[Congressional Record Volume 155, Number 56 (Thursday, April 2, 2009)]
[Senate]
[Pages S4379-S4385]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself, Mr. Casey, and Mr. Menendez):
  S. 819. A bill to provide for enhanced treatment, support, services, 
and research for individuals with autism spectrum disorders and their 
families; to the Committee on Health, Education, Labor, and Pensions.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 819

       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

[[Page S4380]]

     (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

[[Page S4381]]

       ``(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

[[Page S4382]]

     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

[[Page S4383]]

     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

[[Page S4384]]

     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

[[Page S4385]]

       ``(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.
                                 ______