[113th Congress Public Law 157]
[From the U.S. Government Publishing Office]



[[Page 128 STAT. 1831]]

Public Law 113-157
113th Congress

                                 An Act


 
   To reauthorize certain provisions of the Public Health Service Act 
      relating to autism, and for other purposes. <<NOTE: Aug. 8, 
                         2014 -  [H.R. 4631]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Autism 
Collaboration, Accountability, Research, Education, and Support Act of 
2014. 42 USC 201 note. 42 USC 280i note. Consultation.>> 
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Autism Collaboration, Accountability, 
Research, Education, and Support Act of 2014'' or the ``Autism CARES Act 
of 2014''.
SEC. 2. NATIONAL AUTISM SPECTRUM DISORDER INITIATIVE.

    (a) In General.--The Secretary of Health and Human Services shall 
designate an existing official within the Department of Health and Human 
Services to oversee, in consultation with the Secretaries of Defense and 
Education, national autism spectrum disorder research, services, and 
support activities.
    (b) Duties.--The official designated under subsection (a) shall--
            (1) implement autism spectrum disorder activities, taking 
        into account the strategic plan developed by the Interagency 
        Autism Coordinating Committee under section 399CC(b) of the 
        Public Health Service Act (42 U.S.C. 280i-2(b)); and
            (2) ensure that autism spectrum disorder activities of the 
        Department of Health and Human Services and of other Federal 
        departments and agencies are not unnecessarily duplicative.
SEC. 3. RESEARCH PROGRAM.

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

    Section 399BB of the Public Health Service Act (42 U.S.C. 280i-1) is 
amended--

[[Page 128 STAT. 1832]]

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

    Section 399CC of the Public Health Service Act (42 U.S.C. 280i-2) is 
amended--
            (1) in subsection (b)--
                    (A) in paragraph (1)--
                          (i) by striking ``and annually update''; and
                          (ii) by striking ``intervention'' and 
                      inserting ``interventions, including school and 
                      community-based interventions'';
                    (B) by striking paragraph (2);
                    (C) by redesignating paragraph (1) as paragraph (2), 
                and inserting before such redesignated paragraph the 
                following:
            ``(1) monitor autism spectrum disorder research, and to the 
        extent practicable services and support activities, across all 
        relevant Federal departments and agencies, including 
        coordination of Federal activities with respect to autism 
        spectrum disorder;'';
                    (D) in paragraph (3), by striking ``recommendations 
                to the Director of NIH'';
                    (E) in paragraph (4), by inserting before the 
                semicolon the following: ``, and the process by which 
                public feedback can be better integrated into such 
                decisions''; and
                    (F) by striking paragraphs (5) and (6) and inserting 
                the following:
            ``(5) <<NOTE: Strategic plan.>>  develop a strategic plan 
        for the conduct of, and support for, autism spectrum disorder 
        research, including as practicable for services and supports, 
        for individuals with an autism spectrum disorder and the 
        families of such individuals, which shall include--
                    ``(A) proposed budgetary requirements; and
                    ``(B) recommendations to ensure that autism spectrum 
                disorder research, and services and support activities 
                to the extent practicable, of the Department of Health 
                and Human Services and of other Federal departments and 
                agencies are not unnecessarily duplicative; and
            ``(6) submit to Congress and the President--
                    ``(A) an annual update on the summary of advances 
                described in paragraph (2); and

[[Page 128 STAT. 1833]]

                    ``(B) an annual update to the strategic plan 
                described in paragraph (5), including any progress made 
                in achieving the goals outlined in such strategic 
                plan.'';
            (2) in subsection (c)--
                    (A) in paragraph (1)--
                          (i) by striking the paragraph designation, the 
                      heading, and the matter preceding subparagraph (A) 
                      and inserting the following:
            ``(1) Federal membership.--The Committee shall be composed 
        of the following Federal members--'';
                          (ii) in subparagraph (C)--
                                    (I) by inserting ``, such as the 
                                Administration for Community Living, 
                                Administration for Children and 
                                Families, the Centers for Medicare & 
                                Medicaid Services, the Food and Drug 
                                Administration, and the Health Resources 
                                and Services Administration'' before the 
                                semicolon at the end; and
                                    (II) by adding at the end ``and'';
                          (iii) in subparagraph (D)--
                                    (I) by inserting ``and the 
                                Department of Defense'' after 
                                ``Department of Education''; and
                                    (II) by striking at the end ``; 
                                and'' and inserting a period; and
                          (iv) by striking subparagraph (E);
                    (B) in paragraph (2)--
                          (i) in the paragraph heading, by striking 
                      ``Additional'' and inserting ``Non-federal'';
                          (ii) in the matter preceding subparagraph (A), 
                      by striking ``Not fewer than 6 members of the 
                      Committee, or \1/3\ of the total membership of the 
                      Committee, whichever is greater'' and inserting 
                      ``Not more than \1/2\, but not fewer than \1/3\, 
                      of the total membership of the Committee'';
                          (iii) in subparagraph (A), by striking ``one 
                      such member shall be an individual'' and inserting 
                      ``two such members shall be individuals'';
                          (iv) in subparagraph (B), by striking ``one 
                      such member shall be a parent or legal guardian'' 
                      and inserting ``two such members shall be parents 
                      or legal guardians''; and
                          (v) in subparagraph (C), by striking ``one 
                      such member shall be a representative'' and 
                      inserting ``two such members shall be 
                      representatives''; and
                    (C) by adding at the end the following:
            ``(3) Period of appointment; vacancies.--
                    ``(A) Period of appointment for non-federal 
                members.--Non-Federal members shall serve for a term of 
                4 years, and may be reappointed for one or more 
                additional 4-year terms.
                    ``(B) Vacancies.--A vacancy on the Committee shall 
                be filled in the manner in which the original 
                appointment was made and shall not affect the powers or 
                duties of the Committee. Any member appointed to fill a 
                vacancy for an unexpired term shall be appointed for the 
                remainder of such term. A member may serve after the 
                expiration

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                of the member's term until a successor has been 
                appointed.'';
            (3) in subsection (d)--
                    (A) by striking paragraph (2); and
                    (B) by redesignating paragraphs (3) and (4) as 
                paragraphs (2) and (3), respectively; and
            (4) in subsection (f), by striking ``2014'' and inserting 
        ``2019''.
SEC. 6. REPORTS.

    Section 399DD of the Public Health Service Act (42 U.S.C. 280i-3) is 
amended--
            (1) in the section heading, by striking ``report'' and 
        inserting ``reports'';
            (2) in subsection (b), by redesignating paragraphs (1) 
        through (9) as subparagraphs (A) through (I), respectively, and 
        realigning the margins accordingly;
            (3) by redesignating subsections (a) and (b) as paragraphs 
        (1) and (2), respectively, and realigning the margins 
        accordingly;
            (4) by inserting after the section heading the following:

    ``(a) Progress Report.--'';
            (5) in subsection (a)(1) (as so redesignated)--
                    (A) by striking ``2 years after the date of 
                enactment of the Combating Autism Reauthorization Act of 
                2011'' and inserting ``4 years after the date of 
                enactment of the Autism CARES Act of 2014'';
                    (B) by inserting ``and the Secretary of Defense'' 
                after ``the Secretary of Education''; and
                    (C) by inserting ``, and make publicly available, 
                including through posting on the Internet Web site of 
                the Department of Health and Human Services,'' after 
                ``Representatives''; and
            (6) in subsection (a)(2) (as so redesignated)--
                    (A) in subparagraph (A), (as so redesignated), by 
                striking ``Combating Autism Act of 2006'' and inserting 
                ``Autism CARES Act of 2014'';
                    (B) in subparagraph (B) (as so redesignated), by 
                striking ``particular provisions of Combating Autism Act 
                of 2006'' and inserting ``amendments made by the Autism 
                CARES Act of 2014'';
                    (C) by striking subparagraph (C) (as so 
                redesignated), and inserting the following:
                    ``(C) information on the incidence and prevalence of 
                autism spectrum disorder, including available 
                information on the prevalence of autism spectrum 
                disorder among children and adults, and identification 
                of any changes over time with respect to the incidence 
                and prevalence of autism spectrum disorder;'';
                    (D) in subparagraph (D) (as so redesignated), by 
                striking ``6-year period beginning on the date of 
                enactment of the Combating Autism Act of 2006'' and 
                inserting ``4-year period beginning on the date of 
                enactment of the Autism CARES Act of 2014 and, as 
                appropriate, how this age varies across population 
                subgroups'';
                    (E) in subparagraph (E) (as so redesignated), by 
                striking ``6-year period beginning on the date of 
                enactment of the Combating Autism Act of 2006'' and 
                inserting ``4-year period beginning on the date of 
                enactment of the

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                Autism CARES Act of 2014 and, as appropriate, how this 
                age varies across population subgroups'';
                    (F) in subparagraph (F) (as so redesignated), by 
                inserting ``and, as appropriate, on how such average 
                time varies across population subgroups'' before the 
                semicolon at the end;
                    (G) in subparagraph (G) (as so redesignated)--
                          (i) by striking ``including by various 
                      subtypes,'' and inserting ``including by severity 
                      level as practicable,''; and
                          (ii) by striking ``child may'' and inserting 
                      ``child or other factors, such as demographic 
                      characteristics, may''; and
                    (H) by striking subparagraph (I) (as so 
                redesignated), and inserting the following:
                    ``(I) a description of the actions taken to 
                implement and the progress made on implementation of the 
                strategic plan developed by the Interagency Autism 
                Coordinating Committee under section 399CC(b).''; and
            (7) by adding at the end the following new subsection:

    ``(b) Report on Young Adults and Transitioning Youth.--
            ``(1) In general.--Not later than 2 years after the date of 
        enactment of the Autism CARES Act of 2014, the Secretary of 
        Health and Human Services, in coordination with the Secretary of 
        Education and in collaboration with the Secretary of 
        Transportation, the Secretary of Labor, the Secretary of Housing 
        and Urban Development, and the Attorney General, shall prepare 
        and submit to the Committee on Health, Education, Labor, and 
        Pensions of the Senate and the Committee on Energy and Commerce 
        of the House of Representatives, a report concerning young 
        adults with autism spectrum disorder and the challenges related 
        to the transition from existing school-based services to those 
        services available during adulthood.
            ``(2) Contents.--The report submitted under paragraph (1) 
        shall contain--
                    ``(A) demographic characteristics of youth 
                transitioning from school-based to community-based 
                supports;
                    ``(B) an overview of policies and programs relevant 
                to young adults with autism spectrum disorder relating 
                to post-secondary school transitional services, 
                including an identification of existing Federal laws, 
                regulations, policies, research, and programs;
                    ``(C) proposals on establishing best practices 
                guidelines to ensure--
                          ``(i) interdisciplinary coordination between 
                      all relevant service providers receiving Federal 
                      funding;
                          ``(ii) coordination with transitioning youth 
                      and the family of such transitioning youth; and
                          ``(iii) inclusion of the individualized 
                      education program for the transitioning youth, as 
                      prescribed in section 614 of the Individuals with 
                      Disabilities Education Act (20 U.S.C. 1414);
                    ``(D) comprehensive approaches to transitioning from 
                existing school-based services to those services 
                available during adulthood, including--

[[Page 128 STAT. 1836]]

                          ``(i) services that increase access to, and 
                      improve integration and completion of, post-
                      secondary education, peer support, vocational 
                      training (as defined in section 103 of the 
                      Rehabilitation Act of 1973 (29 U.S.C. 723)), 
                      rehabilitation, self-advocacy skills, and 
                      competitive, integrated employment;
                          ``(ii) community-based behavioral supports and 
                      interventions;
                          ``(iii) community-based integrated residential 
                      services, housing, and transportation;
                          ``(iv) nutrition, health and wellness, 
                      recreational, and social activities;
                          ``(v) personal safety services for individuals 
                      with autism spectrum disorder related to public 
                      safety agencies or the criminal justice system; 
                      and
                          ``(vi) evidence-based approaches for 
                      coordination of resources and services once 
                      individuals have aged out of post-secondary 
                      education; and
                    ``(E) proposals that seek to improve outcomes for 
                adults with autism spectrum disorder making the 
                transition from a school-based support system to 
                adulthood by--
                          ``(i) increasing the effectiveness of programs 
                      that provide transition services;
                          ``(ii) increasing the ability of the relevant 
                      service providers described in subparagraph (C) to 
                      provide supports and services to underserved 
                      populations and regions;
                          ``(iii) increasing the efficiency of service 
                      delivery to maximize resources and outcomes, 
                      including with respect to the integration of and 
                      collaboration among services for transitioning 
                      youth;
                          ``(iv) ensuring access to all services 
                      necessary to transitioning youth of all 
                      capabilities; and
                          ``(v) encouraging transitioning youth to 
                      utilize all available transition services to 
                      maximize independence, equal opportunity, full 
                      participation, and self-sufficiency.''.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    Section 399EE of the Public Health Service Act (42 U.S.C. 280i-4) is 
amended--
            (1) in subsection (a), by striking ``fiscal years 2012 
        through 2014'' and inserting ``fiscal years 2015 through 2019'';
            (2) in subsection (b), by striking ``fiscal years 2011 
        through 2014'' and inserting ``fiscal years 2015 through 2019''; 
        and

[[Page 128 STAT. 1837]]

            (3) in subsection (c), by striking ``$161,000,000 for each 
        of fiscal years 2011 through 2014'' and inserting ``$190,000,000 
        for each of fiscal years 2015 through 2019''.

    Approved August 8, 2014.

LEGISLATIVE HISTORY--H.R. 4631:
---------------------------------------------------------------------------

HOUSE REPORTS: No. 113-490 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 160 (2014):
            June 24, considered and passed House.
            July 31, considered and passed Senate.

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