[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2449 Reported in Senate (RS)]

                                                       Calendar No. 444
113th CONGRESS
  2d Session
                                S. 2449

  To reauthorize certain provisions of the Public Health Service Act 
              relating to autism, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 9, 2014

    Mr. Menendez (for himself, Mr. Enzi, Mr. Kirk, Mr. Franken, Ms. 
Klobuchar, Mr. Burr, Mr. Schumer, Mr. Blunt, Mr. Harkin, Mr. Moran, and 
  Mr. Coons) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

                             June 26, 2014

               Reported by Mr. Harkin, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
  To reauthorize certain provisions of the Public Health Service Act 
              relating to autism, and for other purposes.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Autism Collaboration, 
Accountability, Research, Education, and Support Act of 2014'' or the 
``Autism CARES Act of 2014''.</DELETED>

<DELETED>SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER 
              INITIATIVE.</DELETED>

<DELETED>    (a) In General.--The Secretary of Health and Human 
Services shall designate an existing official within the Department of 
Health and Human Services to oversee, in consultation with the 
Secretaries of Defense and Education, national autism spectrum disorder 
research, services, and support activities.</DELETED>
<DELETED>    (b) Duties.--The official designated under subsection (a) 
shall--</DELETED>
        <DELETED>    (1) implement autism spectrum disorder activities, 
        taking into account the strategic plan developed by the 
        Interagency Autism Coordinating Committee under section 
        399CC(b) of the Public Health Service Act (42 U.S.C. 280i-
        2(b)); and</DELETED>
        <DELETED>    (2) ensure that autism spectrum disorder 
        activities of the Department of Health and Human Services and 
        of other Federal departments and agencies are not unnecessarily 
        duplicative.</DELETED>

<DELETED>SEC. 3. RESEARCH PROGRAM.</DELETED>

<DELETED>    Section 399AA of the Public Health Service Act (42 U.S.C. 
280i) is amended--</DELETED>
        <DELETED>    (1) in subsection (a)(1), by inserting ``for 
        children and adults'' after ``reporting of State 
        epidemiological data'';</DELETED>
        <DELETED>    (2) in subsection (b)(1)--</DELETED>
                <DELETED>    (A) by striking ``establishment of 
                regional centers of excellence'' and inserting 
                ``establishment or support of regional centers of 
                excellence''; and</DELETED>
                <DELETED>    (B) by inserting ``for children and 
                adults'' before the period at the end;</DELETED>
        <DELETED>    (3) in subsection (b)(2), by striking ``center to 
        be established'' and inserting ``center to be established or 
        supported''; and</DELETED>
        <DELETED>    (4) in subsection (e), by striking ``2014'' and 
        inserting ``2019''.</DELETED>

<DELETED>SEC. 4. AUTISM INTERVENTION.</DELETED>

<DELETED>    Section 399BB of the Public Health Service Act (42 U.S.C. 
280i-1) is amended--</DELETED>
        <DELETED>    (1) in subsection (b)(1), by inserting 
        ``culturally competent'' after ``provide'';</DELETED>
        <DELETED>    (2) in subsection (c)(2)(A)(ii), by inserting 
        ``(which may include respite care for caregivers of individuals 
        with an autism spectrum disorder)'' after ``services and 
        supports'';</DELETED>
        <DELETED>    (3) in subsection (e)(1)(B)(v), by inserting 
        before the semicolon the following: ``, which may include 
        collaborating with research centers or networks to provide 
        training for providers of respite care (as defined in section 
        2901)'';</DELETED>
        <DELETED>    (4) in subsection (f), by striking ``grants or 
        contracts'' and all that follows through ``for individual 
        with'' and inserting ``grants or contracts, which may include 
        grants or contracts to research centers or networks, to 
        determine the evidence-based practices for interventions to 
        improve the physical and behavioral health of individuals 
        with''; and</DELETED>
        <DELETED>    (5) in subsection (g), by striking ``2014'' and 
        inserting ``2019''.</DELETED>

<DELETED>SEC. 5. INTERAGENCY AUTISM COORDINATING COMMITTEE.</DELETED>

<DELETED>    Section 399CC of the Public Health Service Act (42 U.S.C. 
280i-2) is amended--</DELETED>
        <DELETED>    (1) in subsection (b)--</DELETED>
                <DELETED>    (A) in paragraph (1)--</DELETED>
                        <DELETED>    (i) by striking ``and annually 
                        update''; and</DELETED>
                        <DELETED>    (ii) by striking ``intervention'' 
                        and inserting ``interventions, including school 
                        and community-based interventions'';</DELETED>
                <DELETED>    (B) by striking paragraph (2);</DELETED>
                <DELETED>    (C) by redesignating paragraph (1) as 
                paragraph (2), and inserting before such redesignated 
                paragraph the following:</DELETED>
        <DELETED>    ``(1) monitor autism spectrum disorder research, 
        and to the extent practicable services and support activities, 
        across all Federal departments and agencies, including 
        coordination of Federal activities with respect to autism 
        spectrum disorder;'';</DELETED>
                <DELETED>    (D) in paragraph (3), by striking 
                ``recommendations to the Director of NIH'';</DELETED>
                <DELETED>    (E) in paragraph (4), by inserting before 
                the semicolon the following: ``, and the process by 
                which public feedback can be better integrated into 
                such decisions''; and</DELETED>
                <DELETED>    (F) by striking paragraphs (5) and (6) and 
                inserting the following:</DELETED>
        <DELETED>    ``(5) develop a strategic plan for the conduct of, 
        and support for, autism spectrum disorder research and services 
        and supports for individuals with an autism spectrum disorder 
        and the families of such individuals, which shall include--
        </DELETED>
                <DELETED>    ``(A) proposed budgetary requirements; 
                and</DELETED>
                <DELETED>    ``(B) recommendations to ensure that 
                autism spectrum disorder research, services, and 
                support activities of the Department of Health and 
                Human Services and of other Federal departments and 
                agencies are not unnecessarily duplicative; 
                and</DELETED>
        <DELETED>    ``(6) submit to Congress and the President--
        </DELETED>
                <DELETED>    ``(A) an annual update on the summary of 
                advances described in paragraph (2); and</DELETED>
                <DELETED>    ``(B) an annual update to the strategic 
                plan described in paragraph (5), including any progress 
                made in achieving the goals outlined in such strategic 
                plan.'';</DELETED>
        <DELETED>    (2) in subsection (c)--</DELETED>
                <DELETED>    (A) in paragraph (1)--</DELETED>
                        <DELETED>    (i) by striking the paragraph 
                        heading and matter preceding subparagraph (A) 
                        and inserting the following:</DELETED>
        <DELETED>    ``(1) Federal membership.--The Committee shall be 
        composed of the following Federal members--'';</DELETED>
                        <DELETED>    (ii) in subparagraph (C)--
                        </DELETED>
                                <DELETED>    (I) by inserting ``, such 
                                as the Administration for Community 
                                Living, Administration for Children and 
                                Families, the Centers for Medicare & 
                                Medicaid Services, the Food and Drug 
                                Administration, and the Health 
                                Resources and Services Administration'' 
                                before the semicolon at the end; 
                                and</DELETED>
                                <DELETED>    (II) by adding at the end 
                                ``and'';</DELETED>
                        <DELETED>    (iii) in subparagraph (D)--
                        </DELETED>
                                <DELETED>    (I) by inserting ``and the 
                                Department of Defense'' after 
                                ``Department of Education''; 
                                and</DELETED>
                                <DELETED>    (II) by striking at the 
                                end ``; and'' and inserting a period; 
                                and</DELETED>
                        <DELETED>    (iv) by striking subparagraph 
                        (E);</DELETED>
                <DELETED>    (B) in paragraph (2)--</DELETED>
                        <DELETED>    (i) in the paragraph heading, by 
                        striking ``Additional'' and inserting ``Non-
                        federal'';</DELETED>
                        <DELETED>    (ii) in the matter preceding 
                        subparagraph (A), by striking ``Not fewer than 
                        6 members of the Committee, or 
                        </DELETED>\<DELETED>1/3</DELETED>\ <DELETED>of 
                        the total membership of the Committee, 
                        whichever is greater'' and inserting ``Not more 
                        than </DELETED>\<DELETED>1/
                        2</DELETED>\<DELETED>, but not fewer than 
                        </DELETED>\<DELETED>1/3</DELETED>\<DELETED>, of 
                        the total membership of the 
                        Committee'';</DELETED>
                        <DELETED>    (iii) in subparagraph (A), by 
                        striking ``one such member shall be an 
                        individual'' and inserting ``two such members 
                        shall be individuals'';</DELETED>
                        <DELETED>    (iv) in subparagraph (B), by 
                        striking ``one such member shall be a parent or 
                        legal guardian'' and inserting ``two such 
                        members shall be parents or legal guardians''; 
                        and</DELETED>
                        <DELETED>    (v) in subparagraph (C), by 
                        striking ``one such member shall be a 
                        representative'' and inserting ``two such 
                        members shall be representatives''; 
                        and</DELETED>
                <DELETED>    (C) by adding at the end the 
                following:</DELETED>
        <DELETED>    ``(3) Period of appointment; vacancies.--
        </DELETED>
                <DELETED>    ``(A) Period of appointment for non-
                federal members.--Non-Federal members shall serve for a 
                term of 4 years, and may be reappointed for one or more 
                additional 4-year term.</DELETED>
                <DELETED>    ``(B) Vacancies.--A vacancy on the 
                Committee shall be filled in the manner in which the 
                original appointment was made and shall not affect the 
                powers or duties of the Committee. 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 been appointed.'';</DELETED>
        <DELETED>    (3) in subsection (d)--</DELETED>
                <DELETED>    (A) by striking paragraph (2); 
                and</DELETED>
                <DELETED>    (B) by redesignating paragraphs (3) and 
                (4) as paragraphs (2) and (3), respectively; 
                and</DELETED>
        <DELETED>    (4) in subsection (f), by striking ``2014'' and 
        inserting ``2019''.</DELETED>

<DELETED>SEC. 6. REPORTS.</DELETED>

<DELETED>    Section 399DD of the Public Health Service Act (42 U.S.C. 
280i-3) is amended--</DELETED>
        <DELETED>    (1) in the section heading, by striking ``report'' 
        and inserting ``reports'';</DELETED>
        <DELETED>    (2) in subsection (b), by redesignating paragraphs 
        (1) through (9) as subparagraphs (A) through (I), respectively, 
        and realigning the margins accordingly;</DELETED>
        <DELETED>    (3) by redesignating subsections (a) and (b) as 
        paragraphs (1) and (2), respectively, and realigning the 
        margins accordingly;</DELETED>
        <DELETED>    (4) by inserting after the section heading the 
        following:</DELETED>
<DELETED>    ``(a) Progress Report.--'';</DELETED>
        <DELETED>    (5) in subsection (a)(1) (as so redesignated)--
        </DELETED>
                <DELETED>    (A) by striking ``2 years after the date 
                of enactment of the Combating Autism Reauthorization 
                Act of 2011'' and inserting ``4 years after the date of 
                enactment of the Autism CARES Act of 2014'';</DELETED>
                <DELETED>    (B) by inserting ``and the Secretary of 
                Defense'' after ``the Secretary of Education''; 
                and</DELETED>
                <DELETED>    (C) by inserting ``, and make publicly 
                available, including through posting on the Internet 
                Web site of the Department of Health and Human 
                Services,'' after ``Representatives'';</DELETED>
        <DELETED>    (6) in subsection (a)(2) (as so redesignated)--
        </DELETED>
                <DELETED>    (A) in subparagraph (A), (as so 
                redesignated), by striking ``Combating Autism Act of 
                2006'' and inserting ``the Autism CARES Act of 
                2014'';</DELETED>
                <DELETED>    (B) in subparagraph (B) (as so 
                redesignated), by striking ``particular provision of 
                Combating Autism Act of 2006'' and inserting 
                ``amendments made by the Autism CARES Act of 
                2014'';</DELETED>
                <DELETED>    (C) by striking subparagraph (C) (as so 
                redesignated), and inserting the following:</DELETED>
                <DELETED>    ``(C) information on the incidence and 
                prevalence of autism spectrum disorder, including 
                available information on the prevalence of autism 
                spectrum disorder among children and adults, and 
                identification of any changes over time with respect to 
                the incidence and prevalence of autism spectrum 
                disorder;'';</DELETED>
                <DELETED>    (D) in subparagraph (D) (as so 
                redesignated), by striking ``6-year period beginning on 
                the date of enactment of the Combating Autism Act of 
                2006'' and inserting ``4-year period beginning on the 
                date of enactment of the Autism CARES Act of 2014 and, 
                as appropriate, how this age varies across populations 
                subgroups'';</DELETED>
                <DELETED>    (E) in subparagraph (E) (as so 
                redesignated), by striking ``6-year period beginning on 
                the date of enactment of the Combating Autism Act of 
                2006'' and inserting ``4-year period beginning on the 
                date of enactment of the Autism CARES Act of 2014 and, 
                as appropriate, how this age varies across populations 
                subgroups'';</DELETED>
                <DELETED>    (F) in subparagraph (F) (as so 
                redesignated), by inserting ``and, as appropriate, how 
                this average time varies across populations subgroups'' 
                after ``disabilities'';</DELETED>
                <DELETED>    (G) in subparagraph (G) (as so 
                redesignated)--</DELETED>
                        <DELETED>    (i) by striking ``including by 
                        various subtypes,'' and inserting ``including 
                        by severity level as practicable,''; 
                        and</DELETED>
                        <DELETED>    (ii) by striking ``child may'' and 
                        inserting ``child or other factors, such as 
                        demographic characteristics, may''; 
                        and</DELETED>
                <DELETED>    (H) by striking subparagraph (I) (as so 
                redesignated), and inserting the following:</DELETED>
                <DELETED>    ``(I) a description of the actions taken 
                to implement and the progress made on implementation of 
                the strategic plan developed by the Interagency Autism 
                Coordinating Committee.''; and</DELETED>
        <DELETED>    (7) by adding at the end the following new 
        subsection:</DELETED>
<DELETED>    ``(b) Report on Young Adults and Transitioning Youth.--
</DELETED>
        <DELETED>    ``(1) In general.--Not later than 2 years after 
        the date of enactment of the Autism CARES Act of 2014, the 
        Secretary of Health and Human Services, in coordination with 
        the Secretary of Education and in collaboration with the 
        Secretary of Transportation, the Secretary of Labor, the 
        Secretary of Housing and Urban Development, and the Attorney 
        General, shall prepare and submit to the Committee on Health, 
        Education, Labor, and Pensions of the Senate and the Committee 
        on Energy and Commerce of the House of Representatives, a 
        report concerning young adults with autism spectrum disorder 
        and the challenges related to the transition from existing 
        school-based services to those services available during 
        adulthood.</DELETED>
        <DELETED>    ``(2) Contents.--The report submitted under 
        paragraph (1) shall contain--</DELETED>
                <DELETED>    ``(A) an overview of policies and programs 
                relevant to young adults with autism spectrum disorder 
                relating to post-secondary school transitional 
                services, including an identification of existing 
                Federal laws, regulations, policies, research, and 
                programs;</DELETED>
                <DELETED>    ``(B) demographic characteristics of youth 
                transitioning from school-based to community-based 
                supports;</DELETED>
                <DELETED>    ``(C) proposals on establishing best 
                practices guidelines to ensure--</DELETED>
                        <DELETED>    ``(i) interdisciplinary 
                        coordination between all relevant services 
                        providers receiving Federal funding;</DELETED>
                        <DELETED>    ``(ii) coordination with 
                        transitioning youth and the family of such 
                        transitioning youth; and</DELETED>
                        <DELETED>    ``(iii) the inclusion of the 
                        transitioning youth's Individualized Education 
                        Program as prescribed in section 614 of the 
                        Individuals with Disabilities Education Act (20 
                        U.S.C. 1414);</DELETED>
                <DELETED>    ``(D) comprehensive approaches to 
                transitioning from existing school-based services to 
                services available during adulthood, including--
                </DELETED>
                        <DELETED>    ``(i) services that increase 
                        access to, and improve integration and 
                        completion of, post-secondary education, peer 
                        support, vocational training (as defined in 
                        section 103 of the Rehabilitation Act of 1973 
                        (29 U.S.C. 723)), rehabilitation, self-advocacy 
                        skills, and competitive, integrated 
                        employment;</DELETED>
                        <DELETED>    ``(ii) community-based behavioral 
                        supports and interventions;</DELETED>
                        <DELETED>    ``(iii) community-based integrated 
                        residential services, housing, and 
                        transportation;</DELETED>
                        <DELETED>    ``(iv) nutrition, health and 
                        wellness, recreational, and social 
                        activities;</DELETED>
                        <DELETED>    ``(v) personal safety services for 
                        individuals with autism spectrum disorder 
                        related to public safety agencies or the 
                        criminal justice system; and</DELETED>
                        <DELETED>    ``(vi) evidence-based approaches 
                        for coordination of resources and services once 
                        individuals have aged out of post-secondary 
                        education; and</DELETED>
                <DELETED>    ``(E) proposals that seek to improve 
                outcomes for adults with autism spectrum disorder 
                making the transition from a school-based support 
                system to adulthood by--</DELETED>
                        <DELETED>    ``(i) increasing the effectiveness 
                        of programs that provide transition 
                        services;</DELETED>
                        <DELETED>    ``(ii) increasing the ability of 
                        relevant service providers to provide supports 
                        and services to underserved populations and 
                        regions;</DELETED>
                        <DELETED>    ``(iii) increasing the efficiency 
                        of service delivery to maximize resources and 
                        outcomes, including with respect to the 
                        integration of and collaboration among services 
                        for transitioning youth;</DELETED>
                        <DELETED>    ``(iv) ensuring access to all 
                        services necessary to transitioning youth of 
                        all capabilities; and</DELETED>
                        <DELETED>    ``(v) encouraging transitioning 
                        youth to utilize all available transition 
                        services to maximize independence, equal 
                        opportunity, full participation, and self-
                        sufficiency.''.</DELETED>

<DELETED>SEC. 7. AUTHORIZATION OF APPROPRIATIONS.</DELETED>

<DELETED>    Section 399EE of the Public Health Service Act (42 U.S.C. 
280i-4) is amended--</DELETED>
        <DELETED>    (1) in subsection (a), by striking ``fiscal years 
        2012 through 2014'' and inserting ``fiscal years 2015 through 
        2019'';</DELETED>
        <DELETED>    (2) in subsection (b), by striking ``fiscal years 
        2011 through 2014'' and inserting ``fiscal years 2015 through 
        2019''; and</DELETED>
        <DELETED>    (3) in subsection (c), by striking ``$161,000,000 
        for each of fiscal years 2011 through 2014'' and inserting 
        ``$190,000,000 for each of fiscal years 2015 through 
        2019''.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Autism Collaboration, 
Accountability, Research, Education, and Support Act of 2014'' or the 
``Autism CARES Act of 2014''.

SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER INITIATIVE.

    (a) In General.--The Secretary of Health and Human Services shall 
designate an existing official within the Department of Health and 
Human Services to oversee, in consultation with the Secretaries of 
Defense and Education, national autism spectrum disorder research, 
services, and support activities.
    (b) Duties.--The official designated under subsection (a) shall--
            (1) implement autism spectrum disorder activities, taking 
        into account the strategic plan developed by the Interagency 
        Autism Coordinating Committee under section 399CC(b) of the 
        Public Health Service Act (42 U.S.C. 280i-2(b)); and
            (2) ensure that autism spectrum disorder activities of the 
        Department of Health and Human Services and of other Federal 
        departments and agencies are not unnecessarily duplicative.

SEC. 3. RESEARCH PROGRAM.

    Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is 
amended--
            (1) in subsection (a)(1), by inserting ``for children and 
        adults'' after ``reporting of State epidemiological data'';
            (2) in subsection (b)(1)--
                    (A) by striking ``establishment of regional centers 
                of excellence'' and inserting ``establishment or 
                support of regional centers of excellence''; and
                    (B) by inserting ``for children and adults'' before 
                the period at the end;
            (3) in subsection (b)(2), by striking ``center to be 
        established'' and inserting ``center to be established or 
        supported''; and
            (4) in subsection (e), by striking ``2014'' and inserting 
        ``2019''.

SEC. 4. AUTISM INTERVENTION.

    Section 399BB of the Public Health Service Act (42 U.S.C. 280i-1) 
is amended--
            (1) in subsection (b)(1), by inserting ``culturally 
        competent'' after ``provide'';
            (2) in subsection (c)(2)(A)(ii), by inserting ``(which may 
        include respite care for caregivers of individuals with an 
        autism spectrum disorder)'' after ``services and supports'';
            (3) in subsection (e)(1)(B)(v), by inserting before the 
        semicolon the following: ``, which may include collaborating 
        with research centers or networks to provide training for 
        providers of respite care (as defined in section 2901)'';
            (4) in subsection (f), by striking ``grants or contracts'' 
        and all that follows through ``for individuals with'' and 
        inserting ``grants or contracts, which may include grants or 
        contracts to research centers or networks, to determine the 
        evidence-based practices for interventions to improve the 
        physical and behavioral health of individuals with''; and
            (5) in subsection (g), by striking ``2014'' and inserting 
        ``2019''.

SEC. 5. INTERAGENCY AUTISM COORDINATING COMMITTEE.

    Section 399CC of the Public Health Service Act (42 U.S.C. 280i-2) 
is amended--
            (1) in subsection (b)--
                    (A) in paragraph (1)--
                            (i) by striking ``and annually update''; 
                        and
                            (ii) by striking ``intervention'' and 
                        inserting ``interventions, including school and 
                        community-based interventions'';
                    (B) by striking paragraph (2);
                    (C) by redesignating paragraph (1) as paragraph 
                (2), and inserting before such redesignated paragraph 
                the following:
            ``(1) monitor autism spectrum disorder research, and to the 
        extent practicable services and support activities, across all 
        relevant Federal departments and agencies, including 
        coordination of Federal activities with respect to autism 
        spectrum disorder;'';
                    (D) in paragraph (3), by striking ``recommendations 
                to the Director of NIH'';
                    (E) in paragraph (4), by inserting before the 
                semicolon the following: ``, and the process by which 
                public feedback can be better integrated into such 
                decisions''; and
                    (F) by striking paragraphs (5) and (6) and 
                inserting the following:
            ``(5) develop a strategic plan for the conduct of, and 
        support for, autism spectrum disorder research, including as 
        practicable for services and supports for individuals with an 
        autism spectrum disorder and the families of such individuals, 
        which shall include--
                    ``(A) proposed budgetary requirements; and
                    ``(B) recommendations to ensure that autism 
                spectrum disorder research, and services and support 
                activities to the extent practicable, of the Department 
                of Health and Human Services and of other Federal 
                departments and agencies are not unnecessarily 
                duplicative; and
            ``(6) submit to Congress and the President--
                    ``(A) an annual update on the summary of advances 
                described in paragraph (2); and
                    ``(B) an annual update to the strategic plan 
                described in paragraph (5), including any progress made 
                in achieving the goals outlined in such strategic 
                plan.'';
            (2) in subsection (c)--
                    (A) in paragraph (1)--
                            (i) by striking the paragraph designation, 
                        the heading, and the matter preceding 
                        subparagraph (A) and inserting the following:
            ``(1) Federal membership.--The Committee shall be composed 
        of the following Federal members--'';
                            (ii) in subparagraph (C)--
                                    (I) by inserting ``, such as the 
                                Administration for Community Living, 
                                Administration for Children and 
                                Families, the Centers for Medicare & 
                                Medicaid Services, the Food and Drug 
                                Administration, and the Health 
                                Resources and Services Administration'' 
                                before the semicolon at the end; and
                                    (II) by adding at the end ``and'';
                            (iii) in subparagraph (D)--
                                    (I) by inserting ``and the 
                                Department of Defense'' after 
                                ``Department of Education''; and
                                    (II) by striking at the end ``; 
                                and'' and inserting a period; and
                            (iv) by striking subparagraph (E);
                    (B) in paragraph (2)--
                            (i) in the paragraph heading, by striking 
                        ``Additional'' and inserting ``Non-federal'';
                            (ii) in the matter preceding subparagraph 
                        (A), by striking ``Not fewer than 6 members of 
                        the Committee, or 1/3 of the total membership 
                        of the Committee, whichever is greater'' and 
                        inserting ``Not more than \1/2\, but not fewer 
                        than 1/3, of the total membership of the 
                        Committee'';
                            (iii) in subparagraph (A), by striking 
                        ``one such member shall be an individual'' and 
                        inserting ``two such members shall be 
                        individuals'';
                            (iv) in subparagraph (B), by striking ``one 
                        such member shall be a parent or legal 
                        guardian'' and inserting ``two such members 
                        shall be parents or legal guardians''; and
                            (v) in subparagraph (C), by striking ``one 
                        such member shall be a representative'' and 
                        inserting ``two such members shall be 
                        representatives''; and
                    (C) by adding at the end the following:
            ``(3) Period of appointment; vacancies.--
                    ``(A) Period of appointment for non-federal 
                members.--Non-Federal members shall serve for a term of 
                4 years, and may be reappointed for one or more 
                additional 4-year terms.
                    ``(B) Vacancies.--A vacancy on the Committee shall 
                be filled in the manner in which the original 
                appointment was made and shall not affect the powers or 
                duties of the Committee. 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 been appointed.'';
            (3) in subsection (d)--
                    (A) by striking paragraph (2); and
                    (B) by redesignating paragraphs (3) and (4) as 
                paragraphs (2) and (3), respectively; and
            (4) in subsection (f), by striking ``2014'' and inserting 
        ``2019''.

SEC. 6. REPORTS.

    Section 399DD of the Public Health Service Act (42 U.S.C. 280i-3) 
is amended--
            (1) in the section heading, by striking ``report'' and 
        inserting ``reports'';
            (2) in subsection (b), by redesignating paragraphs (1) 
        through (9) as subparagraphs (A) through (I), respectively, and 
        realigning the margins accordingly;
            (3) by redesignating subsections (a) and (b) as paragraphs 
        (1) and (2), respectively, and realigning the margins 
        accordingly;
            (4) by inserting after the section heading the following:
    ``(a) Progress Report.--'';
            (5) in subsection (a)(1) (as so redesignated)--
                    (A) by striking ``2 years after the date of 
                enactment of the Combating Autism Reauthorization Act 
                of 2011'' and inserting ``4 years after the date of 
                enactment of the Autism CARES Act of 2014'';
                    (B) by inserting ``and the Secretary of Defense'' 
                after ``the Secretary of Education''; and
                    (C) by inserting ``, and make publicly available, 
                including through posting on the Internet Web site of 
                the Department of Health and Human Services,'' after 
                ``Representatives''; and
            (6) in subsection (a)(2) (as so redesignated)--
                    (A) in subparagraph (A), (as so redesignated), by 
                striking ``Combating Autism Act of 2006'' and inserting 
                ``Autism CARES Act of 2014'';
                    (B) in subparagraph (B) (as so redesignated), by 
                striking ``particular provisions of Combating Autism 
                Act of 2006'' and inserting ``amendments made by the 
                Autism CARES Act of 2014'';
                    (C) by striking subparagraph (C) (as so 
                redesignated), and inserting the following:
                    ``(C) information on the incidence and prevalence 
                of autism spectrum disorder, including available 
                information on the prevalence of autism spectrum 
                disorder among children and adults, and identification 
                of any changes over time with respect to the incidence 
                and prevalence of autism spectrum disorder;'';
                    (D) in subparagraph (D) (as so redesignated), by 
                striking ``6-year period beginning on the date of 
                enactment of the Combating Autism Act of 2006'' and 
                inserting ``4-year period beginning on the date of 
                enactment of the Autism CARES Act of 2014 and, as 
                appropriate, how this age varies across population 
                subgroups'';
                    (E) in subparagraph (E) (as so redesignated), by 
                striking ``6-year period beginning on the date of 
                enactment of the Combating Autism Act of 2006'' and 
                inserting ``4-year period beginning on the date of 
                enactment of the Autism CARES Act of 2014 and, as 
                appropriate, how this age varies across population 
                subgroups'';
                    (F) in subparagraph (F) (as so redesignated), by 
                inserting ``and, as appropriate, how such average time 
                varies across population subgroups'' before the 
                semicolon at the end;
                    (G) in subparagraph (G) (as so redesignated)--
                            (i) by striking ``including by various 
                        subtypes,'' and inserting ``including by 
                        severity level as practicable,''; and
                            (ii) by striking ``child may'' and 
                        inserting ``child or other factors, such as 
                        demographic characteristics, may''; and
                    (H) by striking subparagraph (I) (as so 
                redesignated), and inserting the following:
                    ``(I) a description of the actions taken to 
                implement and the progress made on implementation of 
                the strategic plan developed by the Interagency Autism 
                Coordinating Committee under section 399CC(b).''; and
            (7) by adding at the end the following new subsection:
    ``(b) Report on Young Adults and Transitioning Youth.--
            ``(1) In general.--Not later than 2 years after the date of 
        enactment of the Autism CARES Act of 2014, the Secretary of 
        Health and Human Services, in coordination with the Secretary 
        of Education and in collaboration with the Secretary of 
        Transportation, the Secretary of Labor, the Secretary of 
        Housing and Urban Development, and the Attorney General, shall 
        prepare and submit to the Committee on Health, Education, 
        Labor, and Pensions of the Senate and the Committee on Energy 
        and Commerce of the House of Representatives, a report 
        concerning young adults with autism spectrum disorder and the 
        challenges related to the transition from existing school-based 
        services to those services available during adulthood.
            ``(2) Contents.--The report submitted under paragraph (1) 
        shall contain--
                    ``(A) demographic characteristics of youth 
                transitioning from school-based to community-based 
                supports;
                    ``(B) an overview of policies and programs relevant 
                to young adults with autism spectrum disorder relating 
                to post-secondary school transitional services, 
                including an identification of existing Federal laws, 
                regulations, policies, research, and programs;
                    ``(C) proposals on establishing best practices 
                guidelines to ensure--
                            ``(i) interdisciplinary coordination 
                        between all relevant service providers 
                        receiving Federal funding;
                            ``(ii) coordination with transitioning 
                        youth and the family of such transitioning 
                        youth; and
                            ``(iii) inclusion of the individualized 
                        education program for the transitioning youth, 
                        as prescribed in section 614 of the Individuals 
                        with Disabilities Education Act (20 U.S.C. 
                        1414);
                    ``(D) comprehensive approaches to transitioning 
                from existing school-based services to services 
                available during adulthood, including--
                            ``(i) services that increase access to, and 
                        improve integration and completion of, post-
                        secondary education, peer support, vocational 
                        training (as defined in section 103 of the 
                        Rehabilitation Act of 1973 (29 U.S.C. 723)), 
                        rehabilitation, self-advocacy skills, and 
                        competitive, integrated employment;
                            ``(ii) community-based behavioral supports 
                        and interventions;
                            ``(iii) community-based integrated 
                        residential services, housing, and 
                        transportation;
                            ``(iv) nutrition, health and wellness, 
                        recreational, and social activities;
                            ``(v) personal safety services for 
                        individuals with autism spectrum disorder 
                        related to public safety agencies or the 
                        criminal justice system; and
                            ``(vi) evidence-based approaches for 
                        coordination of resources and services once 
                        individuals have aged out of post-secondary 
                        education; and
                    ``(E) proposals that seek to improve outcomes for 
                adults with autism spectrum disorder making the 
                transition from a school-based support system to 
                adulthood by--
                            ``(i) increasing the effectiveness of 
                        programs that provide transition services;
                            ``(ii) increasing the ability of the 
                        relevant service providers described in 
                        subparagraph (C) to provide supports and 
                        services to underserved populations and 
                        regions;
                            ``(iii) increasing the efficiency of 
                        service delivery to maximize resources and 
                        outcomes, including with respect to the 
                        integration of and collaboration among services 
                        for transitioning youth;
                            ``(iv) ensuring access to all services 
                        necessary to transitioning youth of all 
                        capabilities; and
                            ``(v) encouraging transitioning youth to 
                        utilize all available transition services to 
                        maximize independence, equal opportunity, full 
                        participation, and self-sufficiency.''.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    Section 399EE of the Public Health Service Act (42 U.S.C. 280i-4) 
is amended--
            (1) in subsection (a), by striking ``fiscal years 2012 
        through 2014'' and inserting ``fiscal years 2015 through 
        2019'';
            (2) in subsection (b), by striking ``fiscal years 2011 
        through 2014'' and inserting ``fiscal years 2015 through 
        2019''; and
            (3) in subsection (c), by striking ``$161,000,000 for each 
        of fiscal years 2011 through 2014'' and inserting 
        ``$190,000,000 for each of fiscal years 2015 through 2019''.
                                                       Calendar No. 444

113th CONGRESS

  2d Session

                                S. 2449

_______________________________________________________________________

                                 A BILL

  To reauthorize certain provisions of the Public Health Service Act 
              relating to autism, and for other purposes.

_______________________________________________________________________

                             June 26, 2014

                       Reported with an amendment