[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 427 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                 S. 427

  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.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 7, 2019

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

_______________________________________________________________________

                                 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.

    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 persons 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 rule 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(e) of the Public Health Service Act (42 U.S.C. 280i(e)) 
is amended 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), 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)(1), in the matter preceding 
        subparagraph (A), by inserting ``across their lifespan'' before 
        ``and their families'';
            (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 Housing and Urban Development,'' after 
                ``Department of Education''; and
                    (B) 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 such sums as may be necessary for each of fiscal 
        years 2020 through 2024''.
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