H.R. 4631 — what changed
Autism Collaboration, Accountability, Research, Education, and Support Act of 2014
From Introduced in House to Reported in House. 3 sections amended and 4 added between Introduced in House and Reported in House.
Section 1 Short title
changed
This Act may be cited as the “Combating Autism Reauthorization “Autism Collaboration, Accountability, Research, Education, and Support Act of 2014” or the “Autism CARES Act of 2014”.
Sec. 2 National Autism Spectrum Disorder Initiative
changed
National Autism Spectrum Disorder Initiative—In general— Part R of title III The Secretary of Health and Human Services shall designate an existing official within the Public Department of Health Service Act (42 U.S.C. 280i et seq.) is amended—and Human Services to oversee, in consultation with the Secretaries of Defense and Education, national autism spectrum disorder research, services, and support activities.
removed
by redesignating sections 399AA through 399EE as sections 399BB through 399FF, respectively; and
removed
by inserting before section 399BB, as redesignated, the following:
removed
“399AA. National Autism Spectrum Disorder Initiative
removed
“(a) Establishment—For the purposes described in subsection (b), the Secretary shall designate an official within the Department of Health and Human Services to establish and oversee a National Autism Spectrum Disorder Initiative (in this section referred to as the “Initiative”).
removed
“(b) Purposes—The purposes of the Initiative shall be—
removed
“(1) to implement a strategic plan for the conduct of, and support for, autism spectrum disorder research, taking into account the strategic plan developed by the Interagency Autism Coordinating Committee under section 399DD(b); and
removed
“(2) to ensure that autism spectrum disorder research programs and activities of the Department of Health and Human Services are not unnecessarily duplicative of other Federal research programs and activities.”
changed
Developmental disabilities surveillance and research program—Duties— Section 399BB of the Public Health Service Act (42 U.S.C. 280i), as redesignated, is amended—The official designated under subsection (a) shall—
changed
in subsection (a), implement autism spectrum disorder activities, taking into account the strategic plan developed by inserting “for children and adults” after “reporting the Interagency Autism Coordinating Committee under section 399CC(b) of State epidemiological data”;the Public Health Service Act (42 U.S.C. 280i–2(b)); and
changed
in subsection (b)(1), by striking “establishment ensure that autism spectrum disorder activities of regional centers the Department of excellence” Health and inserting “establishment or support of regional centers Human Services and of excellence”;other Federal departments and agencies are not unnecessarily duplicative.
removed
in subsection (b)(2), by striking “center to be established” and inserting “center to be established or supported”; and
removed
in subsection (e), by striking “2014” and inserting “2019”.
removed
Autism education, early detection, and intervention— Section 399CC(g) of the Public Health Service Act (42 U.S.C. 280i–1), as redesignated, is amended by striking “2014” and inserting “2019”.
removed
Interagency Autism Coordinating Committee—
removed
Appointment of members by congressional leaders— Section 399DD(c)(1) of the Public Health Service Act (42 U.S.C. 280i–2(c)(1)), as redesignated, is amended—
removed
in subparagraph (D), by striking “and” at the end;
removed
by redesignating subparagraph (E) as subparagraph (I); and
removed
by inserting after subparagraph (D) the following:
removed
“(E) one member appointed by the Speaker of the House of Representatives;
removed
“(F) one member appointed by the majority leader of the Senate;
removed
“(G) one member appointed by the minority leader of the House of Representatives;
removed
“(H) one member appointed by the minority leader of the Senate; and”
removed
Preventing duplication— Section 399DD(b) of the Public Health Service Act (42 U.S.C. 280i–2(b)), as redesignated, is amended—
removed
in paragraph (5), by striking “and” at the end;
removed
by redesignating paragraph (6) as paragraph (7); and
removed
by inserting after paragraph (5) the following:
removed
“(6) include in such strategic plan recommendations to ensure that autism spectrum disorder research programs and activities of the Department of Health and Human Services are not unnecessarily duplicative of other Federal research programs and activities; and”
removed
Extension of sunset provision— Section 399DD(f) of the Public Health Service Act (42 U.S.C. 280i–2), as redesignated, is amended by striking “2014” and inserting “2019”.
removed
Report to Congress— Section 399EE of the Public Health Service Act (42 U.S.C. 280i–3), as redesignated, is amended—
removed
in subsection (a), by striking “Combating Autism Reauthorization Act of 2011” and inserting “Combating Autism Reauthorization Act of 2014”; and
removed
in subsection (b)—
removed
in paragraph (1), by striking “provisions of the Combating Autism Act of 2006” and inserting “provisions of this part, section 404H, and section 409C”;
removed
in paragraph (2), by striking “provisions of Combating Autism Act of 2006” and inserting “provisions of this part, section 404H, and section 409C”;
removed
in paragraph (3), by striking “Combating Autism Act of 2006” and inserting “Combating Autism Reauthorization Act of 2011”;
removed
in paragraphs (4) and (5), by striking “over the 6-year period beginning on” each place it appears and inserting “since”;
removed
in paragraph (8), by striking “and” at the end;
removed
in paragraph (9), by striking the period at the end and inserting “; and”; and
removed
by adding at the end the following:
removed
“(10) 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.”
removed
Authorization of appropriations— Section 399FF of the Public Health Service Act (42 U.S.C. 280i–4), as redesignated, is amended—
removed
in subsection (a)—
removed
by striking “399AA” and inserting “399BB”; and
removed
by striking “fiscal years 2012 through 2014” and inserting “fiscal years 2015 through 2019”;
removed
in subsection (b)—
removed
by striking “399BB” and inserting “399CC”; and
removed
by striking “fiscal years 2011 through 2014” and inserting “fiscal years 2015 through 2019”; and
removed
in subsection (c)—
removed
by striking “399CC” and inserting “399DD”; and
removed
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”.
Sec. 3 Research program
added Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is amended—
removed
In general— Not later than 24 months after the date of enactment of this Act, the Comptroller General of the United States shall complete a study and submit to the Congress a report on the demographics and needs, if any, of individuals in the United States with an autism spectrum disorder (in this section referred to as “ASD”).
changed
Issues To Be addressed— The study and report under in subsection (a) shall—(a)(1), by inserting “for children and adults” after “reporting of State epidemiological data”;
added
in subsection (b)(1)—
removed
address the demographics of individuals with ASD making the transition from a school-based support system to adulthood;
removed
address the needs, if any, of adults with ASD with respect to—
removed
community integration;
removed
housing and residential supports;
removed
employment;
removed
transportation;
removed
vocational training and rehabilitation;
removed
continued education;
removed
health care and social services;
removed
speech therapy;
removed
public safety; and
removed
day habilitation activities, including those to provide a safe, respectful, and stimulating environment that allows participants to become active members of their community;
removed
provide an overview of Federal, State, and local government policies and programs, and any available private (including private nonprofit) sector assistance, for addressing the needs identified in paragraph (2); and
removed
provide policy recommendations to—
removed
improve outcomes for adults with ASD making the transition from a school-based support system to adulthood;
removed
enhance the effectiveness of the policies, programs, and assistance described in paragraph (3);
removed
ensure integration of and collaboration among services for addressing the needs of adults with ASD; and
removed
encourage independent living, equal opportunity, full participation, and economic self-sufficiency.
removed
Survey—
changed
In general— In carrying out this section, the Comptroller General shall conduct a survey by striking “establishment of public regional centers of excellence” and private sector stakeholders on—inserting “establishment or support of regional centers of excellence”; and
removed
the needs, if any, of adults with ASD;
removed
the services and resources available for addressing such needs; and
removed
the effectiveness of such services and resources.
changed
Stakeholders— The stakeholders to be surveyed under paragraph (1) include by inserting “for children and adults” before the following:period at the end;
added
in subsection (b)(2), by striking “center to be established” and inserting “center to be established or supported”; and
added
in subsection (e), by striking “2014” and inserting “2019”.
removed
Individuals from the business community representing both large and small businesses.
removed
Institutions of higher education, community colleges, vocational schools, and university centers for excellence in developmental disabilities.
removed
Social service providers, including case management experts and health care providers.
removed
Vocational rehabilitation experts.
removed
State and local housing departments and nonprofit organizations that provide housing services for individuals with disabilities.
removed
Individuals with ASD, parents of individuals with ASD, and representatives from advocacy groups that focus on individuals with ASD.
removed
Officials or employees of the Federal Government responsible for overseeing disability services at each of the following departments and agencies:
removed
The Department of Health and Human Services, including the Administration for Children and Families, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, and the Administration for Community Living.
removed
The Department of Education.
removed
The Department of Housing and Urban Development.
removed
The Department of Labor.
removed
The Department of Justice.
removed
The Department of Transportation.
removed
Any other Federal departments and agencies determined appropriate by the Comptroller General.
Sec. 4 Autism intervention
addedadded Section 399BB of the Public Health Service Act (42 U.S.C. 280i–1) is amended—
added
in subsection (b)(1), by inserting “culturally competent” after “provide”;
added
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”;
added
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)”;
added
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
added
in subsection (g), by striking “2014” and inserting “2019”.
Sec. 5 Interagency Autism Coordinating Committee
addedadded Section 399CC of the Public Health Service Act (42 U.S.C. 280i–2) is amended—
added
in subsection (b)—
added
in paragraph (1)—
added
by striking “and annually update”; and
added
by striking “intervention” and inserting “interventions, including school and community-based interventions”;
added
by striking paragraph (2);
added
by redesignating paragraph (1) as paragraph (2), and inserting before such redesignated paragraph the following:
added “(1) monitor autism spectrum disorder research, and to the extent practicable services and support activities, across all Federal departments and agencies, including coordination of Federal activities with respect to autism spectrum disorder;”
added
in paragraph (3), by striking “recommendations to the Director of NIH”;
added
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
added
by striking paragraphs (5) and (6) and inserting the following:
added “(5) develop a strategic plan for the conduct of, and support for, autism spectrum disorder research and services and supports for individuals with an autism spectrum disorder and the families of such individuals, which shall include—
added “(A) proposed budgetary requirements; and
added “(B) recommendations to ensure that autism spectrum disorder research, services, and support activities of the Department of Health and Human Services and of other Federal departments and agencies are not unnecessarily duplicative; and
added “(6) submit to Congress and the President—
added “(A) an annual update on the summary of advances described in paragraph (2); and
added “(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.”
added
in subsection (c)—
added
in paragraph (1)—
added
by striking the paragraph designation, the heading, and the matter preceding subparagraph (A) and inserting the following:
added “(1) Federal membership—The Committee shall be composed of the following Federal members—”
added
in subparagraph (C)—
added
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
added
by adding at the end “and”;
added
in subparagraph (D)—
added
by inserting “and the Department of Defense” after “Department of Education”; and
added
by striking at the end “; and” and inserting a period; and
added
by striking subparagraph (E);
added
in paragraph (2)—
added
in the paragraph heading, by striking “Additional” and inserting “Non-Federal”;
added
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 ½, but not fewer than 1/3, of the total membership of the Committee”;
added
in subparagraph (A), by striking “one such member shall be an individual” and inserting “two such members shall be individuals”;
added
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
added
in subparagraph (C), by striking “one such member shall be a representative” and inserting “two such members shall be representatives”; and
added
by adding at the end the following:
added “(3) Period of appointment; vacancies
added “(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.
added “(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 power 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 of the member’s term until a successor has been appointed.”
added
in subsection (d)—
added
by striking paragraph (2); and
added
by redesignating paragraphs (3) and (4) as paragraphs (2) and (3), respectively; and
added
in subsection (f), by striking “2014” and inserting “2019”.
Sec. 6 Reports
addedadded Section 399DD of the Public Health Service Act (42 U.S.C. 280i–3) is amended—
added
in the section heading, by striking “Report” and inserting “Reports”;
added
in subsection (b), by redesignating paragraphs (1) through (9) as subparagraphs (A) through (I), respectively, and realigning the margins accordingly;
added
by redesignating subsections (a) and (b) as paragraphs (1) and (2), respectively, and realigning the margins accordingly;
added
by inserting after the section heading the following:
added “(a) Progress report”
added
in subsection (a)(1) (as so redesignated)—
added
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”;
added
by inserting “and the Secretary of Defense” after “the Secretary of Education”; and
added
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
added
in subsection (a)(2) (as so redesignated)—
added
in subparagraph (A), (as so redesignated), by striking “Combating Autism Act of 2006” and inserting “Autism CARES Act of 2014”;
added
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”;
added
by striking subparagraph (C) (as so redesignated), and inserting the following:
added “(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;”
added
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 populations subgroups”;
added
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 Autism CARES Act of 2014 and, as appropriate, how this age varies across populations subgroups”;
added
in subparagraph (F) (as so redesignated), by inserting “and, as appropriate, on how such average time varies across populations subgroups” before the semicolon at the end;
added
in subparagraph (G) (as so redesignated)—
added
by striking “including by various subtypes,” and inserting “including by severity level as practicable,”; and
added
by striking “child may” and inserting “child or other factors, such as demographic characteristics, may”; and
added
by striking subparagraph (I) (as so redesignated), and inserting the following:
added “(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).”
added
by adding at the end the following new subsection:
added “(b) Report on young adults and transitioning youth
added “(1) In general—Not later than 2 years after the date of enactment of the Autism CARES Act of 2014, the Secretary, 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.
added “(2) Contents—The report submitted under paragraph (1) shall contain—
added “(A) demographic characteristics of youth transitioning from school-based to community-based supports;
added “(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;
added “(C) proposals on establishing best practices guidelines to ensure—
added “(i) interdisciplinary coordination between all relevant service providers receiving Federal funding;
added “(ii) coordination with transitioning youth and the family of such transitioning youth; and
added “(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);
added “(D) comprehensive approaches to transitioning from existing school-based services to those services available during adulthood, including—
added “(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;
added “(ii) community-based behavioral supports and interventions;
added “(iii) community-based integrated residential services, housing, and transportation;
added “(iv) nutrition, health and wellness, recreational, and social activities;
added “(v) personal safety services for individuals with autism spectrum disorder related to public safety agencies or the criminal justice system; and
added “(vi) evidence-based approaches for coordination of resources and services once individuals have aged out of post-secondary education; and
added “(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—
added “(i) increasing the effectiveness of programs that provide transition services;
added “(ii) increasing the ability of the relevant service providers described in subparagraph (C) to provide supports and services to underserved populations and regions;
added “(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;
added “(iv) ensuring access to all services necessary to transitioning youth of all capabilities; and
added “(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
addedadded Section 399EE of the Public Health Service Act (42 U.S.C. 280i–4) is amended—
added
in subsection (a), by striking “fiscal years 2012 through 2014” and inserting “fiscal years 2015 through 2019”;
added
in subsection (b), by striking “fiscal years 2011 through 2014” and inserting “fiscal years 2015 through 2019”; and
added
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”.