[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 819 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 819

To provide for enhanced treatment, support, services, and research for 
     individuals with autism spectrum disorders and their families.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 2, 2009

 Mr. Durbin (for himself, Mr. Casey, 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 provide for enhanced treatment, support, services, and research for 
     individuals with autism spectrum disorders and their families.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Autism Treatment 
Acceleration Act of 2009''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

                              Sec. 1. Short title; table of contents.
                              Sec. 2. Findings.
                              Sec. 3. Parental rights rule of 
                                        construction.
                              Sec. 4. Definitions; technical amendment 
                                        to the Public Health Service 
                                        Act.
                              Sec. 5. Autism Care Centers Demonstration 
                                        Project.
                              Sec. 6. Planning and demonstration grants 
                                        for services for adults.
                              Sec. 7. National Registry.
                              Sec. 8. Multimedia campaign.
                              Sec. 9. Interdepartmental Autism 
                                        Coordinating Committee.
                              Sec. 10. National Network for Autism 
                                        Spectrum Disorders Research and 
                                        Services.
                              Sec. 11. National training initiatives on 
                                        autism spectrum disorders.
                              Sec. 12. Amendments relating to health 
                                        insurance.
                              Sec. 13. Authorization of appropriations.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Autism (sometimes called ``classical autism'') is the 
        most common condition in a group of developmental disorders 
        known as autism spectrum disorders.
            (2) Autism spectrum disorders include autism as well as 
        Asperger syndrome, Retts syndrome, childhood disintegrative 
        disorder, and pervasive developmental disorder not otherwise 
        specified (usually referred to as PDD-NOS), as well as other 
        related developmental disorders.
            (3) Individuals with autism spectrum disorders have the 
        same rights as other individuals to exert control and choice 
        over their own 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 mainstream of 
        society. Individuals with autism spectrum disorders have the 
        right to a life with dignity and purpose.
            (4) While there is no uniform prevalence or severity of 
        symptoms associated with autism spectrum disorders, the 
        National Institutes of Health has determined that autism 
        spectrum disorders are characterized by 3 distinctive 
        behaviors: impaired social interaction, problems with verbal 
        and nonverbal communication, and unusual, repetitive, or 
        severely limited activities and interests.
            (5) Both children and adults with autism spectrum disorders 
        can show difficulties in verbal and nonverbal communication, 
        social interactions, and sensory processing. Individuals with 
        autism spectrum disorders exhibit different symptoms or 
        behaviors, which may range from mild to significant, and 
        require varying degrees of support from friends, families, 
        service providers, and communities.
            (6) Individuals with autism spectrum disorders 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 spectrum disorders can 
        live rich, full, and productive lives. Greater coordination and 
        streamlining within the service delivery system will enable 
        individuals with autism spectrum disorders and their families 
        to access assistance from all sectors throughout an 
        individual's lifespan.
            (7) A 2007 report from the Centers for Disease Control and 
        Prevention found that the prevalence of autism spectrum 
        disorders is estimated to be 1 in 150 people in the United 
        States.
            (8) The Harvard School of Public Health reported that the 
        cost of caring for and treating individuals with autism 
        spectrum disorders in the United States is more than 
        $35,000,000,000 annually (an estimated $3,200,000 over an 
        individual's lifetime).
            (9) Although the overall incidence of autism is consistent 
        around the globe, researchers with the Journal of Paediatrics 
        and Child Health have found that males are 4 times more likely 
        to develop an autism spectrum disorder than females. Autism 
        spectrum disorders know no racial, ethnic, or social 
        boundaries, nor differences in family income, lifestyle, or 
        educational levels, and can affect any child.
            (10) Individuals with autism spectrum disorders from low-
        income, rural, and minority communities often face significant 
        obstacles to accurate diagnosis and necessary specialized 
        services, supports, and education.
            (11) There is strong consensus within the research 
        community that intensive treatment as soon as possible 
        following diagnosis not only can reduce the cost of lifelong 
        care by two-thirds, but also yields the most positive life 
        outcomes for children with autism spectrum disorders.
            (12) Individuals with autism spectrum disorders and their 
        families experience a wide range of medical issues. Few common 
        standards exist for the diagnosis and management of many 
        aspects of clinical care. Behavioral difficulties may be 
        attributed to the overarching disorder rather than to the pain 
        and discomfort of a medical condition, which may go undetected 
        and untreated. The health care and other treatments available 
        in different communities can vary widely. Many families, 
        lacking access to comprehensive and coordinated health care, 
        must fend for themselves to find the best health care, 
        treatments, and services in a complex clinical world.
            (13) Effective health care, treatment, and services for 
        individuals with autism spectrum disorders depends upon a 
        continuous exchange among researchers and caregivers. Evidence-
        based and promising autism practices should move quickly into 
        communities, allowing individuals with autism spectrum 
        disorders and their families to benefit from the newest 
        research and enabling researchers to learn from the life 
        experiences of the people whom their work most directly 
        affects.
            (14) There is a critical shortage of appropriately trained 
        personnel across numerous important disciplines who can assess, 
        diagnose, treat, and support children and adults with autism 
        spectrum disorders and their families. Practicing 
        professionals, as well as those in training to become 
        professionals, need the most up-to-date practices informed by 
        the most current research findings.
            (15) The appropriate goals of the Nation regarding 
        individuals with autism spectrum disorder are the same as the 
        appropriate goals of the Nation regarding individuals with 
        disabilities in general, as established in the Americans with 
        Disabilities Act of 1990 (42 U.S.C. 12101 et seq.): to assure 
        equality of opportunity, full participation, independent 
        living, and economic self-sufficiency for such individuals.
            (16) Finally, individuals with autism spectrum disorders 
        are often denied health care benefits solely because of their 
        diagnosis, even though proven, effective treatments for autism 
        spectrum disorders do exist.

SEC. 3. PARENTAL RIGHTS RULE OF CONSTRUCTION.

    Nothing in this Act shall be construed to modify the legal rights 
of parents or legal guardians under Federal, State, or local law 
regarding the care of their children.

SEC. 4. DEFINITIONS; TECHNICAL AMENDMENT TO THE PUBLIC HEALTH SERVICE 
              ACT.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i et seq.) is amended--
            (1) by inserting after the header for part R the following:

   ``Subpart 1--Surveillance and Research Program; Education, Early 
             Detection, and Intervention; and Reporting'';

            (2) in section 399AA(d), by striking ``part'' and inserting 
        ``subpart''; and
            (3) by adding at the end the following:

``Subpart 2--Care for People With Autism Spectrum Disorders, Registry, 
                          and Public Education

``SEC. 399GG. DEFINITIONS.

    ``Except as otherwise provided, in this subpart:
            ``(1) Autism spectrum disorder.--The term `autism spectrum 
        disorder' means a developmental disability that causes 
        substantial impairments in the areas of social interaction, 
        emotional regulation, communication, and the integration of 
        higher-order cognitive processes and which may be characterized 
        by the presence of unusual behaviors and interests. Such term 
        includes autistic disorder, pervasive developmental disorder 
        (not otherwise specified), Asperger syndrome, Retts disorder, 
        childhood disintegrative disorder, and other related 
        developmental disorders.
            ``(2) Adult with autism spectrum disorder.--The term `adult 
        with autism spectrum disorder' means an individual with an 
        autism spectrum disorder who has attained 22 years of age.
            ``(3) Affected individual.--The term `affected individual' 
        means an individual with an autism spectrum disorder.
            ``(4) Autism.--The term `autism' means an autism spectrum 
        disorder or a related developmental disability.
            ``(5) Autism management team.--The term `autism management 
        team' means a group of autism care providers, including 
        behavioral specialists, physicians, psychologists, social 
        workers, family therapists, nurse practitioners, nurses, 
        educators, other appropriate personnel, and family members who 
        work in a coordinated manner to treat individuals with autism 
        spectrum disorders and their families. Such team shall 
        determine the specific structure and operational model of its 
        specific autism care center, taking into consideration 
        cultural, regional, and geographical factors.
            ``(6) Care management model.--The term `care management 
        model' means a model of care that with respect to autism--
                    ``(A) is centered on the relationship between an 
                individual with an autism spectrum disorder and his or 
                her family and their personal autism care coordinator;
                    ``(B) provides services to individuals with autism 
                spectrum disorders to improve the management and 
                coordination of care provided to patients and their 
                families; and
                    ``(C) has established, where practicable, effective 
                referral relationships between the autism care 
                coordinator and the major medical, educational, and 
                behavioral specialties and ancillary services in the 
                region.
            ``(7) Child with autism spectrum disorder.--The term `child 
        with autism spectrum disorder' means an individual with an 
        autism spectrum disorder who has not attained 22 years of age.
            ``(8) Interventions.--The term `interventions' means the 
        educational methods and positive behavioral support strategies 
        designed to improve or ameliorate symptoms associated with 
        autism spectrum disorders.
            ``(9) Network.--The term `Network' means the Network for 
        Autism Spectrum Disorders Research and Services described in 
        section 10 of the Autism Treatment Acceleration Act of 2009.
            ``(10) Personal primary care coordinator.--The term 
        `personal primary care coordinator' means a physician, nurse, 
        nurse practitioner, psychologist, social worker, family 
        therapist, educator, or other appropriate personnel (as 
        determined by the Secretary) who has extensive expertise in 
        treatment and services for individuals with autism spectrum 
        disorders, who--
                    ``(A) practices in an autism care center; and
                    ``(B) has been trained to coordinate and manage 
                comprehensive autism care for the whole person.
            ``(11) Project.--The term `project' means the autism care 
        center demonstration project established under section 399HH.
            ``(12) Services.--The term `services' means services to 
        assist individuals with autism spectrum disorders to live more 
        independently in their communities and to improve their quality 
        of life.
            ``(13) Treatments.--The term `treatments' means the health 
        services, including mental health and behavioral therapy 
        services, designed to improve or ameliorate symptoms associated 
        with autism spectrum disorders.
            ``(14) Autism care center.--In this subpart, the term 
        `autism care center' means a center that is directed by a 
        primary care coordinator who is an expert in autism spectrum 
        disorder treatment and practice and provides an array of 
        medical, psychological, behavioral, educational, and family 
        services to individuals with autism and their families. Such a 
        center shall--
                    ``(A) incorporate the attributes of the care 
                management model;
                    ``(B) offer, through on-site service provision or 
                through detailed referral and coordinated care 
                arrangements, an autism management team of appropriate 
                providers, including behavioral specialists, 
                physicians, psychologists, social workers, family 
                therapists, nurse practitioners, nurses, educators, and 
                other appropriate personnel; and
                    ``(C) have the capability to achieve improvements 
                in the management and coordination of care for targeted 
                beneficiaries.''.

SEC. 5. AUTISM CARE CENTERS DEMONSTRATION PROJECT.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i), as amended by section 4, is further amended by adding at the end 
the following:

``SEC. 399HH. AUTISM CARE CENTER DEMONSTRATION PROJECT.

    ``(a) In General.--Not later than 1 year after the date of 
enactment of the Autism Treatment Acceleration Act of 2009, the 
Secretary, acting through the Administrator of the Health Resources and 
Services Administration, shall establish a demonstration project for 
the implementation of an Autism Care Center Program (referred to in 
this section as the `Program') to provide grants and other assistance 
to improve the effectiveness and efficiency in providing comprehensive 
care to individuals diagnosed with autism spectrum disorders and their 
families.
    ``(b) Goals.--The Program shall be designed--
            ``(1) to increase--
                    ``(A) comprehensive autism spectrum disorder care 
                delivery;
                    ``(B) access to appropriate health care services, 
                especially wellness and prevention care, at times 
                convenient for patients;
                    ``(C) patient satisfaction;
                    ``(D) communication among autism spectrum disorder 
                health care providers, behaviorists, educators, 
                specialists, hospitals, and other autism spectrum 
                disorder care providers;
                    ``(E) school placement and attendance;
                    ``(F) successful transition to postsecondary 
                education, vocational or job training and placement, 
                and comprehensive adult services for individuals with 
                autism spectrum disorders, focusing in particular upon 
                the transitional period for individuals between the 
                ages of 18 and 25;
                    ``(G) the quality of health care services, taking 
                into account nationally developed standards and 
                measures;
                    ``(H) development, review, and promulgation of 
                common clinical standards and guidelines for medical 
                care to individuals with autism spectrum disorders;
                    ``(I) development of clinical research projects to 
                support clinical findings in a search for recommended 
                practices; and
                    ``(J) the quality of life of individuals with 
                autism spectrum disorders, including communication 
                abilities, social skills, community integration, and 
                employment and other related services; and
            ``(2) to decrease--
                    ``(A) inappropriate emergency room utilization, 
                which can be accomplished through initiatives such as 
                expanded hours of care;
                    ``(B) avoidable hospitalizations;
                    ``(C) the duplication of health care services;
                    ``(D) the inconvenience of multiple provider 
                locations;
                    ``(E) health disparities and inequalities that 
                individuals with autism spectrum disorders face; and
                    ``(F) preventable and inappropriate involvement 
                with the juvenile and criminal justice systems.
    ``(c) Eligible Entities.--To be eligible to receive assistance 
under the Program, an entity shall--
            ``(1) be a State or a public or private nonprofit entity;
            ``(2) agree to establish and implement an autism care 
        center that--
                    ``(A) enables targeted beneficiaries to designate a 
                personal primary care coordinator in such center to be 
                their source of first contact and to recommend 
                comprehensive and coordinated care for the whole of the 
                individual;
                    ``(B) provides for the establishment of a 
                coordination of care committee that is composed of 
                clinicians and practitioners trained in and working in 
                autism spectrum disorder intervention;
                    ``(C) establishes a network of physicians, 
                psychologists, family therapists, behavioral 
                specialists, social workers, educators, and health 
                centers that have volunteered to participate as 
                consultants to patient-centered autism care centers to 
                provide high-quality care, focusing on autism spectrum 
                disorder care, at the appropriate times and places and 
                in a cost-effective manner;
                    ``(D) works in cooperation with hospitals, local 
                public health departments, and the network of patient-
                centered autism care centers, to coordinate and provide 
                health care;
                    ``(E) utilizes health information technology to 
                facilitate the provision and coordination of health 
                care by network participants; and
                    ``(F) collaborates with other entities to further 
                the goals of the program, particularly by collaborating 
                with entities that provide transitional adult services 
                to individuals between the ages of 18 and 25 with 
                autism spectrum disorder, to ensure successful 
                transition of such individuals to adulthood; and
            ``(3) submit to the Secretary an application, at such time, 
        in such manner, and containing such information as the 
        Secretary may require, including--
                    ``(A) a description of the treatments, 
                interventions, or services that the eligible entity 
                proposes to provide under the Program;
                    ``(B) a demonstration of the capacity of the 
                eligible entity to provide or establish such 
                treatments, interventions, and services within such 
                entity;
                    ``(C) a demonstration of the capacity of the 
                eligible entity to monitor and evaluate the outcomes of 
                the treatments, interventions, and services described 
                in subparagraph (A);
                    ``(D) estimates of the number of individuals and 
                families who will be served by the eligible entity 
                under the Program, including an estimate of the number 
                of such individuals and families in medically 
                underserved areas;
                    ``(E) a description of the ability of the eligible 
                entity to enter into partnerships with community-based 
                or nonprofit providers of treatments, interventions, 
                and services, which may include providers that act as 
                advocates for individuals with autism spectrum 
                disorders and local governments that provide services 
                for individuals with autism spectrum disorders at the 
                community level;
                    ``(F) a description of the ways in which access to 
                such treatments and services may be sustained following 
                the Program period;
                    ``(G) a description of the ways in which the 
                eligible entity plans to collaborate with other 
                entities to develop and sustain an effective protocol 
                for successful transition from children's services to 
                adult services for individuals with autism spectrum 
                disorder, particularly for individuals between the ages 
                of 18 and 25; and
                    ``(H) a description of the compliance of the 
                eligible entity with the integration requirement 
                provided under section 302 of the Americans with 
                Disabilities Act of 1990 (42 U.S.C. 12182).
    ``(d) Grants.--The Secretary shall award 3-year grants to eligible 
entities whose applications are approved under subsection (c). Such 
grants shall be used to--
            ``(1) carry out a program designed to meet the goals 
        described in subsection (b) and the requirements described in 
        subsection (c); and
            ``(2) facilitate coordination with local communities to be 
        better prepared and positioned to understand and meet the needs 
        of the communities served by autism care centers.
    ``(e) Advisory Councils.--
            ``(1) In general.--Each recipient of a grant under this 
        section shall establish an autism care center advisory council, 
        which shall advise the autism care center regarding policies, 
        priorities, and services.
            ``(2) Membership.--Each recipient of a grant shall appoint 
        members of the recipient's advisory council, which shall 
        include a variety of autism care center service providers, 
        individuals from the public who are knowledgeable about autism 
        spectrum disorders, individuals receiving services through the 
        Program, and family members of such individuals. At least 60 
        percent of the membership shall be comprised of individuals who 
        have received, or are receiving, services through the Program 
        or who are family members of such individuals.
            ``(3) Chairperson.--The recipient of a grant shall appoint 
        a chairperson to the advisory council of the recipient's autism 
        care center who shall be--
                    ``(A) an individual with autism spectrum disorder 
                who has received, or is receiving, services through the 
                Program; or
                    ``(B) a family member of such an individual.
    ``(f) Evaluation.--The Secretary shall enter into a contract with 
an independent third-party organization with expertise in evaluation 
activities to conduct an evaluation and, not later than 180 days after 
the conclusion of the 3-year grant program under this section, submit a 
report to the Secretary, which may include measures such as whether and 
to what degree the treatments, interventions, and services provided 
through the Program have resulted in improved health, educational, 
employment, and community integration outcomes for individuals with 
autism spectrum disorders, or other measures, as the Secretary 
determines appropriate.
    ``(g) Administrative Expenses.--Of the amounts appropriated to 
carry out this section, the Secretary shall allocate 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.--Amounts provided to an entity under 
this section shall be used to supplement, not supplant, amounts 
otherwise expended for existing treatments, interventions, and services 
for individuals with autism spectrum disorders.''.

SEC. 6. PLANNING AND DEMONSTRATION GRANTS FOR SERVICES FOR ADULTS.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i), as amended by section 5, is further amended by adding at the end 
the following:

``SEC. 399II. PLANNING AND DEMONSTRATION GRANT FOR SERVICES FOR ADULTS.

    ``(a) In General.--In order to enable selected eligible entities to 
provide appropriate services to adults with autism spectrum disorders, 
to enable such adults to be as independent as possible, the Secretary 
shall establish--
            ``(1) a one-time, single-year planning grant program for 
        eligible entities; and
            ``(2) a multiyear 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 on critical aspects of adult life, such as--
            ``(1) postsecondary education, vocational training, self-
        advocacy skills, and employment;
            ``(2) residential services and supports, housing, and 
        transportation;
            ``(3) nutrition, health and wellness, recreational and 
        social activities; and
            ``(4) personal safety 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 an autism care center.
    ``(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 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 State 
                Developmental Disabilities Council and organizations 
                representing or serving individuals with autism 
                spectrum disorders and their families.
    ``(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 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 
                adults with autism spectrum disorders who receive such 
                services;
                    ``(B) the number of adults and families who will be 
                served by such grant, including an estimate of the 
                adults and families 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 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 such entity's capacity 
                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 adults with autism spectrum disorders 
                who receive such services;
                    ``(F) 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 
                provided 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 health, 
education, employment, and community integration outcomes for adults 
with autism spectrum disorders, 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. 7. NATIONAL REGISTRY.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i), as amended by section 6, is further amended by adding at the end 
the following:

``SEC. 399JJ. NATIONAL REGISTRY FOR AUTISM SPECTRUM DISORDERS.

    ``(a) Establishment.--The Secretary, in consultation with national 
health organizations and professional societies with experience and 
expertise relating to autism spectrum disorders, shall establish a 
voluntary population-based registry of cases of autism spectrum 
disorders. Such registry shall be known as the `National Registry for 
Autism Spectrum Disorders' (referred to in this section as the 
`Registry'). The Secretary shall ensure that the Registry maintains the 
privacy of individuals and the highest level of medical and scientific 
research ethics.
    ``(b) Purpose.--The purpose of the Registry is to facilitate the 
collection, analysis, and dissemination of data related to autism 
spectrum disorders that can increase understanding of causal factors, 
rates, and trends of autism spectrum disorders.
    ``(c) Activities.--In carrying out the Registry, the Secretary 
may--
            ``(1) implement a surveillance and monitoring system that 
        is based on thorough and complete medical diagnosis data, 
        clinical history, and medical findings;
            ``(2) collect standardized information concerning the 
        environmental, medical, social, and genetic circumstances that 
        may correlate with diagnosis of autism spectrum disorders;
            ``(3) promote the use of standardized autism spectrum 
        disorder investigation and reporting tools of the Centers for 
        Disease Control and Prevention, as well as standardized autism 
        spectrum disorder protocols;
            ``(4) establish a standardized classification system for 
        defining subcategories of autism spectrum disorders for 
        surveillance research activities; and
            ``(5) support multidisciplinary reviews of autism spectrum 
        disorders.''.

SEC. 8. MULTIMEDIA CAMPAIGN.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i), as amended by section 7, is further amended by adding at the end 
the following:

``SEC. 399KK. 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, criminal justice professionals, or emergency 
        response professionals.''.

SEC. 9. INTERDEPARTMENTAL AUTISM COORDINATING COMMITTEE.

    (a) Establishment.--There is established a committee, to be known 
as the ``Interdepartmental Autism Coordinating Committee'' (referred to 
in this section as the ``Committee''), to coordinate all Federal 
efforts concerning autism spectrum disorders.
    (b) Responsibilities.--In carrying out its duties under this 
section, the Committee shall--
            (1) develop and annually update a summary of developments 
        in research on autism spectrum disorders, services for people 
        on the autism spectrum and their families, and programs that 
        focus on people on the autism spectrum;
            (2) monitor governmental and nongovernmental activities 
        with respect to autism spectrum disorders;
            (3) make recommendations to the Secretary of Health and 
        Human Services and other relevant heads of agencies (referred 
        to in this subsection as the ``agency heads'') regarding any 
        appropriate changes to such activities and any ethical 
        considerations relating to those activities;
            (4) make recommendations to the agency heads regarding 
        public participation in decisions relating to autism spectrum 
        disorders;
            (5) develop and annually update a strategic plan, including 
        proposed budgetary requirements, for conducting and supporting 
        research related to autism spectrum disorders, services for 
        individuals on the autism spectrum and their families, and 
        programs that focus on such individuals and their families; and
            (6) annually submit to Congress and the President such 
        strategic plan and any updates to such plan.
    (c) Membership.--
            (1) Federal members.--The Committee shall be composed of--
                    (A) the Director of the National Institutes of 
                Health, and the directors of such national research 
                institutes of the National Institutes of Health as the 
                Director determines appropriate;
                    (B) the heads of other agencies within the 
                Department of Health and Human Services, as the 
                Secretary determines appropriate; and
                    (C) representatives of the Department of Education, 
                the Department of Defense, and other Federal agencies 
                that provide services to individuals with autism 
                spectrum disorders and their families or that have 
                programs that affect individuals with autism spectrum 
                disorders, as the Secretary determines appropriate.
            (2) Non-federal members.--Not less than \2/5\ of the total 
        membership of the Committee shall be composed of public members 
        to be appointed by the Secretary, of which--
                    (A) at least one such member shall be an individual 
                with an autism spectrum disorder;
                    (B) at least one such member shall be a parent or 
                legal guardian of an individual with an autism spectrum 
                disorder;
                    (C) at least one such member shall be a 
                representative of a nongovernmental organization that 
                provides services to individuals with autism spectrum 
                disorders or their families; and
                    (D) at least one such member shall be a 
                representative of a leading research, advocacy, and 
                service organization for individuals with autism 
                spectrum disorders and their families.
    (d) Administrative Support; Terms of Service; Other Provisions.--
The following provisions shall apply with respect to the Committee:
            (1) The Committee shall receive necessary and appropriate 
        administrative support from the Secretary.
            (2) Members of the Committee appointed under subsection 
        (c)(2) shall serve for a term of 4 years and may be reappointed 
        for one or more additional 4-year terms. The term of any member 
        appointed under subsection (c)(2)(C) or subsection (c)(2)(D) 
        shall expire if the member no longer represents the 
        organization described in such subsections. Any member 
        appointed to fill a vacancy for an unexpired term shall be 
        appointed for the remainder of such term. A member may serve 
        after the expiration of the member's term until a successor has 
        taken office.
            (3) The Committee shall be chaired by the Secretary or the 
        Secretary's designee. The Committee shall meet at the call of 
        the chairperson and not fewer than 2 times each year.
            (4) All meetings of the Committee or its subcommittees 
        shall be public and shall include appropriate time periods for 
        questions and presentations by the public.
            (5) The Committee may convene workshops and conferences.
    (e) Subcommittees: Establishment and Membership.--
            (1) Establishment of subcommittees.--In carrying out its 
        functions, the Committee may establish--
                    (A) a subcommittee on research on autism spectrum 
                disorders;
                    (B) a subcommittee on services for individuals with 
                autism spectrum disorders and their families and 
                programs that focus on individuals with autism spectrum 
                disorders; and
                    (C) such other subcommittees as the Committee 
                determines appropriate.
            (2) Membership.--Subcommittees may include as members 
        individuals who are not members of the Committee.
            (3) Meetings.--Subcommittees may hold such meetings as are 
        necessary.
    (f) Interagency Autism Coordinating Committee.--Part R of title III 
of the Public Health Service Act (42 U.S.C. 280i) is amended by 
striking section 399CC (42 U.S.C. 284i-2).

SEC. 10. NATIONAL NETWORK FOR AUTISM SPECTRUM DISORDERS RESEARCH AND 
              SERVICES.

    (a) Definitions.--In this section:
            (1) Services.--The term ``services'' means services to 
        assist individuals with autism spectrum disorders to live more 
        independently in their communities and improve the quality of 
        life of such individuals.
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (3) Treatments.--The term ``treatments'' means the health 
        services, including mental health and behavioral therapy 
        services, designed to improve or ameliorate symptoms associated 
        with autism spectrum disorders.
            (4) Autism care center.--In this subpart, the term ``autism 
        care center'' means a center that is directed by a primary care 
        coordinator who is an expert in autism spectrum disorder 
        treatment and practice and provides an array of medical, 
        psychological, behavioral, educational, and family services to 
        individuals with autism and their families. Such a center 
        shall--
                    (A) incorporate the attributes of the care 
                management model;
                    (B) offer, through on-site service provision or 
                through detailed referral and coordinated care 
                arrangements, an autism management team of appropriate 
                providers, including behavioral specialists, 
                physicians, psychologists, social workers, family 
                therapists, nurse practitioners, nurses, educators, and 
                other appropriate personnel; and
                    (C) have the capability to achieve improvements in 
                the management and coordination of care for targeted 
                beneficiaries.
    (b) Establishment of the National Network for Autism Spectrum 
Disorders Research and Services.--Not later than 1 year after the date 
of enactment of this Act, the Secretary shall establish the National 
Network for Autism Spectrum Disorders Research and Services (referred 
to in this section as the ``National Network''). The National Network 
shall provide resources for, and facilitate communication between, 
autism spectrum disorder researchers and service providers for 
individuals with autism spectrum disorders and their families.
    (c) Purposes.--The purposes of the National Network are to--
            (1) build upon the infrastructure relating to autism 
        spectrum disorders that exists on the date of enactment of this 
        Act;
            (2) strengthen linkages between autism spectrum disorders 
        research and service initiatives at the Federal, regional, 
        State, and local levels;
            (3) facilitate the translation of research on autism 
        spectrum disorders into services and treatments to improve the 
        quality of life for individuals with autism and their families; 
        and
            (4) ensure the rapid dissemination of evidence-based or 
        promising autism spectrum disorder practices through the 
        National Data Repository for Autism Spectrum Disorders Research 
        and Services described in subsection (e).
    (d) Organization and Activities of the National Network.--
            (1) In general.--In establishing the National Network, the 
        Secretary, acting through Administrator of the Health Resources 
        and Services Administration, shall ensure that the National 
        Network is composed of entities at the Federal, regional, 
        State, and local levels.
            (2) Regional leadership and organization.--In establishing 
        the National Network, the Secretary shall establish a Committee 
        of Regional Leaders, which shall ensure that regional 
        participation is provided through the appointment of regional 
        leaders such as university- and community-based partnerships 
        that represent the needs and interests of regional stakeholders 
        (including individuals with autism spectrum disorders and their 
        families, providers, and researchers). The Committee of 
        Regional Leaders shall be responsible for monitoring, 
        reporting, analyzing, and disseminating information in the Data 
        Repository described in subsection (e) to other stakeholders to 
        ensure that the information contained in such Data Repository 
        is widely available to policymakers and service providers at 
        the State and local levels, and to facilitate communication 
        between various members of the National Network.
            (3) State and community level leadership and 
        organization.--
                    (A) State directors.--The regional leaders 
                appointed under paragraph (2) shall appoint State 
                directors who shall coordinate the activities of the 
                National Network at the State and community levels.
                    (B) State and community subnetworks.--The Secretary 
                shall ensure that the State directors establish State 
                and community autism subnetworks, which shall engage in 
                a variety of frontline autism activities and provide 
                services, including comprehensive diagnostics, 
                treatment, resource and referral, and support programs, 
                for individuals with autism spectrum disorders.
    (e) National Data Repository for Autism Spectrum Disorders Research 
and Services.--
            (1) In general.--The Secretary shall establish a National 
        Data Repository for Autism Spectrum Disorders Research and 
        Services (referred to in this section as the ``Data 
        Repository'') and shall contract with one eligible third-party 
        entity to develop and administer such repository (referred to 
        in this section as the ``Data Repository Administrator''). The 
        Data Repository shall be used to collect, store, and 
        disseminate information regarding research, data, findings, 
        models of treatment, training modules, and technical assistance 
        materials related to autism spectrum disorders in order to 
        facilitate the development and rapid dissemination of research 
        into best practices that improve care.
            (2) Eligibility.--To be eligible to receive the contract 
        described in paragraph (1), an entity shall--
                    (A) be a public or private nonprofit entity; and
                    (B) have experience--
                            (i) collecting data;
                            (ii) developing systems to store data in a 
                        secure manner that does not personally identify 
                        individuals;
                            (iii) developing internet web portals and 
                        other means of communicating with a wide 
                        audience; and
                            (iv) making information available to the 
                        public.
            (3) Contents.--The Data Repository shall include--
                    (A) emerging research, data, and findings regarding 
                autism spectrum disorders from basic and applied 
                researchers and service providers;
                    (B) emerging or promising models of treatment, 
                service provision, and training related to autism 
                spectrum disorders that are developed in individual 
                care centers or programs; and
                    (C) training modules and technical assistance 
                materials.
            (4) Duties of the administrator.--The Data Repository 
        Administrator shall--
                    (A) collect information from autism spectrum 
                disorders research and service provision agencies and 
                organizations including--
                            (i) Centers of Excellence in Autism 
                        Spectrum Disorder Epidemiology under section 
                        399AA(b) of the Public Health Service Act (42 
                        U.S.C. 280i(b));
                            (ii) autism care centers;
                            (iii) recipients of grants through the 
                        grant program for adult services under section 
                        399II of the Public Health Service Act, as 
                        added by section 6 of this Act;
                            (iv) members and recipients of the national 
                        training initiatives on autism spectrum 
                        disorders under section 399LL of the Public 
                        Health Service Act, as added by section 11 of 
                        this Act; and
                            (v) the Committee of Regional Leaders, 
                        regional leaders, State directors, members of 
                        State and community autism subnetworks, and 
                        other entities, as determined by the Secretary;
                    (B) securely store and maintain information in the 
                Data Repository in a manner that does not personally 
                identify individuals;
                    (C) make information in the Data Repository 
                accessible through an Internet web portal or other 
                appropriate means of sharing information;
                    (D) ensure that the information contained in the 
                Data Repository is accessible to the National Network, 
                including health care providers, educators, and other 
                autism spectrum disorders service providers at the 
                national, State, and local levels; and
                    (E) provide a means through the Internet web 
                portal, or through other means, for members of the 
                National Network to share information, research, and 
                best practices on autism spectrum disorders.
    (f) Supplement Not Supplant.--Amounts provided under this section 
shall be used to supplement, not supplant, amounts otherwise expended 
for existing network or organizational structures relating to autism 
spectrum disorders.

SEC. 11. NATIONAL TRAINING INITIATIVES ON AUTISM SPECTRUM DISORDERS.

    Part R of title III of the Public Health Service Act (42 U.S.C. 
280i), as amended by section 8, is further amended by adding at the end 
the following:

``SEC. 399LL. NATIONAL TRAINING INITIATIVES ON AUTISM SPECTRUM 
              DISORDERS.

    ``(a) National Training Initiative Supplemental Grants.--
            ``(1) In general.--The Secretary shall award multiyear 
        national training initiative supplemental grants to eligible 
        entities so that such entities may provide training and 
        technical assistance and to disseminate information, in order 
        to enable such entities to address the unmet needs of 
        individuals with autism spectrum disorders and their families.
            ``(2) Eligible entity.--To be eligible to receive 
        assistance under this section an entity shall--
                    ``(A) be a public or private nonprofit entity, 
                including University Centers for Excellence in 
                Developmental Disabilities and other service, training, 
                and academic entities; and
                    ``(B) submit an application as described in 
                paragraph (3).
            ``(3) Requirements.--An eligible entity that desires to 
        receive a grant under this paragraph shall submit to the 
        Secretary an application containing such agreements and 
        information as the Secretary may require, including agreements 
        that the training program shall--
                    ``(A) provide trainees with an appropriate balance 
                of interdisciplinary academic and community-based 
                experiences;
                    ``(B) have a demonstrated capacity to include 
                individuals with autism spectrum disorders, parents, 
                and family members as part of the training program to 
                ensure that a person and family-centered approach is 
                used;
                    ``(C) provide to the Secretary, in the manner 
                prescribed by the Secretary, data regarding the 
                outcomes of the provision of training and technical 
                assistance;
                    ``(D) demonstrate a capacity to share and 
                disseminate materials and practices that are developed 
                and evaluated to be effective in the provision of 
                training and technical assistance; and
                    ``(E) provide assurances that training, technical 
                assistance, and information dissemination performed 
                under grants made pursuant to this paragraph shall be 
                consistent with the goals established under already 
                existing disability programs authorized under Federal 
                law and conducted in coordination with other relevant 
                State agencies and service providers.
            ``(4) Activities.--An entity that receives a grant under 
        this section shall expand and develop interdisciplinary 
        training and continuing education initiatives for health, 
        allied health, and educational professionals by engaging in the 
        following activities:
                    ``(A) Promoting and engaging in training for 
                health, allied health, and educational professionals to 
                identify, diagnose, and develop interventions for 
                individuals with, or at risk of developing, autism 
                spectrum disorders.
                    ``(B) Working to expand the availability of 
                training and information regarding effective, lifelong 
                interventions, educational services, and community 
                supports, including specific training for criminal 
                justice system, emergency health care, legal, and other 
                mainstream first responder professionals, to identify 
                characteristics of individuals with autism spectrum 
                disorders and to develop appropriate responses and 
                interventions.
                    ``(C) Providing technical assistance in 
                collaboration with relevant State, regional, or 
                national agencies, institutions of higher education, 
                advocacy groups for individuals with autism spectrum 
                disorders and their families, or community-based 
                service providers.
                    ``(D) Developing mechanisms to provide training and 
                technical assistance, including for-credit courses, 
                intensive summer institutes, continuing education 
                programs, distance-based programs, and web-based 
                information dissemination strategies.
                    ``(E) Collecting data on the outcomes of training 
                and technical assistance programs to meet statewide 
                needs for the expansion of services to children with 
                autism spectrum disorders and adults with autism 
                spectrum disorders.
    ``(b) Technical Assistance.--The Secretary shall reserve 2 percent 
of the appropriated funds to make a grant to a national organization 
with demonstrated capacity for providing training and technical 
assistance to the entities receiving grants under subsection (a) to 
enable such entities to--
            ``(1) assist in national dissemination of specific 
        information, including evidence-based and promising best 
        practices, from interdisciplinary training programs, and when 
        appropriate, other entities whose findings would inform the 
        work performed by entities awarded grants;
            ``(2) 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;
            ``(3) assist in the coordination of activities of grantees 
        under this section;
            ``(4) develop an Internet web 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;
            ``(5) convene experts from multiple interdisciplinary 
        training programs and individuals with autism spectrum 
        disorders and their families to discuss and make 
        recommendations with regard to training issues related to the 
        assessment, diagnosis of, treatment, interventions and services 
        for, children with autism spectrum disorders and adults with 
        autism spectrum disorders; and
            ``(6) undertake any other functions that the Secretary 
        determines to be appropriate.
    ``(c) Supplement Not Supplant.--Amounts provided under this section 
shall be used to supplement, not supplant, amounts otherwise expended 
for existing network or organizational structures.''.

SEC. 12. AMENDMENTS RELATING TO HEALTH INSURANCE.

    (a) ERISA.--
            (1) In general.--Subpart B of part 7 of subtitle B of title 
        I of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1185 et seq.) is amended by adding at the end the 
        following:

``SEC. 715. REQUIRED COVERAGE FOR AUTISM SPECTRUM DISORDERS.

    ``(a) In General.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, shall provide coverage for the diagnosis of autism 
spectrum disorders and the treatment of autism spectrum disorders.
    ``(b) Rule of Construction.--Nothing in this section shall be 
construed--
            ``(1) as preventing a group health plan or health insurance 
        issuer from imposing financial requirements or limits in 
        relation to benefits for the diagnosis and treatment of autism 
        spectrum disorders, except that such financial requirements or 
        limits for any such benefits may not be less favorable to the 
        individual than such financial requirements or limits for 
        substantially all other medical and surgical benefits covered 
        by the plan, and there shall be no separate financial 
        requirements or limits that are applicable only with respect to 
        benefits for the diagnosis or treatment of autism spectrum 
        disorders; and
            ``(2) to prevent a group health plan or a health insurance 
        issuer from negotiating the level and type of reimbursement 
        with a provider for care provided in accordance with this 
        section.
    ``(c) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a)(1), 
for purposes of assuring notice of such requirements under the plan, 
except that the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided not later than the earlier of--
            ``(1) 60 days after the first day of the first plan year in 
        which such requirements apply; or
            ``(2) in the first mailing after the date of enactment of 
        the Autism Treatment Acceleration Act of 2009 made by the plan 
        or issuer to the participant or beneficiary.
    ``(d) Prohibitions.--A group health plan, and a health insurance 
issuer offering group health insurance coverage in connection with a 
group health plan, shall not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section; or
            ``(2) deny coverage otherwise available under this section 
        on the basis that such coverage will not--
                    ``(A) develop skills or functioning;
                    ``(B) maintain skills or functioning;
                    ``(C) restore skills or functioning; or
                    ``(D) prevent the loss of skills or functioning.
    ``(e) Preemption; Relation to State Law.--
            ``(1) In general.--Nothing in this section shall be 
        construed to preempt any State law (or cost sharing 
        requirements under State law) with respect to health insurance 
        coverage that requires coverage of at least the coverage for 
        autism spectrum disorders otherwise required under this 
        section.
            ``(2) Effect on other laws.--Nothing in this section shall 
        be construed to affect or modify the provisions of section 514 
        with respect to group health plans.
    ``(f) Definitions.--In this section:
            ``(1) Autism spectrum disorders.--The term `autism spectrum 
        disorders' means developmental disabilities that cause 
        substantial impairments in the areas of social interaction, 
        emotional regulation, communication, and the integration of 
        higher-order cognitive processes and which may be characterized 
        by the presence of unusual behaviors and interests. Such term 
        includes autistic disorder, pervasive developmental disorder 
        (not otherwise specified), Asperger syndrome, Retts disorder, 
        and childhood disintegrative disorder.
            ``(2) Diagnosis of autism spectrum disorders.--The term 
        `diagnosis of autism spectrum disorders' means medically 
        necessary assessments, evaluations, or tests to diagnose 
        whether an individual has an autism spectrum disorder.
            ``(3) Treatment of autism spectrum disorders.--The term 
        `treatment of autism spectrum disorders' means the following 
        care prescribed, provided, or ordered for an individual 
        diagnosed with an autism spectrum disorder by a physician, 
        psychologist, or other qualified professional who determines 
        the care to be medically necessary:
                    ``(A) Medications prescribed by a physician and any 
                health-related services necessary to determine the need 
                or effectiveness of the medications.
                    ``(B) Occupational therapy, physical therapy, and 
                speech therapy.
                    ``(C) Direct or consultative services provided by a 
                psychiatrist or psychologist.
                    ``(D) Professional, counseling, and guidance 
                services and treatment programs, including applied 
                behavior analysis and other structured behavioral 
                programs. In this subparagraph, the term `applied 
                behavior analysis' means the design, implementation and 
                evaluation of environmental modifications, using 
                behavioral stimuli and consequences, to produce 
                socially significant improvement in human behavior, 
                including the use of direct observation, measurement, 
                and functional analysis of the relationship between 
                environment and behavior.
                    ``(E) Augmentative communication devices and other 
                assistive technology devices.''.
            (2) Clerical amendment.--The table of contents in section 1 
        of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1001 note) is amended by inserting after the item 
        relating to section 714 the following:

``Sec. 715. Required coverage for autism spectrum disorders.''.
    (b) Public Health Service Act.--
            (1) Group market.--Subpart 2 of part A of title XXVII of 
        the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is 
        amended by adding at the end the following:

``SEC. 2708. REQUIRED COVERAGE FOR AUTISM SPECTRUM DISORDERS.

    ``(a) In General.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, shall provide coverage for the diagnosis of autism 
spectrum disorders and the treatment of autism spectrum disorders.
    ``(b) Rule of Construction.--Nothing in this section shall be 
construed--
            ``(1) as preventing a group health plan or health insurance 
        issuer from imposing financial requirements or limits in 
        relation to benefits for the diagnosis and treatment of autism 
        spectrum disorders, except that such financial requirements or 
        limits for any such benefits may not be less favorable to the 
        individual than such financial requirements or limits for 
        substantially all other medical and surgical benefits covered 
        by the plan, and there shall be no separate financial 
        requirements or limits that are applicable only with respect to 
        benefits for the diagnosis or treatment of autism spectrum 
        disorders; or
            ``(2) to prevent a group health plan or a health insurance 
        issuer from negotiating the level and type of reimbursement 
        with a provider for care provided in accordance with this 
        section.
    ``(c) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a)(1), 
for purposes of assuring notice of such requirements under the plan, 
except that the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided not later than the earlier of--
            ``(1) 60 days after the first day of the first plan year in 
        which such requirements apply; or
            ``(2) in the first mailing after the date of enactment of 
        the Autism Treatment Acceleration Act of 2009 made by the plan 
        or issuer to the enrollee.
    ``(d) Prohibitions.--A group health plan, and a health insurance 
issuer offering group health insurance coverage in connection with a 
group health plan, shall not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section; or
            ``(2) deny coverage otherwise available under this section 
        on the basis that such coverage will not--
                    ``(A) develop skills or functioning;
                    ``(B) maintain skills or functioning;
                    ``(C) restore skills or functioning; or
                    ``(D) prevent the loss of skills or functioning.
    ``(e) Preemption; Relation to State Law.--
            ``(1) In general.--Nothing in this section shall be 
        construed to preempt any State law (or cost sharing 
        requirements under State law) with respect to health insurance 
        coverage that requires coverage of at least the coverage for 
        autism spectrum disorders otherwise required under this 
        section.
            ``(2) ERISA.--Nothing in this section shall be construed to 
        affect or modify the provisions of section 514 of the Employee 
        Income Retirement Security Act of 1974 with respect to group 
        health plans.
    ``(f) Definitions.--In this section:
            ``(1) Autism spectrum disorders.--The term `autism spectrum 
        disorders' means developmental disabilities that cause 
        substantial impairments in the areas of social interaction, 
        emotional regulation, communication, and the integration of 
        higher-order cognitive processes and which may be characterized 
        by the presence of unusual behaviors and interests. Such term 
        includes autistic disorder, pervasive developmental disorder 
        (not otherwise specified), and Asperger syndrome.
            ``(2) Diagnosis of autism spectrum disorders.--The term 
        `diagnosis of autism spectrum disorders' means medically 
        necessary assessments, evaluations, or tests to diagnose 
        whether an individual has an autism spectrum disorder.
            ``(3) Treatment of autism spectrum disorders.--The term 
        `treatment of autism spectrum disorders' means the following 
        care prescribed, provided, or ordered for an individual 
        diagnosed with an autism spectrum disorder by a physician, 
        psychologist, or other qualified professional who determines 
        the care to be medically necessary:
                    ``(A) Medications prescribed by a physician and any 
                health-related services necessary to determine the need 
                or effectiveness of the medications.
                    ``(B) Occupational therapy, physical therapy, and 
                speech therapy.
                    ``(C) Direct or consultative services provided by a 
                psychiatrist or psychologist.
                    ``(D) Professional, counseling, and guidance 
                services and treatment programs, including applied 
                behavior analysis and other structured behavioral 
                programs. In this subparagraph, the term `applied 
                behavior analysis' means the design, implementation and 
                evaluation of environmental modifications, using 
                behavioral stimuli and consequences, to produce 
                socially significant improvement in human behavior, 
                including the use of direct observation, measurement, 
                and functional analysis of the relationship between 
                environment and behavior.
                    ``(E) Augmentative communication devices and other 
                assistive technology devices.''.
            (2) Individual market.--Subpart 3 of part B of title XXVII 
        of the Public Health Service Act (42 U.S.C. 300gg-51 et seq.) 
        is amended by adding at the end the following:

``SEC. 2754. REQUIRED COVERAGE FOR AUTISM SPECTRUM DISORDERS.

    ``The provisions of section 2708 shall apply to health insurance 
coverage offered by a health insurance issuer in the individual market 
in the same manner as they apply to health insurance coverage offered 
by a health insurance issuer in connection with a group health plan in 
the small or large group market.''.
    (c) Effective Dates.--
            (1) Group health plans.--
                    (A) In general.--The amendment made by subsection 
                (a) shall apply to group health plans for plan years 
                beginning on or after the date of enactment of this 
                Act.
                    (B) Special rule for collective bargaining 
                agreements.--In the case of a group health plan 
                maintained pursuant to one or more collective 
                bargaining agreements between employee representatives 
                and one or more employers, any plan amendment made 
                pursuant to a collective bargaining agreement relating 
                to the plan which amends the plan solely to conform to 
                any requirement added by the amendment made by 
                subsections (a) and (b)(1) shall not be treated as a 
                termination of such collective bargaining agreement.
            (2) Individual plans.--The amendment made by subsection 
        (b)(2) shall apply with respect to health insurance coverage 
        offered, sold, issued, renewed, in effect, or operated in the 
        individual market on or after the date of enactment of this 
        Act.

SEC. 13. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated for fiscal years 2010 
through 2014 such sums as may be necessary to carry out this Act.
                                 <all>