[United States Statutes at Large, Volume 120, 109th Congress, 2nd Session]
[From the U.S. Government Publishing Office, www.gpo.gov]

120 STAT. 2821

Public Law 109-416
109th Congress

An Act


 
To amend the Public Health Service Act to combat autism through
research, screening, intervention and education.  NOTE: Dec. 19,
2006 -  [S. 843]

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,  NOTE: Combating Autism
Act of 2006.

SECTION 1.  NOTE: 42 USC 201 note.  SHORT TITLE.

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

SEC. 2. CENTERS OF EXCELLENCE; IMPROVING AUTISM-RELATED RESEARCH.

(a) Centers of Excellence Regarding Research on Autism.--Section
409C of the Public Health Service Act (42 U.S.C.284g) is amended--
(1) in the section heading, by striking ``autism'' and
inserting ``autism spectrum disorder'';
(2) by striking the term ``autism'' each place such term
appears (other than the section heading) and inserting ``autism
spectrum disorder''; and
(3) in subsection (a)--
(A) by redesignating paragraph (2) as paragraph (3);
and
(B) by striking paragraph (1) and inserting the
following:
``(1) Expansion of activities.--The Director of NIH (in this
section referred to as the `Director') shall, subject to the
availability of appropriations, expand, intensify, and
coordinate the activities of the National Institutes of Health
with respect to research on autism spectrum disorder, including
basic and clinical research in fields including pathology,
developmental neurobiology, genetics, epigenetics, pharmacology,
nutrition, immunology, neuroimmunology, neurobehavioral
development, endocrinology, gastroenterology, and toxicology.
Such research shall investigate the cause (including possible
environmental causes), diagnosis or rule out, early detection,
prevention, services, supports, intervention, and treatment of
autism spectrum disorder.
``(2) Consolidation.--The Director may consolidate program
activities under this section if such consolidation would
improve program efficiencies and outcomes.''.

(b) Centers of Excellence Generally.--Part A of title IV of the
Public Health Service Act (42 U.S.C. 281 et seq.) is amended by adding
at the end the following:

[[Page 2822]]
120 STAT. 2822

``SEC. 404H.  NOTE: 42 USC 283j.  REVIEW OF CENTERS OF EXCELLENCE.

``(a) In General.--Not  NOTE: Deadline. Reports.  later than April
1, 2008, and periodically thereafter, the Secretary, acting through the
Director of NIH, shall conduct a review and submit a report to the
appropriate committees of the Congress on the centers of excellence.

``(b) Report Contents.--Each report under subsection (a) shall
include the following:
``(1) Evaluation of the performance and research outcomes of
each center of excellence.
``(2) Recommendations for promoting coordination of
information among centers of excellence.
``(3) Recommendations for improving the effectiveness,
efficiency, and outcomes of the centers of excellence.

``(c) Definition.--In this section, the term `center of excellence'
means an entity receiving funding under this title in its capacity as a
center of excellence.''.

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.  NOTE: 42 USC 280i.  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 paragraph (1), 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.--

[[Page 2823]]
120 STAT. 2823

``(1) In general.--
The  NOTE: Grants. Contracts.  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, and 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) Sunset.--This section shall not apply after September 30,
2011.

``SEC. 399BB.  NOTE: 42 USC 280i-1.  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

[[Page 2824]]
120 STAT. 2824

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 (the Maternal and Child Health
Block Grant Program);

[[Page 2825]]
120 STAT. 2825

``(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.--As a condition on the provision
of assistance or the conduct of activities under this
section with respect to a State, the Secretary may
require the Governor of the State--
``(i) to designate a public agency as a lead
agency to coordinate the activities provided for
under paragraph (1) in the State at the State
level; and
``(ii) acting through such lead agency, to
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.
``(B) Requirements of agency.--In designating the
lead agency under subparagraph (A)(i), 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.
``(C) Information.--
Information  NOTE: Communications and tele-
communications. Websites.  under subparagraph (A)(ii)
shall be provided through--
``(i) toll-free telephone numbers;
``(ii) Internet websites;
``(iii) mailings; or
``(iv) such other means as the Governor may
require.


[[Page 2826]]
120 STAT. 2826

``(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 councils 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)  NOTE: Grants. Contracts.  competitive
grants or cooperative agreements are awarded to public
or nonprofit agencies, including institutions of higher
education, to expand 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

[[Page 2827]]
120 STAT. 2827

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  NOTE: Grants. Contracts.  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) Sunset.--This section shall not apply after September 30,
2011.

``SEC. 399CC.  NOTE: 42 USC 280i-2.  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) develop and annually update a summary of advances in
autism spectrum disorder research related to causes, prevention,
treatment, early screening, diagnosis or rule out, intervention,
and access to services and supports for individuals with autism
spectrum disorder;
``(2) monitor Federal activities with respect to autism
spectrum disorder;
``(3) make recommendations to the Secretary regarding any
appropriate changes to such activities, including
recommendations to the Director of NIH with respect to the
strategic plan developed under paragraph (5);
``(4) make recommendations to the Secretary regarding public
participation in decisions relating to autism spectrum disorder;
``(5) develop and annually update a strategic plan for the
conduct of, and support for, autism spectrum disorder research,
including proposed budgetary requirements; and
``(6)  NOTE: Strategic plan.  submit to the Congress such
strategic plan and any updates to such plan.

``(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

[[Page 2828]]
120 STAT. 2828

``(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  NOTE: Applicability.  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) 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.
``(f) Sunset.--This section shall not apply after September 30,
2011, and the Committee shall be terminated on such date.

``SEC. 399DD.  NOTE: 42 USC 280i-3.  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;

[[Page 2829]]
120 STAT. 2829

``(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 102 (42 U.S.C. 247b-4b), relating to the
Developmental Disabilities Surveillance and Research Program.
(2) Section 103 (42 U.S.C. 247b-4c), relating to information
and education.
(3) Section 104 (42 U.S.C. 247b-4d), relating to the Inter-
Agency Autism Coordinating Committee.
(4) Section 105 (42 U.S.C. 247b-4e), relating to reports.

SEC. 4. AUTHORIZATION OF APPROPRIATIONS.

(a) In General.--Part R of title III of the Public Health Service
Act, as added by section 3, is amended by adding at the end the
following:

``SEC. 399EE.  NOTE: 42 USC 280i-4.  AUTHORIZATION OF APPROPRIATIONS.

``(a) Developmental Disabilities Surveillance and Research
Program.--To carry out section 399AA, there are authorized to be
appropriated the following:
``(1) For fiscal year 2007, $15,000,000.
``(2) For fiscal year 2008, $16,500,000.
``(3) For fiscal year 2009, $18,000,000.
``(4) For fiscal year 2010, $19,500,000.
``(5) For fiscal year 2011, $21,000,000.

[[Page 2830]]
120 STAT. 2830

``(b) Autism Education, Early Detection, and Intervention.--To carry
out section 399BB, there are authorized to be appropriated the
following:
``(1) For fiscal year 2007, $32,000,000.
``(2) For fiscal year 2008, $37,000,000.
``(3) For fiscal year 2009, $42,000,000.
``(4) For fiscal year 2010, $47,000,000.
``(5) For fiscal year 2011, $52,000,000.

``(c) Interagency Autism Coordinating Committee; Certain Other
Programs.--To carry out section 399CC, 409C, and section 404H, there are
authorized to be appropriated the following:
``(1) For fiscal year 2007, $100,000,000.
``(2) For fiscal year 2008, $114,500,000.
``(3) For fiscal year 2009, $129,000,000.
``(4) For fiscal year 2010, $143,500,000.
``(5) For fiscal year 2011, $158,000,000.''.

(b) Conforming Amendment.--Section 409C of the Public Health Service
Act (42 U.S.C. 284g) is amended by striking subsection (e) (relating to
funding).

Approved December 19, 2006.

LEGISLATIVE HISTORY--S. 843:
---------------------------------------------------------------------------

SENATE REPORTS: No. 109-318 (Comm. on Health, Education, Labor, and
Pensions).
CONGRESSIONAL RECORD, Vol. 152 (2006):
Aug. 3, considered and passed Senate.
Dec. 6, considered and passed House, amended.
Dec. 7, Senate concurred in House amendment.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 42 (2006):
Dec. 19, Presidential statement.