[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1058 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 137
116th CONGRESS
  1st Session
                                H. R. 1058

                          [Report No. 116-177]

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 7, 2019

   Mr. Smith of New Jersey (for himself and Mr. Michael F. Doyle of 
Pennsylvania) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

                             July 23, 2019

     Additional sponsors: Mr. Fitzpatrick, Mr. Brendan F. Boyle of 
 Pennsylvania, Mr. Sean Patrick Maloney of New York, Mr. Peterson, Mr. 
San Nicolas, Mr. Payne, Mr. Serrano, Mr. Deutch, Mr. Carson of Indiana, 
  Mr. King of New York, Mr. Gottheimer, Mr. Lipinski, Ms. Norton, Mr. 
  Yarmuth, Mr. McGovern, Mr. Hastings, Mr. Brindisi, Mr. Moulton, Ms. 
Slotkin, Mr. Meeks, Mr. Kim, Mr. Welch, Mrs. Walorski, Mr. Schiff, Ms. 
 Lofgren, Mr. Ryan, Ms. Matsui, Ms. Waters, Mr. Kennedy, Ms. Kuster of 
  New Hampshire, Mrs. Davis of California, Mr. Rose of New York, Mr. 
 Pocan, Mr. Ruppersberger, Mrs. Hayes, Mr. Marchant, Mr. Stivers, Mr. 
  Kelly of Pennsylvania, Mr. Stauber, Mr. Sires, Ms. Spanberger, Mr. 
 Young, Mr. Cox of California, Mr. Garcia of Illinois, Mr. Golden, Mr. 
 Reschenthaler, Mr. Raskin, Ms. Brownley of California, Ms. Sherrill, 
 Ms. Wild, Ms. Judy Chu of California, Mr. David P. Roe of Tennessee, 
 Mr. Brown of Maryland, Mr. McKinley, Mr. Cole, Mr. Levin of Michigan, 
Mr. Clay, Ms. Mucarsel-Powell, Mr. Courtney, Mr. Lamborn, Ms. Haaland, 
    Mr. Correa, Mr. Cooper, Ms. Clarke of New York, Mrs. Rodgers of 
Washington, Mr. DeFazio, Mr. Grijalva, Mrs. Watson Coleman, Ms. Castor 
  of Florida, Mr. Blumenauer, Mr. Connolly, Ms. Scanlon, Mr. Morelle, 
  Miss Rice of New York, Ms. Johnson of Texas, Ms. Ocasio-Cortez, Mr. 
Stewart, Mr. Horsford, Mr. Bost, Ms. Stefanik, Mr. Costa, Ms. Pingree, 
 Mr. Malinowski, Mrs. Beatty, Mr. Swalwell of California, Mrs. Lee of 
Nevada, Mrs. Axne, Mr. Lamb, Mr. Thompson of Mississippi, Mr. Loebsack, 
 Ms. DeLauro, Mr. Rodney Davis of Illinois, Mr. Gallego, Mr. Shimkus, 
 Ms. Pressley, Ms. Titus, Mr. Joyce of Ohio, Mr. Chabot, Miss Gonzalez-
     Colon of Puerto Rico, Mr. Larson of Connecticut, Mr. Joyce of 
   Pennsylvania, Ms. Jackson Lee, Ms. Craig, Mr. Hurd of Texas, Ms. 
Finkenauer, Ms. Clark of Massachusetts, Mrs. Dingell, Mrs. Kirkpatrick, 
Mr. Lujan, Ms. Blunt Rochester, Mr. Butterfield, Mrs. Miller, Mr. Heck, 
Mr. Harder of California, Mr. Rouda, Mrs. Lawrence, Mr. Green of Texas, 
Mr. Collins of New York, Mr. Schweikert, Mr. Gianforte, Mr. Engel, Mr. 
Cardenas, Mr. Trone, Mr. Posey, Ms. Lee of California, Mrs. Trahan, Mr. 
  Rush, Mr. Latta, Mr. Upton, Mr. McEachin, Mr. Soto, Mr. Suozzi, Mr. 
   Carter of Georgia, Mr. Spano, Mr. Tonko, Mr. Emmer, Mr. Lawson of 
  Florida, Mr. Cisneros, Mr. Carbajal, Mr. O'Halleran, Ms. Omar, Mrs. 
 Brooks of Indiana, Mr. Steube, Mr. Ted Lieu of California, Ms. Roybal-
Allard, Mr. Phillips, Ms. Fudge, Ms. McCollum, Mr. Guthrie, Mr. Pappas, 
 Mr. Thompson of Pennsylvania, Ms. Underwood, Mr. Huffman, Ms. Kaptur, 
    Mr. Marshall, Mr. Barr, Ms. Wexton, Ms. Wasserman Schultz, Ms. 
 Schakowsky, Mr. Walden, Mr. Johnson of South Dakota, Mr. Himes, Mrs. 
Lowey, Mr. Zeldin, Mr. Van Drew, Mr. Neguse, Mr. Hagedorn, Ms. Herrera 
Beutler, Mr. Quigley, Mr. Sablan, Mr. Gonzalez of Ohio, and Ms. Kendra 
                          S. Horn of Oklahoma

                             July 23, 2019

Reported with amendments, committed to the Committee of the Whole House 
          on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           February 7, 2019]

_______________________________________________________________________

                                 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,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Autism Collaboration, 
Accountability, Research, Education, and Support Act of 2019'' or the 
``Autism CARES Act of 2019''.

SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF 
              THE NIH WITH RESPECT TO RESEARCH ON AUTISM SPECTRUM 
              DISORDER.

    Section 409C of the Public Health Service Act (42 U.S.C. 284g) is 
amended--
            (1) in subsection (a)(1)--
                    (A) in the first sentence, by striking ``and 
                toxicology'' and inserting ``toxicology, and 
                interventions to maximize outcomes for individuals with 
                autism spectrum disorder''; and
                    (B) by striking the second sentence and inserting 
                the following: ``Such research shall investigate the 
                causes (including possible environmental causes), 
                diagnosis or ruling out, early and ongoing detection, 
                prevention, services across the lifespan, supports, 
                intervention, and treatment of autism spectrum 
                disorder, including dissemination and implementation of 
                clinical care, supports, interventions, and 
                treatments.'';
            (2) in subsection (b)--
                    (A) in paragraph (2)--
                            (i) in the second sentence, by striking 
                        ``cause'' and all that follows through 
                        ``disorder'' and inserting ``causes, diagnosis, 
                        early and ongoing detection, prevention, and 
                        treatment of autism spectrum disorder across 
                        the lifespan''; and
                            (ii) in the third sentence, by striking 
                        ``neurobiology'' and all that follows through 
                        the period and inserting ``neurobiology, 
                        genetics, genomics, psychopharmacology, 
                        developmental psychology, behavioral 
                        psychology, and clinical psychology.''; and
                    (B) in paragraph (3), by adding at the end the 
                following:
                    ``(D) Reducing disparities.--The Director may 
                consider, as appropriate, the extent to which a center 
                can demonstrate availability and access to clinical 
                services for youth and adults from diverse racial, 
                ethnic, geographic, or linguistic backgrounds in 
                decisions about awarding grants to applicants which 
                meet the scientific criteria for funding under this 
                section.''.

SEC. 3. PROGRAMS RELATING TO AUTISM.

    (a) Developmental Disabilities Surveillance and Research Program.--
Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is 
amended--
            (1) in subsection (a)(1), by striking ``adults on autism 
        spectrum disorder'' and inserting ``adults with autism spectrum 
        disorder'';
            (2) in subsection (a)(2)--
                    (A) by striking ``State and local public health 
                officials'' and inserting ``State, local, and Tribal 
                public health officials'';
                    (B) by striking ``or other developmental 
                disabilities'' and inserting ``and other developmental 
                disabilities'';
            (3) in subsection (a)(3), by striking ``a university, or 
        any other educational institution'' and inserting ``a 
        university, any other educational institution, an Indian tribe, 
        or a tribal organization'';
            (4) in subsection (b)(2)(A), by striking ``relevant State 
        and local public health officials, private sector developmental 
        disability researchers, and advocates for individuals with 
        developmental disabilities'' and inserting ``State, local, and 
        Tribal public health officials, private sector developmental 
        disability researchers, advocates for individuals with autism 
        spectrum disorder, and advocates for individuals with other 
        developmental disabilities'';
            (5) in subsection (d)--
                    (A) by redesignating paragraphs (1) and (2) as 
                paragraphs (2) and (3), respectively; and
                    (B) by inserting before paragraph (2), as so 
                redesignated, the following new paragraph:
            ``(1) Indian tribe; tribal organization.--The terms `Indian 
        tribe' and `tribal organization' have the meanings given such 
        terms in section 4 of the Indian Health Care Improvement 
        Act.''; and
            (6) in subsection (e), by striking ``2019'' and inserting 
        ``2024''.
    (b) Autism Education, Early Detection, and Intervention.--Section 
399BB of the Public Health Service Act (42 U.S.C. 280i-1) is amended--
            (1) in subsection (a)(1)--
                    (A) by striking ``individuals with autism spectrum 
                disorder or other developmental disabilities'' and 
                inserting ``individuals with autism spectrum disorder 
                and other developmental disabilities''; and
                    (B) by striking ``children with autism spectrum 
                disorder'' and all that follows through 
                ``disabilities;'' and inserting ``individuals with 
                autism spectrum disorder and other developmental 
                disabilities across their lifespan;'';
            (2) in subsection (b)--
                    (A) in paragraph (2), by inserting ``individuals 
                with'' before ``autism spectrum disorder'';
                    (B) by redesignating paragraphs (4) through (6) as 
                paragraphs (5) through (7), respectively; and
                    (C) by inserting after paragraph (3) the following:
            ``(4) promote evidence-based screening techniques and 
        interventions for individuals with autism spectrum disorder and 
        other developmental disabilities across their lifespan;'';
            (3) in subsection (c)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by striking ``the needs of 
                individuals with autism spectrum disorder or other 
                developmental disabilities and their families'' and 
                inserting ``the needs of individuals with autism 
                spectrum disorder and other developmental disabilities 
                across their lifespan and the needs of their 
                families''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (A)(ii), by striking 
                        ``caregivers of individuals with an autism 
                        spectrum disorder'' and inserting ``caregivers 
                        of individuals with autism spectrum disorder or 
                        other developmental disabilities'';
                            (ii) in subparagraph (B)(i)(II), by 
                        inserting ``autism spectrum disorder and'' 
                        after ``individuals with''; and
                            (iii) in subparagraph (B)(ii), by inserting 
                        ``autism spectrum disorder and'' after 
                        ``individuals with'';
            (4) in subsection (e)--
                    (A) in paragraph (1)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``across their lifespan'' 
                        before ``and ensure''; and
                            (ii) in subparagraph (B)(iv), by inserting 
                        ``across their lifespan'' after ``other 
                        developmental disabilities'';
                    (B) by redesignating paragraphs (2) and (3) as 
                paragraphs (3) and (4), respectively; and
                    (C) by inserting after paragraph (1) the following:
            ``(2) Developmental-behavioral pediatrician training 
        programs.--
                    ``(A) In general.--In making awards under this 
                subsection, the Secretary may prioritize awards to 
                applicants that are developmental-behavioral 
                pediatrician training programs located in rural or 
                underserved areas.
                    ``(B) Definition of underserved area.--In this 
                paragraph, the term `underserved area' means--
                            ``(i) a health professional shortage area 
                        (as defined in section 332(a)(1)(A)); and
                            ``(ii) an urban or rural area designated by 
                        the Secretary as an area with a shortage of 
                        personal health services (as described in 
                        section 330(b)(3)(A)).'';
            (5) in subsection (f), by inserting ``across the lifespan 
        of such individuals'' after ``other developmental 
        disabilities''; and
            (6) in subsection (g), by striking ``2019'' and inserting 
        ``2024''.
    (c) 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 (2), by inserting ``across the 
                lifespan of such individuals'' before the semicolon; 
                and
                    (B) in paragraph (5), by inserting ``across the 
                lifespan of such individuals'' before ``and the 
                families'';
            (2) in subsection (c)--
                    (A) in paragraph (1)(D), by inserting ``, the 
                Department of Labor, the Department of Justice, the 
                Department of Veterans Affairs, the Department of 
                Housing and Urban Development,'' after ``Department of 
                Education'';
                    (B) in subparagraphs (A), (B), and (C) of paragraph 
                (2), by striking ``at least two such members'' each 
                place it appears and inserting ``at least three such 
                members'';
                    (C) in paragraph (3)(A), by striking ``one or more 
                additional 4-year terms'' and inserting ``one 
                additional 4-year term''; and
            (3) in subsection (f), by striking ``2019'' and inserting 
        ``2024''.
    (d) Reports to Congress.--Section 399DD of the Public Health 
Service Act (42 U.S.C. 280i-3) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``Autism CARES 
                Act of 2014'' and inserting ``Autism CARES Act of 
                2019''; and
                    (B) in paragraph (2)--
                            (i) in subparagraphs (A), (B), (D), and 
                        (E), by striking ``Autism CARES Act of 2014'' 
                        each place it appears and inserting ``Autism 
                        CARES Act of 2019'';
                            (ii) in subparagraph (G), by striking ``age 
                        of the child'' and inserting ``age of the 
                        individual'';
                            (iii) in subparagraph (H), by striking ``; 
                        and'' and inserting ``;'';
                            (iv) in subparagraph (I), by striking the 
                        period and inserting ``; and''; and
                            (v) by adding at the end the following:
                    ``(J) information on how States use home- and 
                community-based services and other supports to ensure 
                that individuals with autism spectrum disorder and 
                other developmental disabilities are living, working, 
                and participating in their community.''; and
            (2) in subsection (b)--
                    (A) in the heading, by striking ``Young Adults and 
                Transitioning Youth'' and inserting ``the Health and 
                Well-Being of Individuals With Autism Spectrum Disorder 
                Across Their Lifespan'';
                    (B) by amending paragraph (1) to read as follows:
            ``(1) In general.--Not later than 2 years after the date of 
        enactment of the Autism CARES Act of 2019, the Secretary 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 the health and well-being of individuals with autism 
        spectrum disorder.''; and
                    (C) in paragraph (2)--
                            (i) by amending subparagraph (A) to read as 
                        follows:
                    ``(A) demographic factors associated with the 
                health and well-being of individuals with autism 
                spectrum disorder;'';
                            (ii) in subparagraph (B), by striking 
                        ``young adults'' and all that follows through 
                        the semicolon and inserting ``the health and 
                        well-being of individuals with autism spectrum 
                        disorder, including an identification of 
                        existing Federal laws, regulations, policies, 
                        research, and programs;''; and
                            (iii) by amending subparagraphs (C), (D), 
                        and (E) to read as follows:
                    ``(C) recommendations on establishing best 
                practices guidelines to ensure interdisciplinary 
                coordination between all relevant service providers 
                receiving Federal funding;
                    ``(D) comprehensive approaches to improving health 
                outcomes and well-being for individuals with autism 
                spectrum disorder, including--
                            ``(i) community-based behavioral supports 
                        and interventions;
                            ``(ii) nutrition, recreational, and social 
                        activities; and
                            ``(iii) personal safety services related to 
                        public safety agencies or the criminal justice 
                        system for such individuals; and
                    ``(E) recommendations that seek to improve health 
                outcomes for such individuals, including across their 
                lifespan, by addressing--
                            ``(i) screening and diagnosis of children 
                        and adults;
                            ``(ii) behavioral and other therapeutic 
                        approaches;
                            ``(iii) primary and preventative care;
                            ``(iv) communication challenges;
                            ``(v) aggression, self-injury, elopement, 
                        and other behavioral issues;
                            ``(vi) emergency room visits and acute care 
                        hospitalization;
                            ``(vii) treatment for co-occurring physical 
                        and mental health conditions;
                            ``(viii) premature mortality;
                            ``(ix) medical practitioner training; and
                            ``(x) caregiver mental health.''.
    (e) 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 ``$22,000,000 for each 
        of fiscal years 2015 through 2019'' and inserting ``$23,100,000 
        for each of fiscal years 2020 through 2024'';
            (2) in subsection (b), by striking ``$48,000,000 for each 
        of fiscal years 2015 through 2019'' and inserting ``$50,599,000 
        for each of fiscal years 2020 through 2024''; and
            (3) in subsection (c), by striking ``there is authorized to 
        be appropriated $190,000,000 for each of fiscal years 2015 
        through 2019'' and inserting ``there are authorized to be 
        appropriated $296,000,000 for each of fiscal years 2020 through 
        2024''.
            Amend the title so as to read: ``A bill to amend the Public 
        Health Service Act to enhance activities of the National 
        Institutes of Health with respect to research on autism 
        spectrum disorder and enhance programs relating to autism, and 
        for other purposes.''.
                                                 Union Calendar No. 137

116th CONGRESS

  1st Session

                               H. R. 1058

                          [Report No. 116-177]

_______________________________________________________________________

                                 A BILL

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

_______________________________________________________________________

                             July 23, 2019

Reported with amendments, committed to the Committee of the Whole House 
          on the State of the Union, and ordered to be printed