    [United States Statutes at Large, Volume 133, 116th Congress, 1st Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    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. <>

    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 ``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 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 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 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 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) <>  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) <>  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 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.