[Congressional Record (Bound Edition), Volume 152 (2006), Part 12]
[Senate]
[Pages 16930-16940]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      COMBATING AUTISM ACT OF 2005

  Mr. SANTORUM. Mr. President, I understand the paper is in the process 
of being delivered to the desk on S. 843, so while that is happening, 
let me just make some remarks about the legislation.
  The legislation that I am calling up on behalf of myself and Senator 
Dodd and the two leaders who have been outstanding in helping us bring 
this bill to the floor tonight is the Combating Autism Act. I know 
Senator Enzi was just speaking, but I want to thank Senator Enzi and 
Senator Kennedy also and the entire HELP Committee. If you want to talk 
about a team effort, this has been a tremendous team effort, starting 
initially with Senator Dodd and myself and our staffs who have just 
done an outstanding job.
  I thank particularly on my staff Jen Vessey, who has just put in--I 
won't say hours of time but days of time, in working together along 
with Senator Dodd's staff and then subsequently the entire committee 
staff; in particular, Senators Enzi and Kennedy's staff, as well as, as 
we brought this to the process, Senator Frist and Senator Reid.
  This team was committed to getting this bill done and passed before 
the August break. We had many bumps along the way, but tonight, with a 
minor change in the bill, we are going to see this piece of legislation 
pass and pass by unanimous consent.
  I am very excited about all of the work that has been put in by the 
entire autism community. I think, as Senator Dodd will attest, there 
are very many arms of the autistic community, a lot of groups who have 
a very wide variety of people with respect to how to deal with Federal 
legislation regarding autism. But we were able to sit down and work 
together over months of time.
  I thank some people in particular who have worked outside of the 
Congress, outside of the Halls of Congress: Bob and Suzanne Wright 
deserve special recognition as grandparents of an autistic child for 
their tremendous effort in pulling together these outside groups, along 
with Deirdre Imus, who, again, devoted an extraordinary amount of time 
and energy in bringing all of these disparate groups in the autism 
community across the country together to work toward a common goal, and 
that is to authorize an autism coordinator, authorize work and research 
to be done at NIH that looks into all of the issues regarding autism, 
including the causes of autism, how to best screen for autism, how to 
best diagnose autism, and how to best treat autism.
  It is one of the few disorders that I am aware of that is so 
prevalent in America, and we have very few good answers on any one of 
those issues. It creates enormous amounts of frustration for parents 
and relatives and friends of children with autism that we just seem to 
have no answers, and we see an ever-increasing population of autistic 
children with fewer and fewer answers on how to diagnose, screen, test, 
and treat these young children.
  So tonight is a real landmark. It is a step forward for a community 
that has been seeking someone to listen to them in Washington. It has 
been a real honor to work with Senator Dodd. He has just been terrific, 
including tonight, when we ran into a bump and he was able to smooth 
that bump. We had one on our side. After lots of discussion, and thanks 
to the leader and his work here, we were able to deal with that, and 
now we are in a situation where we can move forward and pass this 
important piece of legislation. I believe the paper work is now ready.
  Mr. President, I ask unanimous consent that the Senate proceed to the 
immediate consideration of Calendar No. 578, S. 843.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The assistant legislative clerk read as follows:

       A bill (S. 843) to amend the Public Health Service Act to 
     combat autism through research, screening, intervention and 
     education.

  There being no objection, the Senate proceeded to consider the bill 
which was reported from the Committee on Health, Education, Labor and 
Pensions with an amendment to strike all after the enacting clause and 
insert in lieu thereof the following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Combating Autism Act of 
     2006''.

     SEC. 2. ACTIVITIES TO IMPROVE AUTISM-RELATED RESEARCH.

       Section 409C of the Public Health Service Act (42 U.S.C. 
     284g) is amended to read as follows:

     ``SEC. 409C. AUTHORITY OF THE DIRECTOR OF THE NATIONAL 
                   INSTITUTES OF HEALTH RELATING TO AUTISM.

       ``(a) Strategic Plan for Autism Research.--
       ``(1) In general.--The Secretary, acting through the 
     Director, shall develop and implement a strategic plan for 
     the conduct and support of research related to autism 
     spectrum disorder.
       ``(2) Requirements.--The strategic plan developed under 
     paragraph (1)--
       ``(A) shall--
       ``(i) be updated annually;
       ``(ii) take into account the research recommendations of 
     the Interagency Autism Coordinating Committee under section 
     399CC; and
       ``(iii) using professional judgment, outline the proposed 
     budgetary requirements of the strategic plan, including 
     specific funding expectations for continued multi-year 
     program activities, as well as new and complementary program 
     activities, subject to the availability of appropriations; 
     and
       ``(B) may include investigator-initiated research.
       ``(3) Report.--Not later than April 1, 2008, and annually 
     thereafter, the Secretary, acting through the Director, shall 
     prepare and submit to the appropriate committees of Congress 
     a report that contains--
       ``(A) the strategic plan under paragraph (1) that will be 
     applicable to the upcoming fiscal year; and
       ``(B) a description of the actual dollar expenditures for 
     autism spectrum disorder during the previous fiscal year.
       ``(b) Expansion, Intensification, and Coordination of 
     Activities.--The Secretary, acting through the Director, 
     shall, subject to the availability of appropriations, expand, 
     intensify, and coordinate the activities of the National 
     Institutes of Health with respect to autism spectrum 
     disorder.
       ``(c) Centers of Excellence.--
       ``(1) Autism centers of excellence.--
       ``(A) In general.--The Secretary, acting through the 
     Director, shall, subject to the availability of 
     appropriations, award grants or contracts to public or 
     nonprofit private entities to assist such entities in paying 
     all or part of the costs of planning, establishing, 
     improving, and providing basic operating support for centers 
     of excellence concerning research on autism spectrum 
     disorder.
       ``(B) Research activities.--A center of excellence that 
     receives funding under this paragraph shall conduct basic and 
     clinical research into autism spectrum disorder. Such 
     research shall--
       ``(i) be conducted in the fields of developmental 
     neurobiology, genetics, epigenetics, pharmacology, nutrition, 
     immunology, neuroimmunology, neurobehavioral development, 
     endocrinology, gastroenterology, psychopharmacology, or 
     toxicology; and
       ``(ii) include investigations into the causation, diagnosis 
     or rule out, early detection, prevention, services, supports, 
     or intervention of autism spectrum disorder.
       ``(C) Services.--
       ``(i) In general.--A center of excellence that receives 
     funding under this paragraph may expend amounts provided 
     under a grant or contract under such paragraph to carry out a 
     program to make individuals aware of opportunities to 
     participate as subjects in research conducted by the center.
       ``(ii) Referrals and costs.--A program carried out under 
     clause (i) may, in accordance with such criteria as the 
     Director may establish, provide to the subjects described in 
     such clause, referrals for health and other services and 
     reimbursement of care for individuals as are required for 
     such research.
       ``(iii) Availability and access.--The extent to which a 
     center of excellence that receives funding under this 
     paragraph can demonstrate the availability of and access to 
     clinical services shall be considered by the Director in 
     making decisions concerning the awarding of grants or 
     contracts to applicants that meet the scientific criteria for 
     funding under this section.
       ``(D) Coordination of centers of excellence.--The Director 
     shall provide for the appropriate coordination of information 
     among centers of excellence that receive funding under this 
     paragraph and ensure regular communication between such 
     centers.
       ``(E) Organization.--A center of excellence that receives 
     funding under this paragraph shall use the facilities of a 
     single institution, or be formed through a consortium of 
     cooperating institutions, that meets such requirements as may 
     be required by the Director.
       ``(F) Duration.--The term of a grant or contract awarded 
     under this paragraph shall not

[[Page 16931]]

     exceed a period of 5 years. Such period may be extended for 1 
     or more additional periods not exceeding 5 years if the 
     operations of the center of excellence involved have been 
     reviewed by an appropriate technical and scientific peer 
     review group established by the Director and the group has 
     recommended to the Director the extension of such period.
       ``(G) Geographic diversity.--The Director shall consider 
     geographic diversity in awarding centers of excellence.
       ``(2) Centers of excellence in environmental health and 
     autism.--
       ``(A) In general.--The Director shall, subject to the 
     availability of appropriations, award grants or contracts to 
     public or nonprofit private entities to pay all or part of 
     the cost of planning, establishing, improving, and providing 
     basic operating support for centers of excellence regarding 
     environmental health and autism spectrum disorder.
       ``(B) Research.--A center of excellence established under 
     this paragraph shall conduct basic and clinical research of a 
     broad array of environmental factors that may have a possible 
     role in autism spectrum disorder.
       ``(C) Coordination and organization.--The Secretary, acting 
     through the Director of NIH, shall apply to the centers under 
     this paragraph the same requirements concerning coordination, 
     reporting, and organization as the requirements applied to 
     the centers of excellence under subparagraphs (D), (E), (F), 
     and (G) of paragraph (1).
       ``(d) Collection and Storage of Data.--
       ``(1) In general.--The Secretary, acting through the 
     Director and in coordination with the Director of the Centers 
     for Disease Control and Prevention, shall, subject to the 
     availability of appropriations, establish and provide funding 
     for mechanisms and entities that provide for the collection, 
     storage, coordination, and public availability of data that 
     is collected by the centers of excellence under this section, 
     under section 399AA(b), and under section 409C(c) and, to the 
     extent possible, data generated from public and private 
     research partnerships. In establishing such mechanisms and 
     entities, the Secretary--
       ``(A) shall ensure that there is data sharing among autism 
     spectrum disorder researchers; and
       ``(B) may utilize existing facilities.
       ``(2) Facilitation of research.--
       ``(A) Establishment of program.--The Secretary shall 
     establish a program under which samples of tissues and 
     genetic and other biological materials that are of use in 
     research on autism spectrum disorder are donated, collected, 
     preserved, and made available for such research.
       ``(B) Accepted scientific standards.--The program 
     established under paragraph (1) shall be--
       ``(i) carried out in accordance with accepted scientific 
     and medical standards for the donation, collection, and 
     preservation of such samples; and
       ``(ii) conducted so that the tissues and other materials 
     saved, as well as any database compiled from such tissues and 
     materials, are available to researchers at a reasonable cost 
     and on an expedited basis.
       ``(e) Consolidation.--The Secretary, acting through the 
     Director, may consolidate program activities under this 
     section if such consolidation would improve program 
     efficiencies and outcomes.
       ``(f) Authorization of Appropriations.--
       ``(1) In general.--There is authorized to be appropriated--
       ``(A) $68,000,000 for fiscal year 2007, $82,000,000 for 
     fiscal year 2008, $96,000,000 for fiscal year 2009, 
     $120,000,000 for fiscal year 2010, and $134,000,000 for 
     fiscal year 2011, to carry out subsections (a), (b), and (d);
       ``(B) $26,000,000 for fiscal year 2007, $32,500,000 for 
     fiscal year 2008, $39,000,000 for fiscal year 2009, 
     $45,500,000 for fiscal year 2010, and $52,000,000 for fiscal 
     year 2011, to carry out subsection (c)(1); and
       ``(C) $6,000,000 for fiscal year 2007, $7,500,000 for 
     fiscal year 2008, $9,000,000 for fiscal year 2009, 
     $10,500,000 for fiscal year 2010, and $12,000,000 for fiscal 
     year 2011, to carry out subsection (c)(2).
       ``(2) General usage.--Of the amounts appropriated under 
     subparagraphs (B) and (C) of paragraph (1), not to exceed 5 
     percent of such amounts may be utilized by the National 
     Institutes of Health for administrative and other expenses.
       ``(g) Sunset.--This section shall not apply after September 
     30, 2011.''.

     SEC. 3. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH 
                   PROGRAM.

       (a) In General.--Title III of the Public Health Service Act 
     (42 U.S.C. 241 et seq.) is amended by adding at the end the 
     following:

                 ``PART R--PROGRAMS RELATING TO AUTISM

     ``SEC. 399AA. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND 
                   RESEARCH PROGRAM.

       ``(a) Autism Spectrum Disorder and Other Developmental 
     Disabilities.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     may award grants or cooperative agreements to eligible 
     entities for the collection, analysis, and reporting of State 
     epidemiological data on autism spectrum disorder and other 
     developmental disabilities. An eligible entity shall assist 
     with the development and coordination of State autism 
     spectrum disorder and other developmental disability 
     surveillance efforts within a region. In making such awards, 
     the Secretary may provide direct technical assistance in lieu 
     of cash.
       ``(2) Data standards.--In submitting epidemiological data 
     to the Secretary pursuant to subsection (a), an eligible 
     entity shall report data according to guidelines prescribed 
     by the Director of the Centers for Disease Control and 
     Prevention, after consultation with relevant State and local 
     public health officials, private sector developmental 
     disability researchers, and advocates for individuals with 
     autism spectrum disorder or other developmental disabilities.
       ``(3) Eligibility.--To be eligible to receive an award 
     under paragraph (1), an entity shall be a public or nonprofit 
     private entity (including a health department of a State or a 
     political subdivision of a State, a university, or any other 
     educational institution), and submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require.
       ``(b) Centers of Excellence in Autism Spectrum Disorder 
     Epidemiology.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall, subject to the availability of appropriations, award 
     grants or cooperative agreements for the establishment of 
     regional centers of excellence in autism spectrum disorder 
     and other developmental disabilities epidemiology for the 
     purpose of collecting and analyzing information on the 
     number, incidence, correlates and causes of autism spectrum 
     disorder and other developmental disabilities.
       ``(2) Requirements.--To be eligible to receive a grant or 
     cooperative agreement under paragraph (1), an entity shall 
     submit to the Secretary an application containing such 
     agreements and information as the Secretary may require, 
     including an agreement that the center to be established 
     under the grant or cooperative agreement shall operate in 
     accordance with the following:
       ``(A) The center will collect, analyze, and report autism 
     spectrum disorder and other developmental disability data 
     according to guidelines prescribed by the Director of the 
     Centers for Disease Control and Prevention, after 
     consultation with relevant State and local public health 
     officials, private sector developmental disability 
     researchers, and advocates for individuals with developmental 
     disabilities.
       ``(B) The center will develop or extend an area of special 
     research expertise (including genetics, epigenetics, 
     epidemiological research related to environmental exposures), 
     immunology, and other relevant research specialty areas.
       ``(C) The center will identify eligible cases and controls 
     through its surveillance system and conduct research into 
     factors which may cause or increase the risk of autism 
     spectrum disorder and other developmental disabilities.
       ``(c) Federal Response.--The Secretary shall coordinate the 
     Federal response to requests for assistance from State 
     health, mental health, and education department officials 
     regarding potential or alleged autism spectrum disorder or 
     developmental disability clusters.
       ``(d) Definitions.--In this part:
       ``(1) Other developmental disabilities.--The term `other 
     developmental disabilities' has the meaning given the term 
     `developmental disability' in section 102(8) of the 
     Developmental Disabilities Assistance and Bill of Rights Act 
     of 2000 (42 U.S.C. 15002(8)).
       ``(2) State.--The term `State' means each of the several 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, American Samoa, Guam, the Commonwealth of the Northern 
     Mariana Islands, the Virgin Islands, and the Trust Territory 
     of the Pacific Islands.
       ``(e) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated, $15,000,000 
     for fiscal year 2007, and such sums as may be necessary for 
     each of fiscal years 2008 through 2011.
       ``(f) Sunset.--This section shall not apply after September 
     30, 2011.

     ``SEC. 399BB. AUTISM EDUCATION, EARLY DETECTION, AND 
                   INTERVENTION .

       ``(a) Purpose.--It is the purpose of this section--
       ``(1) to increase awareness, reduce barriers to screening 
     and diagnosis, promote evidence-based interventions for 
     individuals with autism spectrum disorder or other 
     developmental disabilities, and train professionals to 
     utilize valid and reliable screening tools to diagnose or 
     rule out and provide evidence-based interventions for 
     children with autism spectrum disorder and other 
     developmental disabilities; and
       ``(2) to conduct activities under this section with a focus 
     on an interdisciplinary approach (as defined in programs 
     developed under section 501(a)(2) of the Social Security Act) 
     that will also focus on specific issues for children who are 
     not receiving an early diagnosis and subsequent 
     interventions.
       ``(b) In General.--The Secretary shall, subject to the 
     availability of appropriations, establish and evaluate 
     activities to--
       ``(1) provide information and education on autism spectrum 
     disorder and other developmental disabilities to increase 
     public awareness of developmental milestones;
       ``(2) promote research into the development and validation 
     of reliable screening tools for autism spectrum disorder and 
     other developmental disabilities and disseminate information 
     regarding those screening tools;
       ``(3) promote early screening of individuals at higher risk 
     for autism spectrum disorder and other developmental 
     disabilities as early as practicable, given evidence-based 
     screening techniques and interventions;

[[Page 16932]]

       ``(4) increase the number of individuals who are able to 
     confirm or rule out a diagnosis of autism spectrum disorder 
     and other developmental disabilities;
       ``(5) increase the number of individuals able to provide 
     evidence-based interventions for individuals diagnosed with 
     autism spectrum disorder or other developmental disabilities; 
     and
       ``(6) promote the use of evidence-based interventions for 
     individuals at higher risk for autism spectrum disorder and 
     other developmental disabilities as early as practicable.
       ``(c) Information and Education.--
       ``(1) In general.--In carrying out subsection (b)(1), the 
     Secretary, in collaboration with the Secretary of Education 
     and the Secretary of Agriculture, shall, subject to the 
     availability of appropriations, provide culturally competent 
     information regarding autism spectrum disorder and other 
     developmental disabilities, risk factors, characteristics, 
     identification, diagnosis or rule out, and evidence-based 
     interventions to meet the needs of individuals with autism 
     spectrum disorder or other developmental disabilities and 
     their families through--
       ``(A) Federal programs, including--
       ``(i) the Head Start program;
       ``(ii) the Early Start program;
       ``(iii) the Healthy Start program;
       ``(iv) programs under the Child Care and Development Block 
     Grant Act of 1990;
       ``(v) programs under title XIX of the Social Security Act 
     (particularly the Medicaid Early and Periodic Screening, 
     Diagnosis and Treatment Program);
       ``(vi) the program under title XXI of the Social Security 
     Act (the State Children's Health Insurance Program);
       ``(vii) the program under title V of the Social Security 
     Act (Maternal and Child Health Block Grant Program);
       ``(viii) the program under parts B and C of the Individuals 
     with Disabilities Education Act;
       ``(ix) the special supplemental nutrition program for 
     women, infants, and children established under section 17 of 
     the Child Nutrition Act of 1966 (42 U.S.C. 1786); and
       ``(x) the State grant program under the Rehabilitation Act 
     of 1973.
       ``(B) State licensed child care facilities; and
       ``(C) other community-based organizations or points of 
     entry for individuals with autism spectrum disorder and other 
     developmental disabilities to receive services.
       ``(2) Lead agency.--
       ``(A) Designation.--The governor of a State shall designate 
     a public agency as a lead agency to coordinate the activities 
     provided for under paragraph (1) in the State at the State 
     level.
       ``(B) Information.--The Governor or a State, acting through 
     the lead agency under subparagraph (A), shall make available 
     to individuals and their family members, guardians, 
     advocates, or authorized representatives, providers, and 
     other appropriate individuals in the State, comprehensive 
     culturally competent information about State and local 
     resources regarding autism spectrum disorder and other 
     developmental disabilities, risk factors, characteristics, 
     identification, diagnosis or rule out, available services and 
     supports, and evidence-based interventions. Such information 
     shall be provided through--
       ``(i) toll-free telephone numbers;
       ``(ii) Internet websites;
       ``(iii) mailings; or
       ``(iv) other means as the Governor may require.
       ``(C) Requirements of agency.--In designating the lead 
     agency under subparagraph (A), the Governor shall--
       ``(i) select an agency that has demonstrated experience and 
     expertise in--

       ``(I) autism spectrum disorder and other developmental 
     disability issues; and
       ``(II) developing, implementing, conducting, and 
     administering programs and delivering education, information, 
     and referral services (including technology-based curriculum-
     development services) to individuals with developmental 
     disabilities and their family members, guardians, advocates 
     or authorized representatives, providers, and other 
     appropriate individuals locally and across the State; and

       ``(ii) consider input from individuals with developmental 
     disabilities and their family members, guardians, advocates 
     or authorized representatives, providers, and other 
     appropriate individuals.
       ``(d) Tools.--
       ``(1) In general.--To promote the use of valid and reliable 
     screening tools for autism spectrum disorder and other 
     developmental disabilities, the Secretary shall develop a 
     curriculum for continuing education to assist individuals in 
     recognizing the need for valid and reliable screening tools 
     and the use of such tools.
       ``(2) Collection, storage, coordination, and 
     availability.--The Secretary, in collaboration with the 
     Secretary of Education, shall provide for the collection, 
     storage, coordination, and public availability of tools 
     described in paragraph (1), educational materials and other 
     products that are used by the Federal programs referred to in 
     subsection (c)(1)(A), as well as--
       ``(A) programs authorized under the Developmental 
     Disabilities Assistance and Bill of Rights Act of 2000;
       ``(B) early intervention programs or interagency 
     coordinating council's authorized under part C of the 
     Individuals with Disabilities Education Act; and
       ``(C) children with special health care needs programs 
     authorized under title V of the Social Security Act.
       ``(3) Required sharing.--In establishing mechanisms and 
     entities under this subsection, the Secretary, and the 
     Secretary of Education, shall ensure the sharing of tools, 
     materials, and products developed under this subsection among 
     entities receiving funding under this section.
       ``(e) Diagnosis.--
       ``(1) Training.--The Secretary, in coordination with 
     activities conducted under title V of the Social Security 
     Act, shall, subject to the availability of appropriations, 
     expand existing interdisciplinary training opportunities or 
     opportunities to increase the number of sites able to 
     diagnose or rule out individuals with autism spectrum 
     disorder or other developmental disabilities and ensure 
     that--
       ``(A) competitive grants or cooperative agreements are 
     awarded to public or non-profit agencies, including 
     institutions of higher education, to expanding existing or 
     develop new maternal and child health interdisciplinary 
     leadership education in neurodevelopmental and related 
     disabilities programs (similar to the programs developed 
     under section 501(a)(2) of the Social Security Act) in States 
     that do not have such a program;
       ``(B) trainees under such training programs--
       ``(i) receive an appropriate balance of academic, clinical, 
     and community opportunities;
       ``(ii) are culturally competent;
       ``(iii) are ethnically diverse;
       ``(iv) demonstrate a capacity to evaluate, diagnose or rule 
     out, develop, and provide evidence-based interventions to 
     individuals with autism spectrum disorder and other 
     developmental disabilities; and
       ``(v) demonstrate an ability to use a family-centered 
     approach; and
       ``(C) program sites provide culturally competent services.
       ``(2) Technical assistance.--The Secretary may award one or 
     more grants under this section to provide technical 
     assistance to the network of interdisciplinary training 
     programs.
       ``(3) Best practices.--The Secretary shall promote research 
     into additional valid and reliable tools for shortening the 
     time required to confirm or rule out a diagnosis of autism 
     spectrum disorder or other developmental disabilities and 
     detecting individuals with autism spectrum disorder or other 
     developmental disabilities at an earlier age.
       ``(f) Intervention.--The Secretary shall promote research, 
     through grants or contracts, to determine the evidence-based 
     practices for interventions for individuals with autism 
     spectrum disorder or other developmental disabilities, 
     develop guidelines for those interventions, and disseminate 
     information related to such research and guidelines.
       ``(g) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated, $32,000,000 
     for fiscal year 2007, $37,000,000 for fiscal year 2008, 
     $42,000,000 for fiscal year 2009, $47,000,000 for fiscal year 
     2010, and $52,000,000 for fiscal year 2011, of which--
       ``(1) $5,000,000 shall be made available in each fiscal 
     year for activities described in subsection (c); and
       ``(2) $3,000,000 shall be made available in fiscal year 
     2007, $6,000,000 in fiscal year 2008, $9,000,000 in fiscal 
     year 2009, $12,000,000 in fiscal year 2010, and $15,000,000 
     in fiscal year 2011, for activities described in subsection 
     (f).
       ``(h) Sunset.--This section shall not apply after September 
     30, 2011.

     ``SEC. 399CC. INTERAGENCY AUTISM COORDINATING COMMITTEE.

       ``(a) Establishment.--The Secretary shall establish a 
     committee, to be known as the `Interagency Autism 
     Coordinating Committee' (in this section referred to as the 
     `Committee'), to coordinate all efforts within the Department 
     of Health and Human Services concerning autism spectrum 
     disorder.
       ``(b) Responsibilities.--In carrying out its duties under 
     this section, the Committee shall--
       ``(1) make recommendations concerning the strategic plan 
     described in section 409C(a);
       ``(2) develop and annually update advances in autism 
     spectrum disorder research related to causes, early 
     screening, diagnosis or rule out, intervention, and access to 
     services and supports for individuals with autism spectrum 
     disorder; and
       ``(3) make recommendations to the Secretary regarding the 
     public participation in decisions relating to autism spectrum 
     disorder.
       ``(c) Membership.--
       ``(1) In general.--The Committee shall be composed of--
       ``(A) the Director of the Centers for Disease Control and 
     Prevention;
       ``(B) the Director of the National Institutes of Health, 
     and the Directors of such national research institutes of the 
     National Institutes of Health as the Secretary determines 
     appropriate;
       ``(C) the heads of such other agencies as the Secretary 
     determines appropriate;
       ``(D) representatives of other Federal Governmental 
     agencies that serve individuals with autism spectrum disorder 
     such as the Department of Education; and
       ``(E) the additional members appointed under paragraph (2).
       ``(2) Additional members.--Not fewer than 6 members of the 
     Committee, or 1/3 of the total membership of the Committee, 
     whichever is greater, shall be composed of non-federal public 
     members to be appointed by the Secretary, of which--
       ``(A) at least one such member shall be an individual with 
     a diagnosis of autism spectrum disorder;
       ``(B) at least one such member shall be a parent or legal 
     guardian of an individual with an autism spectrum disorder; 
     and
       ``(C) at least one such member shall be a representative of 
     leading research, advocacy, and

[[Page 16933]]

     service organizations for individuals with autism spectrum 
     disorder.
       ``(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 term. 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 meet at the call of the 
     chairperson or upon the request of the Secretary. The 
     Committee shall meet not fewer than 2 times each year.
       ``(4) All meetings of the Committee shall be public and 
     shall include appropriate time periods for questions and 
     presentations by the public.
       ``(e) Compensation and Expenses.--Members of the Committee 
     who are officers or employees of the Federal Government shall 
     serve as members of the Committee without compensation in 
     addition to that received in their regular government 
     employment. Other members of the Committee shall receive 
     compensation at rates not to exceed the daily equivalent of 
     the annual rate in effect for grade GS-18 of the General 
     Schedule for each day (including travel time) they are 
     engaged in the performance of their duties as members of the 
     Committee.
       ``(f) Subcommittees; Establishment and Membership.--In 
     carrying out its functions, the Committee may establish 
     subcommittees and convene workshops and conferences. Such 
     subcommittees shall be composed of Committee members and may 
     hold such meetings as are necessary to enable the 
     subcommittees to carry out their duties.
       ``(g) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated, such sums as 
     may be necessary for each of fiscal years 2007 through 2011.
       ``(h) Sunset.--This section shall not apply after September 
     30, 2011 and the Committee shall be terminated on such date.

     ``SEC. 399DD. REPORT TO CONGRESS.

       ``(a) In General.--Not later than 4 years after the date of 
     enactment of the Combating Autism Act of 2006, the Secretary, 
     in coordination with the Secretary of Education, shall 
     prepare and submit to the Health, Education, Labor, and 
     Pensions Committee of the Senate and the Energy and Commerce 
     Committee of the House of Representatives a progress report 
     on activities related to autism spectrum disorder and other 
     developmental disabilities.
       ``(b) Contents.--The report submitted under subsection (a) 
     shall contain--
       ``(1) a description of the progress made in implementing 
     the provisions of the Combating Autism Act of 2006;
       ``(2) a description of the amounts expended on the 
     implementation of the particular provisions of Combating 
     Autism Act of 2006;
       ``(3) information on the incidence of autism spectrum 
     disorder and trend data of such incidence since the date of 
     enactment of the Combating Autism Act of 2006;
       ``(4) information on the average age of diagnosis for 
     children with autism spectrum disorder and other 
     disabilities, including how that age may have changed over 
     the 4-year period beginning on the date of enactment of this 
     Act;
       ``(5) information on the average age for intervention for 
     individuals diagnosed with autism spectrum disorder and other 
     developmental disabilities, including how that age may have 
     changed over the 4-year period beginning on the date of 
     enactment of this Act;
       ``(6) information on the average time between initial 
     screening and then diagnosis or rule out for individuals with 
     autism spectrum disorder or other developmental disabilities, 
     as well as information on the average time between diagnosis 
     and evidence-based intervention for individuals with autism 
     spectrum disorder or other developmental disabilities;
       ``(7) information on the effectiveness and outcomes of 
     interventions for individuals diagnosed with autism spectrum 
     disorder, including by various subtypes, and other 
     developmental disabilities and how the age of the child may 
     affect such effectiveness;
       ``(8) information on the effectiveness and outcomes of 
     innovative and newly developed intervention strategies for 
     individuals with autism spectrum disorder or other 
     developmental disabilities; and
       ``(9) information on services and supports provided to 
     individuals with autism spectrum disorder and other 
     developmental disabilities who have reached the age of 
     majority (as defined for purposes of section 615(m) of the 
     Individuals with Disabilities Education Act (20 U.S.C. 
     1415(m)).''.
       (b) Repeals.--The following sections of the Children's 
     Health Act of 2000 (Public Law 106-310) are repealed:
       (1) Section 101 (42 U.S.C. 247b-4a) relating to research 
     activities at the National Institutes of Health.
       (2) Section 102 (42 U.S.C. 247b-4b) relating to the 
     Developmental Disabilities Surveillance and Research Program.
       (3) Section 103 (42 U.S.C. 247b-4c) relating to information 
     and education.
       (4) Section 104 (42 U.S.C. 247b-4d) relating to the Inter-
     Agency Autism Coordinating Committee.
       (5) Section 105 (42 U.S.C. 247b-4e) relating to reports.

  Mr. SANTORUM. Mr. President, before I offer the amendment, if Senator 
Dodd would like to take a few minutes to speak.
  Mr. DODD. Mr. President, I will be very brief. The majority leader is 
here, and my friend from Pennsylvania has very adequately--more than 
adequately--described the history of this legislation. It has been a 
journey of some time here to bring this legislation to the point we are 
this evening, to the final adoption unanimously by this body. I am very 
grateful, as well, to the chairman of our committee, Mike Enzi, who has 
been tremendously helpful, along with Senator Kennedy and other members 
of the committee who voted unanimously to report this bill out on a 
bipartisan basis.
  As the Senator from Pennsylvania has pointed out, the majority leader 
and minority leader have been tremendously helpful, along with the 
majority and minority leader staffs who have helped us on the Senate 
floor work through some final little knots on this bill that had to be 
worked out before we could bring this bill to the consideration of the 
full body.
  There are some very special people who worked very hard. The autism 
community is a large community. It is a diverse one. There are many 
points of view that have been represented by various people. It has 
been critically important that there has been an effort to come 
together. They have done that in part because of the leadership of Bob 
and Suzanne Wright, who played a very instrumental role, who are 
grandparents of an autistic child and who work tirelessly with the 
organization they helped found, Autism Speaks. Senator Santorum also 
mentioned Deirdre Imus, a constituent of mine in Connecticut, who is 
tenacious in her commitment to issues she gets involved in and has 
certainly been tenacious on this one. If there were one individual 
outside of the Members and staff of this body who worked so hard on 
this, she probably deserves it more than anyone for keeping the flame 
burning on this effort on behalf on the autism community.
  Mr. President, 1 out of every 166 children in this country are born 
with autism spectrum disorder. It is a growing problem, Mr. President. 
The problem has increased in my own State of Connecticut by close to 
1,100 percent since 1993. We don't know exactly what causes this. But 
this bill will allow us to examine all questions--and I mean every 
question--arising of what may be provoking this rapid increase in 
autism. Clearly, our diagnosis, diagnostic efforts, are better today. 
But that doesn't explain to most of us why the dramatic increases have 
occurred.
  So we believe there may be other reasons out there that deserve full 
examination and exploration. Certainly, looking at ways to treat this 
issue is also critically important, how to support these families who 
have an autistic child. There is a tremendous amount of pressure on 
families who are confronted with this issue. They handle it very well, 
and many of these families will tell you that while one may look at it 
from afar as a disability, in many cases you will be amazed how many 
view it as somehow a blessing in a way. I know that sounds strange to 
many of my colleagues to hear this, but for families with autistic 
children, it is difficult, but it is impressive to see how well they 
handle this. It is inspirational to watch how many families deal with 
this issue.
  So tonight is a special night. It is late. We have major bills we 
have just passed on pension reform, and we are not suggesting this bill 
is more important than that bill in significance, but I want to tell 
you something. To an awful lot of families out there tonight who don't 
know anything about this late hour or what has happened here earlier, 
we are making a difference in their lives, and we may make a huge 
difference down the road in the lives of future children and families 
because we may get to the cause of this and make a difference in trying 
to stem the reach of autism spectrum disorder.
  So I am deeply proud we have been involved. We hope we can get, of 
course, this bill signed into law fairly

[[Page 16934]]

quickly. But, again, I thank my colleagues. I thank, particularly, 
Senator Santorum, who has been terrific on this issue and who has been 
a chief sponsor with me, along with the other Members whom I have 
mentioned.
  In conclusion, hundreds of thousands of families across America 
struggle each and every day with autism spectrum disorder, ASD, one of 
the fastest- growing developmental disabilities in the United States. 
While we used to think of ASD as relatively rare, today it is diagnosed 
at a rate that is 10 times that of a decade ago. In my home State of 
Connecticut, we have witnessed an increase in diagnoses of ASD of close 
to 1,100 percent since 1993. What these numbers tell us is that ASD 
diagnoses are rising at truly alarming rates and we simply must provide 
more answers to all those affected by this devastating condition. As a 
nation, we need to support the families that are struggling to raise a 
child with ASD.
  There are many theories as to why the prevalence of ASD has 
increased. Some have suggested that it is a reflection of better 
diagnostic tools and measures. Other theories focus on genetic or 
environmental factors. But the fact is that when it comes to autism 
spectrum disorder we just don't know for certain what causes it, we 
don't know exactly how to diagnose it, and we don't know how best to 
intervene so that individuals with ASD can achieve their highest 
potential. It is absolutely vital that we do more for families 
struggling with this disorder, which is why the Combating Autism Act is 
so important.
  ASD affects as many as 6 out of every 1,000 children, and the 
economic cost to this country due to autism spectrum disorder is 
staggering. Healthcare for individuals with ASD over their lifetimes 
costs an estimated $35 billion per year. Schooling alone can cost as 
much as $100,000 each year. By 2015, the annual cost of care will be 
about $300 billion, but we know that this figure can be cut in half 
with early diagnosis, services, and intervention. As many as 40 percent 
of new ASD cases are identified in our schools each year, and a child 
is likely to be nearing his or her 10th birthday before a diagnosis is 
made. This means that interventions and services that could help these 
children achieve their full potential are not made available to them 
during the critical period of early development when interventions are 
most successful and cost-effective. As a country, we need to do a 
better job of diagnosing children before they start school. That means 
training pediatricians, early childhood educators, and day care 
providers to recognize the early indicators of ASD so that at-risk 
children are referred to specialists for diagnosis and services as 
early as practicable.
  The Combating Autism Act will promote early detection, early 
evidence-based interventions, and services for individuals with ASD. It 
also significantly increases our investment in the National Institutes 
of Health for autism-related research. This legislation will also 
reauthorize the epidemiologic surveillance programs at the Centers for 
Disease Control and Prevention. Most importantly, this legislation will 
mean answers for the families that have been so deeply affected by ASD. 
For that reason, more than any other, I am grateful that the Senate is 
voting to pass the Combating Autism Act today.
  I want to thank my colleagues, Senator Santorum, Senator Enzi, 
Senator Kennedy, and their staffs for their extraordinary hard work on 
this bill. I also wish to offer my sincere thanks and appreciation to 
all of the individuals who are personally affected by autism spectrum 
disorder--and the many advocacy groups who represent them--for their 
continued dedication and passionate commitment to this legislation. 
Without their commitment, we would not be here today on the verge of 
Senate passage of this critical legislation that will greatly advance 
our Nation's efforts to address the many issues surrounding autism 
spectrum disorder and to serve those per * * *
  The PRESIDING OFFICER. The majority leader is recognized.
  Mr. FRIST. Mr. President, before we move to pass this bill, I, too, 
want to add my commendation, my thanks, my appreciation, my gratitude 
to Senator Santorum and Senator Dodd. I have had the opportunity to 
work almost daily with Senator Santorum on this particular issue and 
because of his focus and his dedication and hard work, indeed, at 11:15 
tonight, we do have a reason to celebrate--celebrate not just for the 
bill itself but because it is a major step forward for the hundreds and 
thousands of families across this Nation who are exposed to, are 
touched by, who celebrate autism, and that this bill itself recognizes 
we have a long way to go.
  It was a year ago that I asked the Government Accountability Office 
to look at and evaluate our country's efforts to combat autism and to 
look at the challenges that we have before us. It was 6 years ago that 
Senator Kennedy and I cosponsored a bill, the Children's Health Act of 
2000. The report was released today, the General Accounting Office 
report. It states that while Federal funding coordination and research 
have increased since the Children's Health Act of 2000, there is a 
significant need for more coordination, for expanded research, for 
better strategies for education, and indeed for more health care 
professionals to serve the autism community.
  If you wrap all of that up, there is a need for better research, 
diagnosis, and treatment. And there is a need for a cure.
  On the Senate floor we will talk about that need, but it is parents 
like Brian and Tracy Noll who feel it every day. Brian and Tracy are 
parents, actually Pennsylvanian parents--referring to my distinguished 
colleague, the sponsor of this bill--of a 7-year-old son with autism. 
As an infant, their son Tyler exhibited--this is the usual course--all 
the normal signs of a healthy baby, a happy baby. But at 18 months 
Brian started to notice that Tyler would no longer look him in the eye.
  Again, as is the custom, after repeated visits to doctors, repeated 
visits, there was a lot of mystery initially. He was ultimately 
diagnosed with autism at the age of 3. Today Tyler struggles with 
communication and coordination, his language and sensory skills are 
limited. He knows, yes, that he is different from other children, but 
he really can't understand why. Brian and Tracy see their fun-loving 
son whose smile lights up the room and they hope for new treatments 
that will help him lead a normal and productive life. They hope 
researchers will help cure autism, and, yes, they hope someday we will 
understand why. Because of the tremendous work of Senators Santorum and 
Dodd, under the chairmanship of Chairman Enzi and Chairman Kennedy--who 
I mentioned back from our work together in 2006--we are on the way to 
that becoming a reality.
  It is one of the least understood developmental disorders of our 
time. The difficulties with communication skills and social skills are 
well known. But no case is the same. Every case is a little bit 
different. It covers, as its name suggests, a spectrum of behaviors. 
Approximately 40 percent of children with autism do not talk. Others 
will learn to talk but later stop speaking altogether. Some read at an 
advanced pace. Some have unique athletic abilities. Some will exhibit 
excellent fine motor skills but will have a great deal of difficulty 
with the more simple tasks before them.
  I think back to 30 years ago when I graduated from medical school: 
Autism was little talked about as a disorder. But over the next three 
decades we have watched its incidence steadily grow. That is why, as I 
mentioned, in the year 2000, Senator Kennedy and I were compelled to 
introduce that Children's Health Care Act. The intent was for America 
to better understand and treat and one day prevent a disorder that had 
for so long eluded the scientific community as well as the medical and 
clinical community.
  As the GAO report released today highlights, coordination of Federal 
autism activities in NIH research has increased. Indeed, NIH funding 
has doubled between 2000 and today. Yet, for as many strides as we made 
in the last 5 years, one fact remains: There is no

[[Page 16935]]

cure. We shed more light on autism, but we are still at the very dawn 
of understanding the disorder and its origins.
  As a physician I have witnessed firsthand the power of research--if 
we invest, if we set up a framework for the appropriate research. And 
with reason, I harbor hope for a day when autism has a cure.
  But that day depends on this body making a commitment.
  We have laid a foundation. But today we have an opportunity to build 
on it by passing the Combating Autism Act, which not only reauthorizes 
The Children's Health Act of 2000--it addresses the specific challenges 
laid out in the GAO report. The GAO report highlights that we need 
greater coordination of Federal autism activities, and this bill 
ensures it. The report states that surveillance of autism can be 
improved through better coordination--and this bill ensures it. The 
report identifies the need for more health care professionals who are 
trained to interact with autism patients--and this bill ensures it. The 
report makes clear that because there is no cure and no known cause, 
research must be continued, and it must be expanded. And this bill 
ensures it.
  For the parents of children with autism, there is so little 
certainty. There is no guarantee when they wake up in the morning that 
it will be a good day for their child. There is no guarantee that their 
child will learn to talk or to read or interact with his peers. And 
there is no certainty what the future holds for that child who will one 
day be an adult.
  Today is an opportunity to provide those parents with what little 
certainty we can.
  Today is the opportunity to assure them that we are continuing to 
push forward for better treatment, for more research, for a greater 
understanding, and one day, perhaps a cure.
  I thank my colleagues Senators Santorum and Dodd for sponsoring this 
legislation.
  And I am pleased we have passed this important bill.
  What we are about to do is a great victory for this body, for the 
country, and indeed for the parents of children with autism. I am 
pleased in a few moments we will pass this very important deal.
  Both of my colleagues have previously mentioned their relationship 
with others who have autism. Again, Bob and Susan Wright have been 
tremendous leaders in their communities, across the country, and indeed 
globally in fighting autism. A good friend, Phil Geier, who they know 
very well, a close friend of mine, has been instrumental in shedding 
that communication, that light on this entity. We can all celebrate 
today that, because of all their hard work and the leadership of 
Chairman Enzi, we will be passing that bill shortly.
  The PRESIDING OFFICER. The Senator from Illinois.
  Mr. DURBIN. Mr. President, I salute the source of this effort for 
their hard work, Senator Santorum, Senator Dodd, and many others, and 
ask unanimous consent my name be added as a cosponsor.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Wyoming.
  Mr. ENZI. Mr. President, I want to take a moment to add my 
congratulations to the people who have had a key role in doing this 
bill. First of all, I want to recognize the leader, who always inspires 
us on a lot of these issues and then provides the time for us to be 
able to do it as well--not only on this but on the pensions bill. He 
has to handle a lot of strategy and a lot of different personalities 
and does just a marvelous job moving the whole body along.
  I primarily want to thank Senator Dodd and Senator Santorum for 
bringing this to our committee and working it diligently. I also thank 
them for sending all the different people to see me who had an interest 
in this bill, who had a number of different likes and wants and needs. 
They are to be commended for the tremendous effort they put into making 
sure that some day we have a solution to autism.
  It is the most diligent-working bunch of people I think I have ever 
been associated with. They are also at the very beginning of a process, 
it seems. We need to expedite that process. This bill will help to get 
that done.
  Senator Santorum has just been a real leader on this issue and 
probably understands it better than anybody that I have worked with and 
has worked through all the difficulties of the last-minute kinds of 
changes.
  I thank all of you for getting this for America. One of the things 
this bill does is help people understand autism better. It is 
relatively unknown. This elevates it. As we continue to do that, we 
will get solutions. I thank all of you for doing that.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SANTORUM. Mr. President, I thank Senator Enzi for just the 
tremendous commitment that he and Senator Kennedy made to being patient 
and working through the months of time it took to bring this bill 
together.
  I know his intention was to move a comprehensive reform of the NIH, 
and he made an exception for this piece of legislation. Senator Dodd 
and I thank both Senator Enzi and Senator Kennedy for breaking ranks, 
making sure we could move this as a separate piece of legislation, 
apart from the overall reauthorization of NIH.
  I want to say to the leader, as Senator Enzi said, we wouldn't be 
here if it were not for your commitment to get this bill done. I know 
Senator Reid, with whom I spoke just a few minutes ago, said: This is a 
very important bill to me; this is something I want to see done. We 
worked through the bumps here right at the end to get that done thanks 
to you, our two leaders.
  Up until the very end this has been a difficult process, but we are 
here. Having worked on a lot of bills, I have been very blessed in the 
time that I have been here. I have had my share of legislative 
successes and bills I have worked on and worked hard on to make a 
difference. I can't think of any piece of legislation that I will feel 
better about as I reflect back on what I have accomplished here than 
what we have done tonight.
  People who are dealing with children with autism are a special group 
of people. Senator Dodd laid that out very eloquently. They are a 
special group of people who are, in many cases, just more determined to 
be able to solve this enigma that is in their family, this disorder 
about which they just can't seem to get the answers they need.
  I always say when I meet with a group of autistic kids and their 
parents, the commonality in every one of those meetings is tears. In 
most cases, we are talking to parents who are very, very stressed out 
and really sort of at their wits end as to how to grapple with this 
problem. Tonight, hopefully, we will begin the process of drying those 
tears and creating hope for a whole group of Americans and their 
families who deserve better answers than what we are getting from the 
medical community today.
  One final note. I want to say that Senator Dodd, I think, referred to 
Deirdre Imus as the flame that just burned. I say, then her husband is 
the torch that is burning many places--many parts of our body at times, 
in getting this legislation through. Don Imus deserves, certainly, his 
credit for taking this issue on in a very public way and, because of 
what he does on the radio, increasing public awareness about this 
disorder and making a contribution to this effort that we are seeing 
successful tonight. But also the effort improving awareness of this 
order.
  I am happy to yield to Senator Dodd.
  Mr. DODD. Mr. President, I suspect that Don Imus is so dedicated to 
raising awareness of this issues because of the work of his wife. That 
is why he does this, more than anything else. We are delighted to have 
both of their support and commitment to this important issue.
  On my own staff, I wish to thank Jim Fenton, Tamar Magarik, and 
Elizabeth Hoffman; Jen Vesey with Senator Santorum; Shana Christrup and 
Steve Northrup of Chairman Enzi's staff, and Caya Lewis with Ranking 
Member Kennedy's staff.
  We have had some wonderful people on all sides work on this, and I am

[[Page 16936]]

pleased to recognize them and add their names to the Record.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SANTORUM. Mr. President, I earlier thanked my staff member, Jen 
Vesey, and I want to reiterate that. I really cannot tell you how much 
credit she deserves for this legislation and the enormous amount of 
time she spent in pulling this altogether. As Senator Dodd mentioned 
staff again, I thought it was important for everyone who is working out 
there in the autism community to understand what a champion you have in 
Jen Vesey, who is on my staff.
  I ask unanimous consent that Senator Chambliss and Senator Thune be 
added as cosponsors to the legislation.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. SANTORUM. Mr. President, I understand there is an amendment at 
the desk. Let me explain what this amendment does before I ask consent 
it be adopted and the bill be passed, because I know people are going 
to hear that this bill passed and passed with an amendment and they are 
going to wonder what the amendment is and whether this does anything to 
change the bill.
  The amendment is as a result of one of the bumps that we ran into 
tonight, trying to get this bill passed unanimously. It is not easy to 
get the Senate to do anything unanimously, particularly anything 
complex, and this is a very lengthy piece of legislation that has a lot 
of complexity to it.
  We had one issue brought up by a Member with respect to the increase 
in the amount of authorization for research. That Member thought that 
number was excessive and was going to object to the consideration of 
the bill tonight unless we were able to do something about that 
authorization number. In order to get the legislation adopted--because, 
again, there would have been objection tonight and that objection would 
have carried into the fall, and with a very short timeframe the 
likelihood of that bill being able to pass this fall and be considered 
by the House and then passed and sent to the President would have been 
highly unlikely--so I was able to negotiate with this Senator to reduce 
the level of authorization, the increase, from $100 million in the area 
of research in the NIH to $200 million--which is what the bill calls 
for--from $100 million to $150 million. Instead of the research going 
up $20 million a year for 5 years up to $200 million in the final year, 
it will go up at $10 million a year to $150 million in the final year. 
Again, still a sizable increase.
  It is a 50 percent increase in funding over 5 years in the 
authorization. If you look at what we are doing here in the Senate 
these days, we are not increasing funding for many programs at 50 
percent. So it is not all we had hoped, not all we had wanted, but it 
is better than nothing. Unfortunately, with the late hour of this bill 
being brought up, nothing was a real alternative and not a pleasant 
one.
  As a result, that is the amendment we will be considering here in a 
moment. After the amendment is adopted, then the bill will be passed. 
We will send the bill over to the House and hope that when the House 
returns in September and is willing to bring up this legislation, pass 
it as it is, and send it on to the President so we can get moving on 
finding a cure for the autism spectrum disorder.
  Mr. ENZI. Mr. President, I rise today in support of S. 843, the 
Combating Autism Act. I am pleased to note that the Senate will pass 
this bill today.
  This legislation, which was recently reported out of the Senate 
Health, Education, Labor, and Pensions Committee, focuses on expanding 
autism spectrum disorder research and coordination at the National 
Institutes of Health, NIH. It also increases awareness of autism 
spectrum disorder and its symptoms through the Centers for Disease 
Control and Prevention, CDC. Additionally, the bill integrates our 
various health, education, and disability programs that serve 
individuals and families affected by autism spectrum disorder and 
ensures that the community of people affected by this disorder have a 
voice in all of this.
  No one knows exactly how many individuals are affected by autism 
spectrum disorder, but some studies suggest it could be as high as 1 
out of every 166 American individuals.
  But there are many things we do know about autism spectrum disorder. 
We know we need to begin intervention as early as possible to help 
individuals with autism spectrum disorder reach their full potential. 
And given the importance of early intervention, we need further 
research into the possible causes of autism spectrum disorder.
  We need to understand more about the various forms of autism spectrum 
disorder to improve our ability to provide the right kinds of 
intervention and support. And, we need to provide better integration of 
the health, education, and disability programs already available to 
meet the increased demand for these interventions, supports and 
services.
  I believe the ``Combating Autism Act'' is an important step toward 
addressing these needs and finding some solutions that will improve the 
lives of individuals and families whose daily lives have been turned 
upside down by autism spectrum disorder.
  This bill is the result of a tremendous amount of work across party 
lines. I want to thank the original bill cosponsors, Senators Santorum 
and Dodd for introducing this legislation and for working with me to 
fine-tune it. I would also like to express my deep appreciation and 
thanks to the ranking member, Senator Kennedy, for his hard work during 
this process. Of course, in providing thanks to the members, I would be 
remiss if I did not mention the staff. Specifically, I want to thank 
Jen Vesey with Senator Santorum; Jim Fenton, Ben Berwick, Tamar 
Magarik, and Elizabeth Hoffman with Senator Dodd, and Caya Lewis with 
Senator Kennedy's office, as well as my staff--Steve Northrup, Aaron 
Bishop, Tec Chapman, Martina Bebin, and Shana Christrup.
  I also want to thank the various groups and individuals who work on 
behalf of individuals and families affected by autism spectrum 
disorder. I appreciate the way in which this community of advocates has 
come together to work with me and my colleagues on this. If they had 
not worked together so well--with each other and with us as our 
Committee worked on this bill--I doubt we would be here today.
  Mr. SANTORUM. Mr. President, first let me express my sincere 
gratitude to Chairman Enzi and your staff for investing so much time 
and thoughtful effort in this important legislation, as well as thank 
Senators Dodd and Kennedy, and their staffs. Few things are more 
important than the health and happiness of our Nation's children, and 
the Combating Autism Act will go a long way to helping those diagnosed 
with autism live up to their full potential. We have a tremendous 
opportunity to make a real difference in the lives of children with 
autism and their families. This Federal investment will lead to better 
understanding of autism, increase awareness, diagnosis and 
intervention--all things that will make a profound impact on families 
struggling for answers and hope.
  Autism raises complex and emotional issues. All of us who worked so 
hard on this legislation sought to keep the primary focus of the bill 
on autism research and awareness. However, in addressing the key issues 
within S. 843, some have raised concerns regarding a potential link 
between vaccines, vaccine components, such as thimerosal, and autism. 
Can the Chairman clarify his position on this issue?
  Mr. ENZI. Mr. President, I am happy to do so. In 2004 the Institute 
of Medicine's Immunization Safety Review Committee concluded that the 
body of epidemiological evidence ``favors rejection of a causal 
relationship between the MMR vaccine and autism spectrum disorder'' and 
also ``favors rejection of a causal relationship between thimerosal-
containing vaccines and autism spectrum disorder.'' The IOM committee 
also found that ``potential biological mechanisms for vaccine-induced 
autism spectrum disorder that have been generated to date are 
theoretical only.''
  However, the IOM committee also acknowledged that ``[a]bsent 
biomarkers,

[[Page 16937]]

well-defined risk factors, or large effect sizes, the committee cannot 
rule out, based on the epidemiological evidence, the possibility that 
vaccines contribute to autism spectrum disorder in some small subset or 
very unusual circumstances.'' The IOM committee also noted that 
``experiments showing effects of thimerosal on biochemical pathways in 
cell culture systems and showing abnormalities in the immune system or 
metal metabolism in people with autism spectrum disorder are 
provocative,'' and suggested that ``the autism spectrum disorder 
research community should consider the appropriate composition of the 
autism spectrum disorder research portfolio with some of these new 
findings in mind.''
  I agree with the IOM committee's recommendation that ``available 
funding for autism spectrum disorder research be channeled to the most 
promising areas.'' The HELP Committee reported this bill without making 
the determination for the autism spectrum disorder research community 
of what are the ``most promising areas'' for investigation. Instead, 
the bill reported by the HELP Committee contemplates key research 
activities, including environmental research, that focus on a broad 
range of potential contributing factors, with meaningful public 
involvement and advice in setting the research agenda.
  However, I want to be clear that, for the purposes of biomedical 
research, no research avenue should be eliminated, including biomedical 
research examining potential links between vaccines, vaccine 
components, and autism spectrum disorder. Thus, I hope that the 
National Institutes of Health will consider broad research avenues into 
this critical area, within the Autism Centers of Excellence as well as 
the Centers of Excellence for Environmental Health and Autism. No stone 
should remain unturned in trying to learn more about this baffling 
disorder, especially given how little we know.
  I also want to note that this broad statement is appropriately 
limited to biomedical and not epidemiological research. Although S. 843 
provides for specific centers of excellence to examine epidemiological 
issues related to autism spectrum disorder, there is currently no 
expectation that the Centers for Disease Control and Prevention should 
further pursue additional epidemiological research regarding the link 
between autism spectrum disorder and vaccines or vaccine components, 
unless new biomedical research provides additional information about 
specific at-risk subpopulations. At this point, given what we know and 
what has already been done in this area, no new epidemiological 
research is required.
  Mr. SANTORUM. I agree with the comments of the chairman. I thank him 
for clarifying, and again for all of his hard work on this legislation.
  Mr. KENNEDY. I also agree with the comments of the chairman.
  Mr. DODD. As my colleagues are well aware, the prevalence of ASD in 
the U.S. is 10 times greater than a decade ago. In my own State of 
Connecticut, ASD diagnoses have increased by close to 1100 percent 
since 1993. What these numbers tell us is that ASD diagnoses are rising 
at truly alarming rates and we simply must provide more answer to all 
those affected by this devastating condition.
  We must also create a larger pool of experts in the field so that 
families can be directed to nearby specialty clinics for confirmation 
of diagnosis, care and services. Waiting lists at the Nation's top 
developmental disability centers are as long as 2 to 3 years, and 
families are often forced to travel far from home to receive needed 
care and to participate in clinical research studies. Increasing the 
number of trained physicians and allied health professionals who can 
provide a medical home for individuals with ASD will enable all those 
affected to receive the optimal and timely care that they deserve.
  It is my sincere hope and expectation that by expanding the federal 
response to ASD and other developmental disabilities through the 
Combating Autism Act, we will see improved research on ASD, including 
its causes, and families across America will get the services they so 
urgently need. In our search for the cause of this growing 
developmental disability, we should close no doors on promising avenues 
of research. Through the Combating Autism Act, all biomedical research 
opportunities on ASD can be pursued, and they include environmental 
research examining potential links between vaccines, vaccine components 
and ASD.
  Mr. SANTORUM. I ask unanimous consent that the amendment at the desk 
be agreed to, the committee-reported amendment, as amended, be agreed 
to, the bill, as amended, be read a third time and passed, and the 
motion to reconsider be laid upon table and that any statements 
relating to the bill be printed in the Record.
  The PRESIDING OFFICER (Mr. Burr). Without objection, it is so 
ordered.
  The amendment (No. 4878) was agreed to, as follows:

       On page 39, line 20, strike ``2007'' through page 40, line 
     5 and insert:
       ``(A) $68,000,000 for fiscal year 2007, $74,500,000 for 
     fiscal year 2008, $81,000,000 for fiscal year 2009, 
     $87,500,000 for fiscal year 2010, and $94,000,000 for fiscal 
     year 2011, to carry out subsections (a), (b), and (d);
       ``(B) $24,000,000 for fiscal year 2007, $30,500,000 for 
     fiscal year 2008, $37,000,000 for fiscal year 2009, 
     $43,500,000 for fiscal year 2010, and $50,000,000 for fiscal 
     year 2011, to carry out subsection (c)(1); and

  The committee amendment in the nature of a substitute, as amended, 
was agreed to.
  The bill was ordered to be engrossed for a third reading, was read 
the third time, and passed, as follows:

                                 S. 843

       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 ``Combating Autism Act of 
     2006''.

     SEC. 2. ACTIVITIES TO IMPROVE AUTISM-RELATED RESEARCH.

       Section 409C of the Public Health Service Act (42 U.S.C. 
     284g) is amended to read as follows:

     ``SEC. 409C. AUTHORITY OF THE DIRECTOR OF THE NATIONAL 
                   INSTITUTES OF HEALTH RELATING TO AUTISM.

       ``(a) Strategic Plan for Autism Research.--
       ``(1) In general.--The Secretary, acting through the 
     Director, shall develop and implement a strategic plan for 
     the conduct and support of research related to autism 
     spectrum disorder.
       ``(2) Requirements.--The strategic plan developed under 
     paragraph (1)--
       ``(A) shall--
       ``(i) be updated annually;
       ``(ii) take into account the research recommendations of 
     the Interagency Autism Coordinating Committee under section 
     399CC; and
       ``(iii) using professional judgment, outline the proposed 
     budgetary requirements of the strategic plan, including 
     specific funding expectations for continued multi-year 
     program activities, as well as new and complementary program 
     activities, subject to the availability of appropriations; 
     and
       ``(B) may include investigator-initiated research.
       ``(3) Report.--Not later than April 1, 2008, and annually 
     thereafter, the Secretary, acting through the Director, shall 
     prepare and submit to the appropriate committees of Congress 
     a report that contains--
       ``(A) the strategic plan under paragraph (1) that will be 
     applicable to the upcoming fiscal year; and
       ``(B) a description of the actual dollar expenditures for 
     autism spectrum disorder during the previous fiscal year.
       ``(b) Expansion, Intensification, and Coordination of 
     Activities.--The Secretary, acting through the Director, 
     shall, subject to the availability of appropriations, expand, 
     intensify, and coordinate the activities of the National 
     Institutes of Health with respect to autism spectrum 
     disorder.
       ``(c) Centers of Excellence.--
       ``(1) Autism centers of excellence.--
       ``(A) In general.--The Secretary, acting through the 
     Director, shall, subject to the availability of 
     appropriations, award grants or contracts to public or 
     nonprofit private entities to assist such entities in paying 
     all or part of the costs of planning, establishing, 
     improving, and providing basic operating support for centers 
     of excellence concerning research on autism spectrum 
     disorder.
       ``(B) Research activities.--A center of excellence that 
     receives funding under this paragraph shall conduct basic and 
     clinical research into autism spectrum disorder. Such 
     research shall--
       ``(i) be conducted in the fields of developmental 
     neurobiology, genetics, epigenetics, pharmacology, nutrition, 
     immunology, neuroimmunology, neurobehavioral development, 
     endocrinology, gastroenterology, psychopharmacology, or 
     toxicology; and
       ``(ii) include investigations into the causation, diagnosis 
     or rule out, early detection, prevention, services, supports, 
     or intervention of autism spectrum disorder.
       ``(C) Services.--

[[Page 16938]]

       ``(i) In general.--A center of excellence that receives 
     funding under this paragraph may expend amounts provided 
     under a grant or contract under such paragraph to carry out a 
     program to make individuals aware of opportunities to 
     participate as subjects in research conducted by the center.
       ``(ii) Referrals and costs.--A program carried out under 
     clause (i) may, in accordance with such criteria as the 
     Director may establish, provide to the subjects described in 
     such clause, referrals for health and other services and 
     reimbursement of care for individuals as are required for 
     such research.
       ``(iii) Availability and access.--The extent to which a 
     center of excellence that receives funding under this 
     paragraph can demonstrate the availability of and access to 
     clinical services shall be considered by the Director in 
     making decisions concerning the awarding of grants or 
     contracts to applicants that meet the scientific criteria for 
     funding under this section.
       ``(D) Coordination of centers of excellence.--The Director 
     shall provide for the appropriate coordination of information 
     among centers of excellence that receive funding under this 
     paragraph and ensure regular communication between such 
     centers.
       ``(E) Organization.--A center of excellence that receives 
     funding under this paragraph shall use the facilities of a 
     single institution, or be formed through a consortium of 
     cooperating institutions, that meets such requirements as may 
     be required by the Director.
       ``(F) Duration.--The term of a grant or contract awarded 
     under this paragraph shall not exceed a period of 5 years. 
     Such period may be extended for 1 or more additional periods 
     not exceeding 5 years if the operations of the center of 
     excellence involved have been reviewed by an appropriate 
     technical and scientific peer review group established by the 
     Director and the group has recommended to the Director the 
     extension of such period.
       ``(G) Geographic diversity.--The Director shall consider 
     geographic diversity in awarding centers of excellence.
       ``(2) Centers of excellence in environmental health and 
     autism.--
       ``(A) In general.--The Director shall, subject to the 
     availability of appropriations, award grants or contracts to 
     public or nonprofit private entities to pay all or part of 
     the cost of planning, establishing, improving, and providing 
     basic operating support for centers of excellence regarding 
     environmental health and autism spectrum disorder.
       ``(B) Research.--A center of excellence established under 
     this paragraph shall conduct basic and clinical research of a 
     broad array of environmental factors that may have a possible 
     role in autism spectrum disorder.
       ``(C) Coordination and organization.--The Secretary, acting 
     through the Director of NIH, shall apply to the centers under 
     this paragraph the same requirements concerning coordination, 
     reporting, and organization as the requirements applied to 
     the centers of excellence under subparagraphs (D), (E), (F), 
     and (G) of paragraph (1).
       ``(d) Collection and Storage of Data.--
       ``(1) In general.--The Secretary, acting through the 
     Director and in coordination with the Director of the Centers 
     for Disease Control and Prevention, shall, subject to the 
     availability of appropriations, establish and provide funding 
     for mechanisms and entities that provide for the collection, 
     storage, coordination, and public availability of data that 
     is collected by the centers of excellence under this section, 
     under section 399AA(b), and under section 409C(c) and, to the 
     extent possible, data generated from public and private 
     research partnerships. In establishing such mechanisms and 
     entities, the Secretary--
       ``(A) shall ensure that there is data sharing among autism 
     spectrum disorder researchers; and
       ``(B) may utilize existing facilities.
       ``(2) Facilitation of research.--
       ``(A) Establishment of program.--The Secretary shall 
     establish a program under which samples of tissues and 
     genetic and other biological materials that are of use in 
     research on autism spectrum disorder are donated, collected, 
     preserved, and made available for such research.
       ``(B) Accepted scientific standards.--The program 
     established under paragraph (1) shall be--
       ``(i) carried out in accordance with accepted scientific 
     and medical standards for the donation, collection, and 
     preservation of such samples; and
       ``(ii) conducted so that the tissues and other materials 
     saved, as well as any database compiled from such tissues and 
     materials, are available to researchers at a reasonable cost 
     and on an expedited basis.
       ``(e) Consolidation.--The Secretary, acting through the 
     Director, may consolidate program activities under this 
     section if such consolidation would improve program 
     efficiencies and outcomes.
       ``(f) Authorization of Appropriations.--
       ``(1) In general.--There is authorized to be appropriated--
       ``(A) $68,000,000 for fiscal year 2007, $74,500,000 for 
     fiscal year 2008, $81,000,000 for fiscal year 2009, 
     $87,500,000, for fiscal year 2010, and $94,000,000 for fiscal 
     year 2011, to carry out subsections (a), (b), and (d);
       ``(B) $24,000,000 for fiscal year 2007, $30,500,000 for 
     fiscal year 2008, $37,000,000 for fiscal year 2009, 
     $43,500,000 for fiscal year 2010, and $50,000,000 for fiscal 
     year 2011, to carry out subsection (c)(1); and
       ``(C) $6,000,000 for fiscal year 2007, $7,500,000 for 
     fiscal year 2008, $9,000,000 for fiscal year 2009, 
     $10,500,000 for fiscal year 2010, and $12,000,000 for fiscal 
     year 2011, to carry out subsection (c)(2).
       ``(2) General usage.--Of the amounts appropriated under 
     subparagraphs (B) and (C) of paragraph (1), not to exceed 5 
     percent of such amounts may be utilized by the National 
     Institutes of Health for administrative and other expenses.
       ``(g) Sunset.--This section shall not apply after September 
     30, 2011.''.

     SEC. 3. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH 
                   PROGRAM.

       (a) In General.--Title III of the Public Health Service Act 
     (42 U.S.C. 241 et seq.) is amended by adding at the end the 
     following:

                 ``PART R--PROGRAMS RELATING TO AUTISM

     ``SEC. 399AA. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND 
                   RESEARCH PROGRAM.

       ``(a) Autism Spectrum Disorder and Other Developmental 
     Disabilities.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     may award grants or cooperative agreements to eligible 
     entities for the collection, analysis, and reporting of State 
     epidemiological data on autism spectrum disorder and other 
     developmental disabilities. An eligible entity shall assist 
     with the development and coordination of State autism 
     spectrum disorder and other developmental disability 
     surveillance efforts within a region. In making such awards, 
     the Secretary may provide direct technical assistance in lieu 
     of cash.
       ``(2) Data standards.--In submitting epidemiological data 
     to the Secretary pursuant to subsection (a), an eligible 
     entity shall report data according to guidelines prescribed 
     by the Director of the Centers for Disease Control and 
     Prevention, after consultation with relevant State and local 
     public health officials, private sector developmental 
     disability researchers, and advocates for individuals with 
     autism spectrum disorder or other developmental disabilities.
       ``(3) Eligibility.--To be eligible to receive an award 
     under paragraph (1), an entity shall be a public or nonprofit 
     private entity (including a health department of a State or a 
     political subdivision of a State, a university, or any other 
     educational institution), and submit to the Secretary an 
     application at such time, in such manner, and containing such 
     information as the Secretary may require.
       ``(b) Centers of Excellence in Autism Spectrum Disorder 
     Epidemiology.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall, subject to the availability of appropriations, award 
     grants or cooperative agreements for the establishment of 
     regional centers of excellence in autism spectrum disorder 
     and other developmental disabilities epidemiology for the 
     purpose of collecting and analyzing information on the 
     number, incidence, correlates and causes of autism spectrum 
     disorder and other developmental disabilities.
       ``(2) Requirements.--To be eligible to receive a grant or 
     cooperative agreement under paragraph (1), an entity shall 
     submit to the Secretary an application containing such 
     agreements and information as the Secretary may require, 
     including an agreement that the center to be established 
     under the grant or cooperative agreement shall operate in 
     accordance with the following:
       ``(A) The center will collect, analyze, and report autism 
     spectrum disorder and other developmental disability data 
     according to guidelines prescribed by the Director of the 
     Centers for Disease Control and Prevention, after 
     consultation with relevant State and local public health 
     officials, private sector developmental disability 
     researchers, and advocates for individuals with developmental 
     disabilities.
       ``(B) The center will develop or extend an area of special 
     research expertise (including genetics, epigenetics, 
     epidemiological research related to environmental exposures), 
     immunology, and other relevant research specialty areas.
       ``(C) The center will identify eligible cases and controls 
     through its surveillance system and conduct research into 
     factors which may cause or increase the risk of autism 
     spectrum disorder and other developmental disabilities.
       ``(c) Federal Response.--The Secretary shall coordinate the 
     Federal response to requests for assistance from State 
     health, mental health, and education department officials 
     regarding potential or alleged autism spectrum disorder or 
     developmental disability clusters.
       ``(d) Definitions.--In this part:
       ``(1) Other developmental disabilities.--The term `other 
     developmental disabilities' has the meaning given the term 
     `developmental disability' in section 102(8) of the 
     Developmental Disabilities Assistance and Bill of Rights Act 
     of 2000 (42 U.S.C. 15002(8)).
       ``(2) State.--The term `State' means each of the several 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico,

[[Page 16939]]

     American Samoa, Guam, the Commonwealth of the Northern 
     Mariana Islands, the Virgin Islands, and the Trust Territory 
     of the Pacific Islands.
       ``(e) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated, $15,000,000 
     for fiscal year 2007, and such sums as may be necessary for 
     each of fiscal years 2008 through 2011.
       ``(f) Sunset.--This section shall not apply after September 
     30, 2011.

     ``SEC. 399BB. AUTISM EDUCATION, EARLY DETECTION, AND 
                   INTERVENTION.

       ``(a) Purpose.--It is the purpose of this section--
       ``(1) to increase awareness, reduce barriers to screening 
     and diagnosis, promote evidence-based interventions for 
     individuals with autism spectrum disorder or other 
     developmental disabilities, and train professionals to 
     utilize valid and reliable screening tools to diagnose or 
     rule out and provide evidence-based interventions for 
     children with autism spectrum disorder and other 
     developmental disabilities; and
       ``(2) to conduct activities under this section with a focus 
     on an interdisciplinary approach (as defined in programs 
     developed under section 501(a)(2) of the Social Security Act) 
     that will also focus on specific issues for children who are 
     not receiving an early diagnosis and subsequent 
     interventions.
       ``(b) In General.--The Secretary shall, subject to the 
     availability of appropriations, establish and evaluate 
     activities to--
       ``(1) provide information and education on autism spectrum 
     disorder and other developmental disabilities to increase 
     public awareness of developmental milestones;
       ``(2) promote research into the development and validation 
     of reliable screening tools for autism spectrum disorder and 
     other developmental disabilities and disseminate information 
     regarding those screening tools;
       ``(3) promote early screening of individuals at higher risk 
     for autism spectrum disorder and other developmental 
     disabilities as early as practicable, given evidence-based 
     screening techniques and interventions;
       ``(4) increase the number of individuals who are able to 
     confirm or rule out a diagnosis of autism spectrum disorder 
     and other developmental disabilities;
       ``(5) increase the number of individuals able to provide 
     evidence-based interventions for individuals diagnosed with 
     autism spectrum disorder or other developmental disabilities; 
     and
       ``(6) promote the use of evidence-based interventions for 
     individuals at higher risk for autism spectrum disorder and 
     other developmental disabilities as early as practicable.
       ``(c) Information and Education.--
       ``(1) In general.--In carrying out subsection (b)(1), the 
     Secretary, in collaboration with the Secretary of Education 
     and the Secretary of Agriculture, shall, subject to the 
     availability of appropriations, provide culturally competent 
     information regarding autism spectrum disorder and other 
     developmental disabilities, risk factors, characteristics, 
     identification, diagnosis or rule out, and evidence-based 
     interventions to meet the needs of individuals with autism 
     spectrum disorder or other developmental disabilities and 
     their families through--
       ``(A) Federal programs, including--
       ``(i) the Head Start program;
       ``(ii) the Early Start program;
       ``(iii) the Healthy Start program;
       ``(iv) programs under the Child Care and Development Block 
     Grant Act of 1990;
       ``(v) programs under title XIX of the Social Security Act 
     (particularly the Medicaid Early and Periodic Screening, 
     Diagnosis and Treatment Program);
       ``(vi) the program under title XXI of the Social Security 
     Act (the State Children's Health Insurance Program);
       ``(vii) the program under title V of the Social Security 
     Act (Maternal and Child Health Block Grant Program);
       ``(viii) the program under parts B and C of the Individuals 
     with Disabilities Education Act;
       ``(ix) the special supplemental nutrition program for 
     women, infants, and children established under section 17 of 
     the Child Nutrition Act of 1966 (42 U.S.C. 1786); and
       ``(x) the State grant program under the Rehabilitation Act 
     of 1973.
       ``(B) State licensed child care facilities; and
       ``(C) other community-based organizations or points of 
     entry for individuals with autism spectrum disorder and other 
     developmental disabilities to receive services.
       ``(2) Lead agency.--
       ``(A) Designation.--The governor of a State shall designate 
     a public agency as a lead agency to coordinate the activities 
     provided for under paragraph (1) in the State at the State 
     level.
       ``(B) Information.--The Governor or a State, acting through 
     the lead agency under subparagraph (A), shall make available 
     to individuals and their family members, guardians, 
     advocates, or authorized representatives, providers, and 
     other appropriate individuals in the State, comprehensive 
     culturally competent information about State and local 
     resources regarding autism spectrum disorder and other 
     developmental disabilities, risk factors, characteristics, 
     identification, diagnosis or rule out, available services and 
     supports, and evidence-based interventions. Such information 
     shall be provided through--
       ``(i) toll-free telephone numbers;
       ``(ii) Internet websites;
       ``(iii) mailings; or
       ``(iv) other means as the Governor may require.
       ``(C) Requirements of agency.--In designating the lead 
     agency under subparagraph (A), the Governor shall--
       ``(i) select an agency that has demonstrated experience and 
     expertise in--

       ``(I) autism spectrum disorder and other developmental 
     disability issues; and
       ``(II) developing, implementing, conducting, and 
     administering programs and delivering education, information, 
     and referral services (including technology-based curriculum-
     development services) to individuals with developmental 
     disabilities and their family members, guardians, advocates 
     or authorized representatives, providers, and other 
     appropriate individuals locally and across the State; and

       ``(ii) consider input from individuals with developmental 
     disabilities and their family members, guardians, advocates 
     or authorized representatives, providers, and other 
     appropriate individuals.
       ``(d) Tools.--
       ``(1) In general.--To promote the use of valid and reliable 
     screening tools for autism spectrum disorder and other 
     developmental disabilities, the Secretary shall develop a 
     curriculum for continuing education to assist individuals in 
     recognizing the need for valid and reliable screening tools 
     and the use of such tools.
       ``(2) Collection, storage, coordination, and 
     availability.--The Secretary, in collaboration with the 
     Secretary of Education, shall provide for the collection, 
     storage, coordination, and public availability of tools 
     described in paragraph (1), educational materials and other 
     products that are used by the Federal programs referred to in 
     subsection (c)(1)(A), as well as--
       ``(A) programs authorized under the Developmental 
     Disabilities Assistance and Bill of Rights Act of 2000;
       ``(B) early intervention programs or interagency 
     coordinating council's authorized under part C of the 
     Individuals with Disabilities Education Act; and
       ``(C) children with special health care needs programs 
     authorized under title V of the Social Security Act.
       ``(3) Required sharing.--In establishing mechanisms and 
     entities under this subsection, the Secretary, and the 
     Secretary of Education, shall ensure the sharing of tools, 
     materials, and products developed under this subsection among 
     entities receiving funding under this section.
       ``(e) Diagnosis.--
       ``(1) Training.--The Secretary, in coordination with 
     activities conducted under title V of the Social Security 
     Act, shall, subject to the availability of appropriations, 
     expand existing interdisciplinary training opportunities or 
     opportunities to increase the number of sites able to 
     diagnose or rule out individuals with autism spectrum 
     disorder or other developmental disabilities and ensure 
     that--
       ``(A) competitive grants or cooperative agreements are 
     awarded to public or non-profit agencies, including 
     institutions of higher education, to expanding existing or 
     develop new maternal and child health interdisciplinary 
     leadership education in neurodevelopmental and related 
     disabilities programs (similar to the programs developed 
     under section 501(a)(2) of the Social Security Act) in States 
     that do not have such a program;
       ``(B) trainees under such training programs--
       ``(i) receive an appropriate balance of academic, clinical, 
     and community opportunities;
       ``(ii) are culturally competent;
       ``(iii) are ethnically diverse;
       ``(iv) demonstrate a capacity to evaluate, diagnose or rule 
     out, develop, and provide evidence-based interventions to 
     individuals with autism spectrum disorder and other 
     developmental disabilities; and
       ``(v) demonstrate an ability to use a family-centered 
     approach; and
       ``(C) program sites provide culturally competent services.
       ``(2) Technical assistance.--The Secretary may award one or 
     more grants under this section to provide technical 
     assistance to the network of interdisciplinary training 
     programs.
       ``(3) Best practices.--The Secretary shall promote research 
     into additional valid and reliable tools for shortening the 
     time required to confirm or rule out a diagnosis of autism 
     spectrum disorder or other developmental disabilities and 
     detecting individuals with autism spectrum disorder or other 
     developmental disabilities at an earlier age.
       ``(f) Intervention.--The Secretary shall promote research, 
     through grants or contracts, to determine the evidence-based 
     practices for interventions for individuals with autism 
     spectrum disorder or other developmental disabilities, 
     develop guidelines for those interventions, and disseminate 
     information related to such research and guidelines.
       ``(g) Authorization of Appropriations.--To carry out this 
     section, there is authorized

[[Page 16940]]

     to be appropriated, $32,000,000 for fiscal year 2007, 
     $37,000,000 for fiscal year 2008, $42,000,000 for fiscal year 
     2009, $47,000,000 for fiscal year 2010, and $52,000,000 for 
     fiscal year 2011, of which--
       ``(1) $5,000,000 shall be made available in each fiscal 
     year for activities described in subsection (c); and
       ``(2) $3,000,000 shall be made available in fiscal year 
     2007, $6,000,000 in fiscal year 2008, $9,000,000 in fiscal 
     year 2009, $12,000,000 in fiscal year 2010, and $15,000,000 
     in fiscal year 2011, for activities described in subsection 
     (f).
       ``(h) Sunset.--This section shall not apply after September 
     30, 2011.

     ``SEC. 399CC. INTERAGENCY AUTISM COORDINATING COMMITTEE.

       ``(a) Establishment.--The Secretary shall establish a 
     committee, to be known as the `Interagency Autism 
     Coordinating Committee' (in this section referred to as the 
     `Committee'), to coordinate all efforts within the Department 
     of Health and Human Services concerning autism spectrum 
     disorder.
       ``(b) Responsibilities.--In carrying out its duties under 
     this section, the Committee shall--
       ``(1) make recommendations concerning the strategic plan 
     described in section 409C(a);
       ``(2) develop and annually update advances in autism 
     spectrum disorder research related to causes, early 
     screening, diagnosis or rule out, intervention, and access to 
     services and supports for individuals with autism spectrum 
     disorder; and
       ``(3) make recommendations to the Secretary regarding the 
     public participation in decisions relating to autism spectrum 
     disorder.
       ``(c) Membership.--
       ``(1) In general.--The Committee shall be composed of--
       ``(A) the Director of the Centers for Disease Control and 
     Prevention;
       ``(B) the Director of the National Institutes of Health, 
     and the Directors of such national research institutes of the 
     National Institutes of Health as the Secretary determines 
     appropriate;
       ``(C) the heads of such other agencies as the Secretary 
     determines appropriate;
       ``(D) representatives of other Federal Governmental 
     agencies that serve individuals with autism spectrum disorder 
     such as the Department of Education; and
       ``(E) the additional members appointed under paragraph (2).
       ``(2) Additional members.--Not fewer than 6 members of the 
     Committee, or 1/3 of the total membership of the Committee, 
     whichever is greater, shall be composed of non-federal public 
     members to be appointed by the Secretary, of which--
       ``(A) at least one such member shall be an individual with 
     a diagnosis of autism spectrum disorder;
       ``(B) at least one such member shall be a parent or legal 
     guardian of an individual with an autism spectrum disorder; 
     and
       ``(C) at least one such member shall be a representative of 
     leading research, advocacy, and service organizations for 
     individuals with autism spectrum disorder.
       ``(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 term. 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 meet at the call of the 
     chairperson or upon the request of the Secretary. The 
     Committee shall meet not fewer than 2 times each year.
       ``(4) All meetings of the Committee shall be public and 
     shall include appropriate time periods for questions and 
     presentations by the public.
       ``(e) Compensation and Expenses.--Members of the Committee 
     who are officers or employees of the Federal Government shall 
     serve as members of the Committee without compensation in 
     addition to that received in their regular government 
     employment. Other members of the Committee shall receive 
     compensation at rates not to exceed the daily equivalent of 
     the annual rate in effect for grade GS-18 of the General 
     Schedule for each day (including travel time) they are 
     engaged in the performance of their duties as members of the 
     Committee.
       ``(f) Subcommittees; Establishment and Membership.--In 
     carrying out its functions, the Committee may establish 
     subcommittees and convene workshops and conferences. Such 
     subcommittees shall be composed of Committee members and may 
     hold such meetings as are necessary to enable the 
     subcommittees to carry out their duties.
       ``(g) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated, such sums as 
     may be necessary for each of fiscal years 2007 through 2011.
       ``(h) Sunset.--This section shall not apply after September 
     30, 2011 and the Committee shall be terminated on such date.

     ``SEC. 399DD. REPORT TO CONGRESS.

       ``(a) In General.--Not later than 4 years after the date of 
     enactment of the Combating Autism Act of 2006, the Secretary, 
     in coordination with the Secretary of Education, shall 
     prepare and submit to the Health, Education, Labor, and 
     Pensions Committee of the Senate and the Energy and Commerce 
     Committee of the House of Representatives a progress report 
     on activities related to autism spectrum disorder and other 
     developmental disabilities.
       ``(b) Contents.--The report submitted under subsection (a) 
     shall contain--
       ``(1) a description of the progress made in implementing 
     the provisions of the Combating Autism Act of 2006;
       ``(2) a description of the amounts expended on the 
     implementation of the particular provisions of Combating 
     Autism Act of 2006;
       ``(3) information on the incidence of autism spectrum 
     disorder and trend data of such incidence since the date of 
     enactment of the Combating Autism Act of 2006;
       ``(4) information on the average age of diagnosis for 
     children with autism spectrum disorder and other 
     disabilities, including how that age may have changed over 
     the 4-year period beginning on the date of enactment of this 
     Act;
       ``(5) information on the average age for intervention for 
     individuals diagnosed with autism spectrum disorder and other 
     developmental disabilities, including how that age may have 
     changed over the 4-year period beginning on the date of 
     enactment of this Act;
       ``(6) information on the average time between initial 
     screening and then diagnosis or rule out for individuals with 
     autism spectrum disorder or other developmental disabilities, 
     as well as information on the average time between diagnosis 
     and evidence-based intervention for individuals with autism 
     spectrum disorder or other developmental disabilities;
       ``(7) information on the effectiveness and outcomes of 
     interventions for individuals diagnosed with autism spectrum 
     disorder, including by various subtypes, and other 
     developmental disabilities and how the age of the child may 
     affect such effectiveness;
       ``(8) information on the effectiveness and outcomes of 
     innovative and newly developed intervention strategies for 
     individuals with autism spectrum disorder or other 
     developmental disabilities; and
       ``(9) information on services and supports provided to 
     individuals with autism spectrum disorder and other 
     developmental disabilities who have reached the age of 
     majority (as defined for purposes of section 615(m) of the 
     Individuals with Disabilities Education Act (20 U.S.C. 
     1415(m)).''.
       (b) Repeals.--The following sections of the Children's 
     Health Act of 2000 (Public Law 106-310) are repealed:
       (1) Section 101 (42 U.S.C. 247b-4a) relating to research 
     activities at the National Institutes of Health.
       (2) Section 102 (42 U.S.C. 247b-4b) relating to the 
     Developmental Disabilities Surveillance and Research Program.
       (3) Section 103 (42 U.S.C. 247b-4c) relating to information 
     and education.
       (4) Section 104 (42 U.S.C. 247b-4d) relating to the Inter-
     Agency Autism Coordinating Committee.
       (5) Section 105 (42 U.S.C. 247b-4e) relating to reports.

  Mr. SANTORUM. I thank the Chair.
  For the information of those who might be listening, the bill is now 
passed and we are off to the House with great hope that this fall will 
bring us successful passage there and final action by the President 
sometime in September.
  I yield the floor.

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