[116th Congress Public Law 60]
[From the U.S. Government Publishing Office]



[[Page 1109]]

 AUTISM COLLABORATION, ACCOUNTABILITY, RESEARCH, EDUCATION, AND SUPPORT 
                               ACT OF 2019

[[Page 133 STAT. 1110]]

Public Law 116-60
116th Congress

                                 An Act


 
  To amend the Public Health Service Act to enhance activities of the 
    National Institutes of Health with respect to research on autism 
spectrum disorder and enhance programs relating to autism, and for other 
           purposes. <<NOTE: Sept. 30, 2019 -  [H.R. 1058]>> 

    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 
2019.>> 
SECTION 1. <<NOTE: 42 USC 201 note.>>  SHORT TITLE.

    This Act may be cited as the ``Autism Collaboration, Accountability, 
Research, Education, and Support Act of 2019'' or the ``Autism CARES Act 
of 2019''.
SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES 
                    OF THE NIH WITH RESPECT TO RESEARCH ON AUTISM 
                    SPECTRUM DISORDER.

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

[[Page 133 STAT. 1111]]

                demonstrate availability and access to clinical services 
                for youth and adults from diverse racial, ethnic, 
                geographic, or linguistic backgrounds in decisions about 
                awarding grants to applicants which meet the scientific 
                criteria for funding under this section.''.
SEC. 3. PROGRAMS RELATING TO AUTISM.

    (a) Developmental Disabilities Surveillance and Research Program.--
Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is 
amended--
            (1) in subsection (a)(1), by striking ``adults on autism 
        spectrum disorder'' and inserting ``adults with autism spectrum 
        disorder'';
            (2) in subsection (a)(2)--
                    (A) by striking ``State and local public health 
                officials'' and inserting ``State, local, and Tribal 
                public health officials'';
                    (B) by striking ``or other developmental 
                disabilities'' and inserting ``and other developmental 
                disabilities'';
            (3) in subsection (a)(3), by striking ``a university, or any 
        other educational institution'' and inserting ``a university, 
        any other educational institution, an Indian tribe, or a tribal 
        organization'';
            (4) in subsection (b)(2)(A), by striking ``relevant State 
        and local public health officials, private sector developmental 
        disability researchers, and advocates for individuals with 
        developmental disabilities'' and inserting ``State, local, and 
        Tribal public health officials, private sector developmental 
        disability researchers, advocates for individuals with autism 
        spectrum disorder, and advocates for individuals with other 
        developmental disabilities'';
            (5) in subsection (d)--
                    (A) by redesignating paragraphs (1) and (2) as 
                paragraphs (2) and (3), respectively; and
                    (B) by inserting before paragraph (2), as so 
                redesignated, the following new paragraph:
            ``(1) Indian tribe; tribal organization.--The terms `Indian 
        tribe' and `tribal organization' have the meanings given such 
        terms in section 4 of the Indian Health Care Improvement Act.''; 
        and
            (6) in subsection (e), by striking ``2019'' and inserting 
        ``2024''.

    (b) Autism Education, Early Detection, and Intervention.--Section 
399BB of the Public Health Service Act (42 U.S.C. 280i-1) is amended--
            (1) in subsection (a)(1)--
                    (A) by striking ``individuals with autism spectrum 
                disorder or other developmental disabilities'' and 
                inserting ``individuals with autism spectrum disorder 
                and other developmental disabilities''; and
                    (B) by striking ``children with autism spectrum 
                disorder'' and all that follows through 
                ``disabilities;'' and inserting ``individuals with 
                autism spectrum disorder and other developmental 
                disabilities across their lifespan;'';
            (2) in subsection (b)--
                    (A) in paragraph (2), by inserting ``individuals 
                with'' before ``autism spectrum disorder'';

[[Page 133 STAT. 1112]]

                    (B) by redesignating paragraphs (4) through (6) as 
                paragraphs (5) through (7), respectively; and
                    (C) by inserting after paragraph (3) the following:
            ``(4) promote evidence-based screening techniques and 
        interventions for individuals with autism spectrum disorder and 
        other developmental disabilities across their lifespan;'';
            (3) in subsection (c)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by striking ``the needs of individuals 
                with autism spectrum disorder or other developmental 
                disabilities and their families'' and inserting ``the 
                needs of individuals with autism spectrum disorder and 
                other developmental disabilities across their lifespan 
                and the needs of their families''; and
                    (B) in paragraph (2)--
                          (i) in subparagraph (A)(ii), by striking 
                      ``caregivers of individuals with an autism 
                      spectrum disorder'' and inserting ``caregivers of 
                      individuals with autism spectrum disorder or other 
                      developmental disabilities'';
                          (ii) in subparagraph (B)(i)(II), by inserting 
                      ``autism spectrum disorder and'' after 
                      ``individuals with''; and
                          (iii) in subparagraph (B)(ii), by inserting 
                      ``autism spectrum disorder and'' after 
                      ``individuals with'';
            (4) in subsection (e)--
                    (A) in paragraph (1)--
                          (i) in the matter preceding subparagraph (A), 
                      by inserting ``across their lifespan'' before 
                      ``and ensure''; and
                          (ii) in subparagraph (B)(iv), by inserting 
                      ``across their lifespan'' after ``other 
                      developmental disabilities'';
                    (B) by redesignating paragraphs (2) and (3) as 
                paragraphs (3) and (4), respectively; and
                    (C) by inserting after paragraph (1) the following:
            ``(2) Developmental-behavioral pediatrician training 
        programs.--
                    ``(A) In general.--In making awards under this 
                subsection, the Secretary may prioritize awards to 
                applicants that are developmental-behavioral 
                pediatrician training programs located in rural or 
                underserved areas.
                    ``(B) Definition of underserved area.--In this 
                paragraph, the term `underserved area' means--
                          ``(i) a health professional shortage area (as 
                      defined in section 332(a)(1)(A)); and
                          ``(ii) an urban or rural area designated by 
                      the Secretary as an area with a shortage of 
                      personal health services (as described in section 
                      330(b)(3)(A)).'';
            (5) in subsection (f), by inserting ``across the lifespan of 
        such individuals'' after ``other developmental disabilities''; 
        and
            (6) in subsection (g), by striking ``2019'' and inserting 
        ``2024''.

    (c) Interagency Autism Coordinating Committee.--Section 399CC of the 
Public Health Service Act (42 U.S.C. 280i-2) is amended--
            (1) in subsection (b)--
                    (A) in paragraph (2), by inserting ``across the 
                lifespan of such individuals'' before the semicolon; and

[[Page 133 STAT. 1113]]

                    (B) in paragraph (5), by inserting ``across the 
                lifespan of such individuals'' before ``and the 
                families'';
            (2) in subsection (c)--
                    (A) in paragraph (1)(D), by inserting ``, the 
                Department of Labor, the Department of Justice, the 
                Department of Veterans Affairs, the Department of 
                Housing and Urban Development,'' after ``Department of 
                Education'';
                    (B) in subparagraphs (A), (B), and (C) of paragraph 
                (2), by striking ``at least two such members'' each 
                place it appears and inserting ``at least three such 
                members'';
                    (C) in paragraph (3)(A), by striking ``one or more 
                additional 4-year terms'' and inserting ``one additional 
                4-year term''; and
            (3) in subsection (f), by striking ``2019'' and inserting 
        ``2024''.

    (d) Reports to Congress.--Section 399DD of the Public Health Service 
Act (42 U.S.C. 280i-3) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``Autism CARES Act 
                of 2014'' and inserting ``Autism CARES Act of 2019''; 
                and
                    (B) in paragraph (2)--
                          (i) in subparagraphs (A), (B), (D), and (E), 
                      by striking ``Autism CARES Act of 2014'' each 
                      place it appears and inserting ``Autism CARES Act 
                      of 2019'';
                          (ii) in subparagraph (G), by striking ``age of 
                      the child'' and inserting ``age of the 
                      individual'';
                          (iii) in subparagraph (H), by striking ``; 
                      and'' and inserting ``;'';
                          (iv) in subparagraph (I), by striking the 
                      period and inserting ``; and''; and
                          (v) by adding at the end the following:
                    ``(J) information on how States use home- and 
                community-based services and other supports to ensure 
                that individuals with autism spectrum disorder and other 
                developmental disabilities are living, working, and 
                participating in their community.''; and
            (2) in subsection (b)--
                    (A) in the heading, by striking ``Young Adults and 
                Transitioning Youth'' and inserting ``the Health and 
                Well-Being of Individuals With Autism Spectrum Disorder 
                Across Their Lifespan'';
                    (B) by amending paragraph (1) to read as follows:
            ``(1) In general.--Not later than 2 years after the date of 
        enactment of the Autism CARES Act of 2019, the Secretary shall 
        prepare and submit, to the Committee on Health, Education, 
        Labor, and Pensions of the Senate and the Committee on Energy 
        and Commerce of the House of Representatives, a report 
        concerning the health and well-being of individuals with autism 
        spectrum disorder.''; and
                    (C) in paragraph (2)--
                          (i) by amending subparagraph (A) to read as 
                      follows:
                    ``(A) demographic factors associated with the health 
                and well-being of individuals with autism spectrum 
                disorder;'';
                          (ii) in subparagraph (B), by striking ``young 
                      adults'' and all that follows through the 
                      semicolon and inserting ``the health and well-
                      being of individuals with

[[Page 133 STAT. 1114]]

                      autism spectrum disorder, including an 
                      identification of existing Federal laws, 
                      regulations, policies, research, and programs;''; 
                      and
                          (iii) by amending subparagraphs (C), (D), and 
                      (E) to read as follows:
                    ``(C) <<NOTE: Recommenda- tions.>>  recommendations 
                on establishing best practices guidelines to ensure 
                interdisciplinary coordination between all relevant 
                service providers receiving Federal funding;
                    ``(D) comprehensive approaches to improving health 
                outcomes and well-being for individuals with autism 
                spectrum disorder, including--
                          ``(i) community-based behavioral supports and 
                      interventions;
                          ``(ii) nutrition, recreational, and social 
                      activities; and
                          ``(iii) personal safety services related to 
                      public safety agencies or the criminal justice 
                      system for such individuals; and
                    ``(E) <<NOTE: Recommenda- tions.>>  recommendations 
                that seek to improve health outcomes for such 
                individuals, including across their lifespan, by 
                addressing--
                          ``(i) screening and diagnosis of children and 
                      adults;
                          ``(ii) behavioral and other therapeutic 
                      approaches;
                          ``(iii) primary and preventative care;
                          ``(iv) communication challenges;
                          ``(v) aggression, self-injury, elopement, and 
                      other behavioral issues;
                          ``(vi) emergency room visits and acute care 
                      hospitalization;
                          ``(vii) treatment for co-occurring physical 
                      and mental health conditions;
                          ``(viii) premature mortality;
                          ``(ix) medical practitioner training; and
                          ``(x) caregiver mental health.''.

    (e) Authorization of Appropriations.--Section 399EE of the Public 
Health Service Act (42 U.S.C. 280i-4) is amended--
            (1) in subsection (a), by striking ``$22,000,000 for each of 
        fiscal years 2015 through 2019'' and inserting ``$23,100,000 for 
        each of fiscal years 2020 through 2024'';
            (2) in subsection (b), by striking ``$48,000,000 for each of 
        fiscal years 2015 through 2019'' and inserting ``$50,599,000 for 
        each of fiscal years 2020 through 2024''; and
            (3) in subsection (c), by striking ``there is authorized to 
        be appropriated $190,000,000 for each of fiscal years 2015

[[Page 133 STAT. 1115]]

        through 2019'' and inserting ``there are authorized to be 
        appropriated $296,000,000 for each of fiscal years 2020 through 
        2024''.

    Approved September 30, 2019.

LEGISLATIVE HISTORY--H.R. 1058:
---------------------------------------------------------------------------

HOUSE REPORTS: No. 116-177 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 165 (2019):
            July 24, considered and passed House.
            Sept. 19, considered and passed Senate.

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