Institutes of Health as the Director of NIH determines 
        to be appropriate;
            (2) may, for quarters of the Institute, use such facilities 
        of the National Institutes of Health as the Director determines 
        to be appropriate; and
            (3) may obtain administrative support for the Institute 
        from the other agencies of the National Institutes of Health, 
        including national research institutes.
    (d) Construction of Facilities.--None of the provisions of this 
section or the amendments made by this Act shall be construed as 
authorizing the construction of facilities, or the acquisition of land, 
for purposes of the establishment or operation of the National 
Institute of Autism Spectrum Disorders.
    (e) Conforming Amendment.--
            (1) Organization of nih.--Section 401(b) of the Public 
        Health Service Act (42 U.S.C. 281(b)) is amended--
                    (A) in subsection (b)--
                            (i) by redesignating paragraph (25) as 
                        paragraph (26); and
                            (ii) by inserting after paragraph (24) the 
                        following:
            ``(25) The National Institute of Autism Spectrum 
        Disorders.''; and
                    (B) in subsection (d)(1), by striking ``27'' and 
                inserting ``28''.
            (2) Appointment and authority of directors.--Section 405(a) 
        of the Public Health Service Act (42 U.S.C. 284(a)) is amended 
        by inserting ``and the Director of the National Institute of 
        Autism Spectrum Disorders'' after ``National Cancer 
        Institute''.
    (f) Effective Date.--The provisions of this section, including the 
amendments made by this section, shall take effect on October 1, 2011.

SEC. 4. CONTINUATION OF PROGRAMS RELATING TO AUTISM.

    (a) Repeal of Sunset Provisions.--Part R of title III of the Public 
Health Service Act (42 U.S.C. 280i et seq.) is amended--
            (1) by striking section 399AA(e);
            (2) by striking section 399BB(g); and
            (3) by striking section 399CC(f).
    (b) Clarifying Amendment.--Section 399BB(f) of the Public Health 
Service Act (42 U.S.C. 280i-1(f)) is amended--
            (1) by inserting ``to research networks'' after 
        ``contracts'';
            (2) by striking ``interventions for individuals'' and 
        inserting ``interventions to improve the physical and 
        behavioral health and well-being of individuals''.
    (c) Interagency Autism Coordinating Committee.--Section 399CC of 
the Public Health Service Act (42 U.S.C. 280i-2) is amended--
            (1) in subsection (a), by striking ``within the Department 
        of Health and Human Services'' and inserting ``of Federal 
        agencies'';
            (2) in subsection (b)--
                    (A) in paragraph (1), by inserting ``and the 
                families of such individuals'' before the semicolon at 
                the end;
                    (B) in paragraph (2)--
                            (i) by inserting ``, evaluate, and assess'' 
                        after ``monitor''; and
                            (ii) by inserting ``and facilitate 
                        collaboration among Federal agencies'' before 
                        the semicolon at the end;
                    (C) in paragraph (3), by inserting ``and other 
                appropriate Federal Government department and agency 
                heads'' after ``Secretary'';
                    (D) in paragraph (4), by inserting ``and other 
                appropriate Federal Government department and agency 
                heads'' after ``Secretary'';
                    (E) in paragraph (5), by inserting ``and services 
                and supports for individuals with autism spectrum 
                disorder and the families of such individuals'' after 
                ``research''; and
                    (F) in paragraph (6), by striking ``submit to the 
                Congress'' and inserting ``submit to the President, who 
                shall review and transmit to Congress,'';
            (3) in subsection (c)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (B), by striking ``and 
                        the Directors of such national research 
                        institutes'' and inserting ``the Director of 
                        the National Institute of Autism Spectrum 
                        Disorders, and the Directors of such national 
                        research institutes''; and
                            (ii) in subparagraph (D), by inserting ``, 
                        the Department of Defense, the National Council 
                        on Disability, the Department of Housing and 
                        Urban Development, the Department of Justice, 
                        and the Department of Labor'' before the 
                        semicolon at the end; and
                    (B) in paragraph (2)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``fewer than 6 members of the 
                        Committee, or \1/3\ of the total membership of 
                        the Committee, whichever is greater,'' and 
                        inserting ``less than \1/2\ of the total 
                        membership of the Committee'';
                            (ii) in subparagraph (A), by striking ``one 
                        such member shall be an individual'' and 
                        inserting ``2 such members shall be 
                        individuals'';
                            (iii) in subparagraph (B)--
                                    (I) by striking ``one such member 
                                shall be a parent or legal guardian'' 
                                and inserting ``2 such members shall be 
                                a parent or a legal guardian''; and
                                    (II) by striking ``and'' at the 
                                end;
                            (iv) in subparagraph (C)--
                                    (I) by striking ``one such member 
                                shall be a representative'' and 
                                inserting ``2 such members shall be 
                                representatives''; and
                                    (II) by striking the period at the 
                                end and inserting ``; and''; and
                            (v) by adding at the end the following:
                    ``(D) at least 2 such members shall be clinicians 
                who treat individuals with autism spectrum disorder.'';
            (4) in subsection (d)--
                    (A) in paragraph (2), by inserting ``, except that 
                the term of any member appointed under subsection 
                (c)(2)(C) shall expire if such member no longer 
                represents the organization described in such 
                subsection'' after ``additional 4 year term''; and
                    (B) by inserting after paragraph (4) the following:
            ``(5) The Committee shall be chaired by the Director of the 
        National Institute of Autism Spectrum Disorders or such other 
        person designated by the Secretary.'';
            (5) in subsection (e), by striking the first sentence and 
        inserting ``In carrying out its functions, the Committee may 
        convene workshop and conferences. The Committee shall establish 
        a subcommittee on research on autism spectrum disorders, a 
        subcommittee on services and supports for individuals with 
        autism spectrum disorders and the families of such individuals, 
        and such other subcommittees as the Committee determines 
        appropriate. Such subcommittees shall vote separately on 
        matters within their respective jurisdictions.''; and
            (6) by adding at the end the following:
    ``(f) Report.--Not later than 1 year after the date of enactment of 
the Combating Autism Reauthorization Act of 2010 and annually 
thereafter, the Comptroller General of the United States shall submit a 
report to Congress concerning the progress of the Federal Government in 
implementing the strategic plan for autism spectrum disorder research 
and services and supports for individuals with autism spectrum disorder 
and the families of such individuals.''.

SEC. 5. CARE FOR PEOPLE WITH AUTISM SPECTRUM DISORDERS AND PUBLIC 
              EDUCATION.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i et seq.) is amended--
            (1) by redesignating section 399EE as section 399FF; and
            (2) by inserting after section 399DD the following:

``SEC. 399EE. PLANNING AND DEMONSTRATION GRANT FOR SERVICES FOR 
              CHILDREN, TRANSITIONING YOUTH, AND ADULTS.

    ``(a) In General.--To assist selected eligible entities in 
providing appropriate services to children, youth with autism spectrum 
disorders who are transitioning from secondary education to careers or 
post-secondary education (referred to in this section as `transitioning 
youth'), adults with autism spectrum disorders, and individuals of any 
age with autism spectrum disorders who may be at risk due to behavioral 
and preventable environmental factors, such as wandering (referred to 
in this section as `individuals at risk'), the Secretary shall 
establish--
            ``(1) a one-time, single-year planning grant program for 
        eligible entities; and
            ``(2) a multi-year service provision demonstration grant 
        program for selected eligible entities.
    ``(b) Purpose of Grants.--Grants shall be awarded to eligible 
entities to provide all or part of the funding needed to carry out 
programs that focus critical aspects of life for children, 
transitioning youth, and adults with autism spectrum disorders 
(including adults not eligible for developmental disability services 
provided by a State), such as--
            ``(1) postsecondary education, peer support, vocational 
        training, self-advocacy skills, and employment;
            ``(2) community-based behavioral supports and 
        interventions;
            ``(3) residential services, housing, and transportation;
            ``(4) nutrition, health and wellness, recreational and 
        social activities; and
            ``(5) personal safety for individuals at risk and the needs 
        of individuals with autism spectrum disorders who become 
        involved with the criminal justice system.
    ``(c) Eligible Entity.--An eligible entity desiring to receive a 
grant under this section shall be a State or other public or private 
nonprofit organization, including a State Council on Developmental 
Disabilities, as defined in section 102 of the Developmental 
Disabilities Assistance and Bill of Rights Act of 2000.
    ``(d) Planning Grants.--
            ``(1) In general.--The Secretary shall award one-time 
        grants to eligible entities to support the planning and 
        development of initiatives that will expand and enhance service 
        delivery systems for children, individuals at risk, 
        transitioning youth, and adults with autism spectrum disorders.
            ``(2) Application.--In order to receive such a grant, an 
        eligible entity shall--
                    ``(A) submit an application at such time and 
                containing such information as the Secretary may 
                require; and
                    ``(B) demonstrate the ability to carry out such 
                planning grant in coordination with the applicable 
                State Council on Developmental Disabilities and 
                organizations representing or serving individuals with 
                autism spectrum disorders and the families of such 
                individuals.
    ``(e) Implementation Grants.--
            ``(1) In general.--The Secretary shall award grants to 
        eligible entities that have received a planning grant under 
        subsection (d) to enable such entities to provide appropriate 
        services to children, individuals at risk, transitioning youth, 
        and adults with autism spectrum disorders.
            ``(2) Application.--In order to receive a grant under 
        paragraph (1), the eligible entity shall submit an application 
        at such time and containing such information as the Secretary 
        may require, including--
                    ``(A) the services that the eligible entity 
                proposes to provide and the expected outcomes for the 
                individuals who receive such services;
                    ``(B) the number of individuals who will be served 
                by such grant, including an estimate of the individuals 
                in underserved areas who will be served by such grant;
                    ``(C) the ways in which services will be 
                coordinated among both public and nonprofit providers 
                of services for children, transitioning youth, and 
                adults with disabilities, including community-based 
                services;
                    ``(D) where applicable, the process through which 
                the eligible entity will distribute funds to a range of 
                community-based or nonprofit providers of services, 
                including local governments, and the capacity of such 
                entity to provide such services;
                    ``(E) the process through which the eligible entity 
                will monitor and evaluate the outcome of activities 
                funded through the grant, including the effect of the 
                activities upon individuals who receive such services;
                    ``(F) where applicable, the plans of the eligible 
                entity to coordinate and streamline transitions from 
                youth to adult services;
                    ``(G) the process by which the eligible entity will 
                ensure compliance with the integration requirement 
                under section 302 of the Americans With Disabilities 
                Act of 1990 (42 U.S.C. 12182); and
                    ``(H) a description of how such services may be 
                sustained following the grant period.
    ``(f) Evaluation.--The Secretary shall contract with a third-party 
organization with expertise in evaluation to evaluate such 
demonstration grant program and, not later than 180 days after the 
conclusion of the grant program under subsection (e), submit a report 
to the Secretary. The evaluation and report may include an analysis of 
whether and to what extent the services provided through the grant 
program described in this section resulted in improved safety, health, 
education, employment, and community integration outcomes or other 
measures, as the Secretary determines appropriate.
    ``(g) Administrative Expenses.--Of the amounts appropriated to 
carry out this section, the Secretary shall set aside not more than 7 
percent for administrative expenses, including the expenses related to 
carrying out the evaluation described in subsection (f).
    ``(h) Supplement, Not Supplant.--Demonstration grant funds provided 
under this section shall supplement, not supplant, existing treatments, 
interventions, and services for individuals with autism spectrum 
disorders.''.

``SEC. 399EE-1. MULTIMEDIA CAMPAIGN.

    ``(a) In General.--The Secretary, in order to enhance existing 
awareness campaigns and provide for the implementation of new 
campaigns, shall award grants to public and nonprofit private entities 
for the purpose of carrying out multimedia campaigns to increase public 
education and awareness and reduce stigma concerning--
            ``(1) healthy developmental milestones for infants and 
        children that may assist in the early identification of the 
        signs and symptoms of autism spectrum disorders; and
            ``(2) autism spectrum disorders through the lifespan and 
        the challenges that individuals with autism spectrum disorders 
        face, which may include transitioning into adulthood, securing 
        appropriate job training or postsecondary education, securing 
        and holding jobs, finding suitable housing, interacting with 
        the correctional system, increasing independence, and attaining 
        a good quality of life.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), an entity shall--
            ``(1) submit to the Secretary an application at such time, 
        in such manner, and containing such information as the 
        Secretary may require; and
            ``(2) provide assurance that the multimedia campaign 
        implemented under such grant will provide information that is 
        tailored to the intended audience, which may be a diverse 
        public audience or a specific audience, such as health 
        professionals, employers, criminal justice professionals, or 
        emergency response professionals.

``SEC. 399EE-2. NATIONAL TECHNICAL ASSISTANCE CENTER FOR AUTISM 
              TREATMENTS, INTERVENTIONS, AND SERVICES.

    ``(a) Establishment of National Technical Assistance Center for 
Autism Treatments, Interventions, and Services.--The Secretary shall 
award a grant to a national nonprofit organization for the 
establishment and maintenance of a national technical assistance 
center.
    ``(b) Eligibility.--An organization shall be eligible to receive a 
grant under subsection (a) if the organization--
            ``(1) has demonstrated knowledge and expertise in serving 
        children with autism and adults with autism and the families of 
        such individuals;
            ``(2) has demonstrated knowledge of how to translate 
        research to practice, and present information in a way that is 
        easily accessible and understandable to the family members of 
        individuals with autism;
            ``(3) has demonstrated capacity of training educators, 
        health care providers, family members, and others to support 
        the needs of individuals with autism;
            ``(4) has demonstrated capacity of disseminating 
        information throughout the United States; and
            ``(5) has demonstrated capacity to establish and maintain a 
        Web site through which to disseminate information in an easily 
        accessible manner.
    ``(c) Use of Funds.--The national technical assistance center 
established under this section shall--
            ``(1) gather and disseminate information on evidence-based 
        treatments, interventions, and services for children with 
        autism and adults with autism, including best practices in 
        delivering such treatments, interventions, and services, and 
        make this information available to State agencies with 
        responsibilities under section 399BB(c)(2), local communities, 
        and individuals;
            ``(2) gather and disseminate information on activities of 
        the Interagency Autism Coordinating Committee established under 
        section 399CC;
            ``(3) provide analysis of activities funded under the 
        Combating Autism Reauthorization Act of 2010, including--
                    ``(A) the effectiveness of State and community-
                based models for delivering comprehensive services to 
                individuals with autism;
                    ``(B) identification and dissemination of best 
                practices emerging from States, community-based 
                organizations, nonprofit providers, and local 
                governments receiving demonstration grants under this 
                subpart;
                    ``(C) the State-by-State availability of, and gaps 
                in, services for individuals with autism spectrum 
                disorders, including information on services or service 
                gaps in rural areas; and
                    ``(D) levels of funding and funding sources of 
                services for individuals with autism spectrum disorders 
                in States;
            ``(4) provide technical assistance to States and 
        organizations funded under this part;
            ``(5) gather and disseminate information about autism 
        spectrum disorders;
            ``(6) establish and maintain a Web site through which to 
        disseminate the information gathered under this section in an 
        easily accessible manner;
            ``(7) establish partnerships with advocacy organizations to 
        disseminate accurate information on education, service-
        provision, and support options and provide assistance in 
        navigating service-provision systems; and
            ``(8) gather and disseminate other information as 
        determined appropriate by the Secretary.''.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

    Section 399FF of the Public Health Service Act, as so redesignated 
by section 5, is amended--
            (1) in subsection (a) (relating to developmental 
        disabilities surveillance and research program), by adding at 
        the end the following:
            ``(6) For fiscal year 2012, $30,000,000.
            ``(7) For fiscal year 2013, $33,000,000.
            ``(8) For fiscal year 2014, $36,000,000.
            ``(9) For fiscal year 2015, $39,000,000.
            ``(10) For fiscal year 2016, $42,000,000.'';
            (2) in subsection (b) (relating to autism education, early 
        detection, and intervention), by adding at the end the 
        following:
            ``(6) For fiscal year 2012, $80,000,000.
            ``(7) For fiscal year 2013, $86,000,000.
            ``(8) For fiscal year 2014, $92,000,000.
            ``(9) For fiscal year 2015, $98,000,000.
            ``(10) For fiscal year 2016, $104,000,000.''; and
            (3) in subsection (c) (relating to interagency autism 
        coordinating committee, certain other programs)--
                    (A) by striking ``section 399CC, 409C, and section 
                404H'' and inserting ``sections 399CC, 404H, 464z-8, 
                and 464z-9''; and
                    (B) by adding at the end the following:
            ``(6) For fiscal year 2012, $450,000,000.
            ``(7) For fiscal year 2013, $500,000,000.
            ``(8) For fiscal year 2014, $550,000,000.
            ``(9) For fiscal year 2015, $600,000,000.
            ``(10) For fiscal year 2016, $650,000,000.'';
            (4) by adding at the end the following:
    ``(d) Planning and Demonstration Grant for Services for Children, 
Transitioning Youth and Adults.--To carry out section 399EE, there are 
authorized to be appropriated the following:
            ``(1) For fiscal year 2011, $400,000,000.
            ``(2) For fiscal year 2012, $450,000,000.
            ``(3) For fiscal year 2013, $500,000,000.
            ``(4) For fiscal year 2014, $550,000,000.
            ``(5) For fiscal year 2015, $600,000,000.
            ``(6) For fiscal year 2016, $650,000,000.
    ``(e) Multimedia Campaign.--To carry out section 399EE-1, there are 
authorized to be appropriated the following:
            ``(1) For fiscal year 2011, $10,000,000.
            ``(2) For fiscal year 2012, $11,500,000.
            ``(3) For fiscal year 2013, $13,000,000.
            ``(4) For fiscal year 2014, $14,500,000.
            ``(5) For fiscal year 2015, $16,000,000.
            ``(6) For fiscal year 2016, $17,500,000.
    ``(f) National Technical Assistance Center for Autism Treatments, 
Interventions, and Services.--To carry out section 399EE-2, there are 
authorized to be appropriated the following:
            ``(1) For fiscal year 2011, $2,000,000.
            ``(2) For fiscal year 2012, $2,100,000.
            ``(3) For fiscal year 2013, $2,200,000.
            ``(4) For fiscal year 2014, $2,300,000.
            ``(5) For fiscal year 2015, $2,400,000.
            ``(6) For fiscal year 2016, $2,500,000.''.

SEC. 7. GAO STUDY ON SERVICE PROVISION AND FINANCING.

    Not later than 1 year after the date of enactment of this Act, the 
Comptroller General of the United States shall release a report that 
examines the following issues:
            (1) The ways in which autism services and treatments are 
        currently financed in the United States.
            (2) Current policies for public and private health 
        insurance coverage of autism treatments, interventions, and 
        services.
            (3) Geographic and regional disparities in provision of 
        services across the lifespan of individuals with autism, levels 
        of community-based versus institutional services, and coverage 
        for such services.
            (4) Ways in which to improve financing of autism 
        treatments, interventions, and services, so as to ensure a 
        minimum level of coverage across the United States.
            (5) Gaps in financing and availability of services for 
        adults on the autism spectrum, focusing particularly on the 
        needs of adults not eligible for developmental disability 
        services provided by the State.
            (6) Areas of need to improve the quality of services 
        available to individuals on the autism spectrum in cross-
        disability contexts, such as vocational rehabilitation and 
        centers for independent living.
            (7) Findings from replicable studies that indicate an 
        increased risk of mortality for individuals with autism due to 
        preventable circumstances such as wandering, exposure, 
        drowning, and untreated seizure disorders.

SEC. 8. EMERGING NEEDS PROTECTION AND ADVOCACY PROGRAM FOR INDIVIDUALS 
              WITH AUTISM SPECTRUM DISORDERS.

    (a) Initiatives on Autism Spectrum Disorders.--Title I of the 
Developmental Disabilities Assistance and Bill of Rights Act of 2000 
(42 U.S.C. 15001 et seq.) is amended by adding at the end the 
following:

         ``Subtitle F--Initiatives on Autism Spectrum Disorders

``SEC. 171. EMERGING NEEDS PROTECTION AND ADVOCACY PROGRAM.

    ``(a) In General.--The Secretary shall make grants to protection 
and advocacy systems for the purpose of enabling such systems to 
address the needs of individuals with autism spectrum disorders.
    ``(b) Services Provided.--Services provided under this section may 
include the provision of--
            ``(1) information, referrals, and advice;
            ``(2) individual and family advocacy;
            ``(3) legal representation;
            ``(4) specific assistance in self-advocacy and assistance 
        in capacity building for organizations that advocate on behalf 
        of individuals with autism spectrum disorder; or
            ``(5) training to individuals with autism spectrum 
        disorders, the families of such individuals, or advocates for 
        individuals with autism spectrum disorders.
    ``(c) Eligibility.--To be eligible to receive a grant under this 
section, a protection and advocacy system shall--
            ``(1) have the right and authority to investigate incidents 
        of abuse and neglect of youth and adults with autism spectrum 
        disorders if the incidents are reported to the protection and 
        advocacy system or if there is probable cause to believe that 
        the incidents occurred;
            ``(2) have the right and authority to pursue 
        administrative, legal, and other appropriate remedies and 
        approaches to ensure the protection of youth and adults with 
        autism spectrum disorders; and
            ``(3) have the rights and authorities, including access 
        authority, described in section 143 of this Act and section 105 
        of the Protection and Advocacy for Individuals with Mental 
        Illness Act.
    ``(d) Grant Amounts.--The Secretary shall make grants under this 
section during each fiscal year beginning on October 1 to protection 
and advocacy systems as follows:
            ``(1) Appropriations less than $6,700,000.--With respect to 
        any fiscal year for which the amount appropriated under 
        subsection (i) is less than $6,700,000, the Secretary shall 
        make grants from such amount to protection and advocacy systems 
        that apply for a grant under this section in the amounts 
        described in paragraph (3).
            ``(2) Appropriations of $6,700,000 or more.--
                    ``(A) In general.--With respect to any fiscal year 
                for which the amount appropriated under subsection (i) 
                is $6,700,000 or more, the Secretary shall make grants 
                from such amount to protection and advocacy systems 
                under this section in accordance with subparagraph (B).
                    ``(B) Amount of grant.--Subject to paragraph (3), 
                the amount of a grant to a protection and advocacy 
                system under subparagraph (A) shall be equal to an 
                amount bearing the same ratio to the total amount 
                appropriated for the fiscal year involved as the 
                population of the State, Territory, or Consortium in 
                which the grantee is located bears to the cumulative 
                population of all States, Territories, and the 
                Consortium that receive such grant.
            ``(3) Minimum amounts.--
                    ``(A) In general.--The amount of a grant under this 
                section shall not be less than--
                            ``(i) in the case of a protection and 
                        advocacy system located in a State, $120,000; 
                        and
                            ``(ii) in the case of a protection and 
                        advocacy system located in a Territory or 
                        Consortium, $60,000.
                    ``(B) Adjustments to minimum amounts.--
                            ``(i) In general.--In the case of a fiscal 
                        year (referred to in this subparagraph as the 
                        `current fiscal year') in which the total 
                        amount appropriated under subsection (i) is 
                        $10,000,000 or more, and such amount 
                        appropriated exceeds the total amount 
                        appropriated under such subsection for the 
                        preceding fiscal year, the Secretary shall 
                        increase the minimum grant amounts under 
                        subparagraph (A) by a percentage equal to the 
                        percentage by which the total amount 
                        appropriated for the current fiscal year 
                        exceeds the amount appropriated for the 
                        previous fiscal year.
                            ``(ii) Exception.--Clause (i) shall not 
                        apply in the case that the total amount 
                        appropriated for the current fiscal year is 
                        less than the amount appropriated for any 
                        fiscal year in the period between the date of 
                        enactment of the Combating Autism 
                        Reauthorization Act of 2010 and such current 
                        fiscal year.
                    ``(C) Applicability of adjustments.--An increase in 
                the minimum grant amounts under subparagraph (B) shall 
                be effective for each subsequent fiscal year.
            ``(4) Lower appropriation years.--In the case of a fiscal 
        year for which the amount appropriated under subsection (i) is 
        insufficient to satisfy the requirements of paragraph (3) for 
        each protection and advocacy system that applies for a grant 
        under this section, the Secretary shall award grants in the 
        amounts described in paragraph (3) to as many protection and 
        advocacy systems as the amount appropriated allows.
            ``(5) Definitions.--For purposes of this subsection and 
        subsection (e):
                    ``(A) Consortium.--The term `Consortium' means an 
                American Indian Consortium, as defined in section 
                102(1).
                    ``(B) State.--The term `State' means each of the 50 
                States of the United States, the District of Columbia, 
                and the Commonwealth of Puerto Rico.
                    ``(C) Territory.--The term `Territory' means 
                American Samoa, the Commonwealth of the Northern 
                Mariana Islands, Guam, and the United States Virgin 
                Islands.
    ``(e) Carryover.--Any amount paid to a protection and advocacy 
system that serves a Consortium, State, or Territory for a fiscal year 
under this section that remains unobligated at the end of such fiscal 
year shall remain available to such system for obligation during the 
next fiscal year for the purposes for which such amount was originally 
provided.
    ``(f) Direct Payment.--Notwithstanding any other provision of law, 
the Secretary shall pay directly to any protection and advocacy system 
that complies with the provisions of this section, the total amount of 
the grant for such system, unless the system provides otherwise for 
such payment.
    ``(g) Administrative, Reporting, and Oversight Requirements.--To 
the extent practicable, reporting, monitoring, program financing, and 
other administrative and oversight requirements established by the 
Secretary under this section shall be consistent with the other 
administrative, reporting, and oversight requirements for a protection 
and advocacy system.
    ``(h) Annual Report.--Each protection and advocacy system that 
receives a payment under this section shall submit an annual report to 
the Secretary concerning the services provided to individuals with 
autism spectrum disorders by such system.
    ``(i) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated the following:
            ``(1) For fiscal year 2011, $8,000,000.
            ``(2) For fiscal year 2012, $9,000,000.
            ``(3) For fiscal year 2013, $10,000,000.
            ``(4) For fiscal year 2014, $11,000,000.
            ``(5) For fiscal year 2015, $12,000,000.
            ``(6) For fiscal year 2016, $13,000,000.
    ``(j) Definition.--In this section, the term `protection and 
advocacy system' means a protection and advocacy system established 
under section 143.
    ``(k) Technical Assistance.--
            ``(1) Appropriations of less than $6,750,000.--For a fiscal 
        year for which the amount appropriated to carry out this 
        section is less than $6,750,000, the Secretary shall set aside 
        the greater of--
                    ``(A) 1 percent of the funds appropriated; or
                    ``(B) $25,000,
        to make a grant to a national organization with experience in 
        providing training and technical assistance to protection and 
        advocacy systems to provide such training and technical 
        assistance.
            ``(2) Appropriations of not less than $6,750,000.--For a 
        fiscal year for which the amount appropriated to carry out this 
        section is not less than $6,750,000, the Secretary shall set 
        aside 2 percent of the funds appropriated to make a grant to a 
        national organization with experience in providing training and 
        technical assistance to protection and advocacy systems to 
        provide such training and technical assistance.

``SEC. 172. NATIONAL TRAINING INITIATIVE.

    ``(a) Grants and Technical Assistance.--
            ``(1) Grants.--
                    ``(A) In general.--The Secretary, in consultation 
                with the Interagency Autism Coordinating Committee 
                established under section 399CC of the Public Health 
                Service Act, shall award multi-year grants to eligible 
                entities to provide individuals with interdisciplinary 
                training, continuing education, technical assistance, 
                and information for the purpose of improving services 
                rendered to individuals with autism spectrum disorders 
                and the families of such individuals, to address unmet 
                needs related to autism spectrum disorders.
                    ``(B) Eligible entity.--To be eligible to receive a 
                grant under this subsection, an entity shall be--
                            ``(i) a University Center for Excellence in 
                        Developmental Disabilities Education, Research, 
                        and Service; or
                            ``(ii) a comparable interdisciplinary 
                        education, research, and service entity.
                    ``(C) Application requirements.--An entity that 
                desires to receive a grant for a program under this 
                subsection shall submit to the Secretary an 
                application--
                            ``(i) demonstrating that the entity has 
                        capacity to--
                                    ``(I) provide training and 
                                technical assistance in evidence-based 
                                practices to evaluate, and provide 
                                effective interventions, services, 
                                treatments, and supports to individuals 
                                with autism spectrum disorders and the 
                                families of such individuals; and
                                    ``(II) establish a consumer 
                                advisory committee that includes 
                                individuals with autism spectrum 
                                disorder and family members of 
                                individuals with autism spectrum 
                                disorder;
                            ``(ii) providing assurances that the entity 
                        will--
                                    ``(I) provide trainees under this 
                                subsection with an appropriate balance 
                                of interdisciplinary academic and 
                                community-based experiences; and
                                    ``(II) provide to the Secretary, in 
                                the manner prescribed by the Secretary, 
                                data regarding the number of 
                                individuals who have benefitted from, 
                                and outcomes of, the provision of 
                                training and technical assistance under 
                                this subsection;
                            ``(iii) providing assurances that training, 
                        technical assistance, dissemination of 
                        information, and services under this subsection 
                        will be--
                                    ``(I) consistent with the goals of 
                                this Act, the Americans with 
                                Disabilities Act of 1990, the 
                                Individuals with Disabilities Education 
                                Act, and the Elementary and Secondary 
                                Education Act of 1965; and
                                    ``(II) conducted in coordination 
                                with relevant State agencies, 
                                institutions of higher education, and 
                                service providers; and
                            ``(iv) containing such other information 
                        and assurances as the Secretary may require.
                    ``(D) Use of funds.--A grant received under this 
                subsection shall be used to provide individuals 
                (including parents and health, allied health, 
                vocational, and educational professionals) with 
                interdisciplinary training, continuing education, 
                technical assistance, and information for the purpose 
                of improving services rendered to individuals with 
                autism spectrum disorders and the families of such 
                individuals, to address unmet needs related to autism 
                spectrum disorders. Such training, education, 
                assistance, and information shall include each of the 
                following:
                            ``(i) Training health, allied health, 
                        vocational, and educational professionals to 
                        identify, evaluate the needs of, and develop 
                        interventions, services, treatments, and 
                        supports (including housing, personal safety, 
                        and employment related supports) for 
                        individuals with autism spectrum disorders.
                            ``(ii) Developing, demonstrating, and 
                        disseminating a standard curriculum for the 
                        training of first responders, including police, 
                        firefighters, emergency medical technicians, 
                        and other law enforcement and public safety 
                        officers.
                            ``(iii) Training direct service 
                        professionals to provide housing and employment 
                        related supports.
                            ``(iv) Developing model services and 
                        supports that demonstrate evidence-based 
                        practices.
                            ``(v) Developing systems and products that 
                        allow for the interventions, services, 
                        treatments, and supports to be evaluated for 
                        fidelity of implementation.
                            ``(vi) Working to expand the availability 
                        of evidence-based, lifelong interventions; 
                        educational, employment, and transition 
                        services; and community supports.
                            ``(vii) Providing statewide technical 
                        assistance in collaboration with relevant State 
                        agencies, institutions of higher education, 
                        advocacy organizations, family groups, and 
                        community-based service providers.
                            ``(viii) Working to develop comprehensive 
                        systems of supports and services for 
                        individuals with autism spectrum disorders and 
                        the families of such individuals, including 
                        seamless transitions between education and 
                        health systems across the lifespan.
                            ``(ix) Promoting training, technical 
                        assistance, dissemination of information, 
                        supports, and services.
                            ``(x) Developing mechanisms to provide 
                        training and technical assistance, including 
                        for-credit courses, intensive summer 
                        institutes, continuing education programs, 
                        distance-based programs, and Internet Web site-
                        based information dissemination strategies.
                            ``(xi) Promoting activities that support 
                        community-based family and individual services 
                        and enable individuals with autism spectrum 
                        disorders to fully participate in society and 
                        achieve good quality-of-life outcomes.
                            ``(xii) Collecting data on the outcomes of 
                        training and technical assistance programs to 
                        meet statewide needs for the expansion of 
                        services to individuals with autism spectrum 
                        disorders.
                    ``(E) Amount of grants.--The amount of a grant to 
                any entity for a fiscal year under this paragraph shall 
                be not less than $250,000.
            ``(2) Technical assistance.--The Secretary shall reserve 2 
        percent of the amount appropriated to carry out this subsection 
        for a fiscal year to make a grant to a national organization 
        with demonstrated capacity for providing training and technical 
        assistance to--
                    ``(A) assist in national dissemination of specific 
                information, including evidence-based best practices, 
                from interdisciplinary training programs, and when 
                appropriate, other entities whose findings would inform 
                the work performed by entities awarded grants;
                    ``(B) compile and disseminate strategies and 
                materials that prove to be effective in the provision 
                of training and technical assistance so that the entire 
                network can benefit from the models, materials, and 
                practices developed in individual centers;
                    ``(C) assist in the coordination of activities of 
                grantees under this subsection;
                    ``(D) develop an Internet portal that will provide 
                linkages to each of the individual training initiatives 
                and provide access to training modules, promising 
                training, and technical assistance practices and other 
                materials developed by grantees;
                    ``(E) serve as a research-based resource for 
                Federal and State policymakers on information 
                concerning the provision of training and technical 
                assistance for the assessment, and provision of 
                supports and services for, individuals with autism 
                spectrum disorders;
                    ``(F) partner with Federal, State, and local 
                advocacy organizations to ensure effective 
                dissemination of research findings to individuals on 
                the autism spectrum;
                    ``(G) convene experts from multiple 
                interdisciplinary training programs, individuals with 
                autism spectrum disorders, and the families of such 
                individuals to discuss and make recommendations with 
                regard to training issues related to assessment, 
                interventions, services, treatment, and supports for 
                individuals with autism spectrum disorders; and
                    ``(H) undertake any other functions that the 
                Secretary determines to be appropriate.
            ``(3) Authorization of appropriations.--To carry out this 
        subsection, there are authorized to be appropriated the 
        following:
                    ``(A) For fiscal year 2011, $20,000,000.
                    ``(B) For fiscal year 2012, $22,000,000.
                    ``(C) For fiscal year 2013, $24,000,000.
                    ``(D) For fiscal year 2014, $26,000,000.
                    ``(E) For fiscal year 2015, $28,000,000.
                    ``(F) For fiscal year 2016, $30,000,000.
    ``(b) Expansion of the Number of University Centers for Excellence 
in Developmental Disabilities Education, Research, and Service.--
            ``(1) In general.--To provide for the establishment of up 
        to 4 new University Centers for Excellence in Developmental 
        Disabilities Education, Research, and Service, the Secretary 
        shall award up to 4 grants to institutions of higher education 
        in accordance with the requirements of this subtitle.
            ``(2) Applicable provisions.--Except for subsection (a)(3), 
        the provisions of subsection (a) shall apply with respect to 
        grants under this subsection to the same extent and in the same 
        manner as such provisions apply with respect to grants under 
        subsection (a).
            ``(3) Priority.--In awarding grants under this section, the 
        Secretary shall give priority to applicants that--
                    ``(A) are minority institutions that have 
                demonstrated capacity to meet the requirements of this 
                section and provide services to individuals with autism 
                spectrum disorders and the families of such 
                individuals; or
                    ``(B) are located in a State with one or more 
                unserved or underserved populations.
            ``(4) Authorization of appropriations.--To carry out this 
        section, there are authorized to be appropriated the following:
                    ``(A) For fiscal year 2011, $2,000,000.
                    ``(B) For fiscal year 2012, $2,200,000.
                    ``(C) For fiscal year 2013, $2,400,000.
                    ``(D) For fiscal year 2014, $2,600,000.
                    ``(E) For fiscal year 2015, $2,800,000.
                    ``(F) For fiscal year 2016, $3,000,000.
            ``(5) Definition.--In this subsection:
                    ``(A) The term `minority institution' has the 
                meaning given such term in section 365 of the Higher 
                Education Act of 1965.
                    ``(B) The term `University Center for Excellence in 
                Developmental Disabilities Education, Research, and 
                Service' means a University Center for Excellence in 
                Developmental Disabilities Education, Research, and 
                Service that has been or is funded through subtitle D 
                or this subsection.''.

SEC. 9. REPORT TO CONGRESS.

    Not later than January 1, 2013, and each January 1 thereafter, the 
Secretary shall submit to the appropriate committees of Congress a 
report concerning the implementation of this Act, including the 
amendments made by this Act.
                                 <all>