--- kind: "diff" citation: "H.R. 4631" bill: "113-hr-4631" heading: "Autism Collaboration, Accountability, Research, Education, and Support Act of 2014" from: "ih" from_label: "Introduced in House" to: "rh" to_label: "Reported in House" sections_amended: 3 sections_added: 4 sections_removed: 0 url: "https://uscodex.org/bills/113/hr/4631/changes/rh" --- # H.R. 4631 — what changed H.R. 4631, Autism Collaboration, Accountability, Research, Education, and Support Act of 2014 — 3 sections amended and 4 added between Introduced in House and Reported in House. Edits are marked `struck` and `inserted`. ## Section 1 Short title - 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 - (a) 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. - (1) by redesignating sections 399AA through 399EE as sections 399BB through 399FF, respectively; and - (2) by inserting before section 399BB, as redesignated, the following: - “399AA. National Autism Spectrum Disorder Initiative - “(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”). - “(b) Purposes—The purposes of the Initiative shall be— - “(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 - “(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.” - (b) 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— - (1) 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 - (2) 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. - (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”. - (c) 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”. - (d) Interagency Autism Coordinating Committee— - (1) 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— - (A) in subparagraph (D), by striking “and” at the end; - (B) by redesignating subparagraph (E) as subparagraph (I); and - (C) by inserting after subparagraph (D) the following: - “(E) one member appointed by the Speaker of the House of Representatives; - “(F) one member appointed by the majority leader of the Senate; - “(G) one member appointed by the minority leader of the House of Representatives; - “(H) one member appointed by the minority leader of the Senate; and” - (2) Preventing duplication— Section 399DD(b) of the Public Health Service Act (42 U.S.C. 280i–2(b)), as redesignated, is amended— - (A) in paragraph (5), by striking “and” at the end; - (B) by redesignating paragraph (6) as paragraph (7); and - (C) by inserting after paragraph (5) the following: - “(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” - (3) 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”. - (e) Report to Congress— Section 399EE of the Public Health Service Act (42 U.S.C. 280i–3), as redesignated, is amended— - (1) in subsection (a), by striking “Combating Autism Reauthorization Act of 2011” and inserting “Combating Autism Reauthorization Act of 2014”; and - (2) in subsection (b)— - (A) in paragraph (1), by striking “provisions of the Combating Autism Act of 2006” and inserting “provisions of this part, section 404H, and section 409C”; - (B) in paragraph (2), by striking “provisions of Combating Autism Act of 2006” and inserting “provisions of this part, section 404H, and section 409C”; - (C) in paragraph (3), by striking “Combating Autism Act of 2006” and inserting “Combating Autism Reauthorization Act of 2011”; - (D) in paragraphs (4) and (5), by striking “over the 6-year period beginning on” each place it appears and inserting “since”; - (E) in paragraph (8), by striking “and” at the end; - (F) in paragraph (9), by striking the period at the end and inserting “; and”; and - (G) by adding at the end the following: - “(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.” - (f) Authorization of appropriations— Section 399FF of the Public Health Service Act (42 U.S.C. 280i–4), as redesignated, is amended— - (1) in subsection (a)— - (A) by striking “399AA” and inserting “399BB”; and - (B) by striking “fiscal years 2012 through 2014” and inserting “fiscal years 2015 through 2019”; - (2) in subsection (b)— - (A) by striking “399BB” and inserting “399CC”; and - (B) by striking “fiscal years 2011 through 2014” and inserting “fiscal years 2015 through 2019”; and - (3) in subsection (c)— - (A) by striking “399CC” and inserting “399DD”; and - (B) 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 - Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is amended— - (a) 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”). - (1) 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”; - (2) in subsection (b)(1)— - (1) address the demographics of individuals with ASD making the transition from a school-based support system to adulthood; - (2) address the needs, if any, of adults with ASD with respect to— - (A) community integration; - (B) housing and residential supports; - (C) employment; - (D) transportation; - (E) vocational training and rehabilitation; - (F) continued education; - (G) health care and social services; - (H) speech therapy; - (I) public safety; and - (J) day habilitation activities, including those to provide a safe, respectful, and stimulating environment that allows participants to become active members of their community; - (3) 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 - (4) provide policy recommendations to— - (A) improve outcomes for adults with ASD making the transition from a school-based support system to adulthood; - (B) enhance the effectiveness of the policies, programs, and assistance described in paragraph (3); - (C) ensure integration of and collaboration among services for addressing the needs of adults with ASD; and - (D) encourage independent living, equal opportunity, full participation, and economic self-sufficiency. - (c) Survey— - (A) 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 - (A) the needs, if any, of adults with ASD; - (B) the services and resources available for addressing such needs; and - (C) the effectiveness of such services and resources. - (B) Stakeholders— The stakeholders to be surveyed under paragraph (1) include by inserting “for children and adults” before the following: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”. - (A) Individuals from the business community representing both large and small businesses. - (B) Institutions of higher education, community colleges, vocational schools, and university centers for excellence in developmental disabilities. - (C) Social service providers, including case management experts and health care providers. - (D) Vocational rehabilitation experts. - (E) State and local housing departments and nonprofit organizations that provide housing services for individuals with disabilities. - (F) Individuals with ASD, parents of individuals with ASD, and representatives from advocacy groups that focus on individuals with ASD. - (G) Officials or employees of the Federal Government responsible for overseeing disability services at each of the following departments and agencies: - (i) 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. - (ii) The Department of Education. - (iii) The Department of Housing and Urban Development. - (iv) The Department of Labor. - (v) The Department of Justice. - (vi) The Department of Transportation. - (vii) Any other Federal departments and agencies determined appropriate by the Comptroller General. ## Sec. 4 Autism intervention — added - Section 399BB of the Public Health Service Act (42 U.S.C. 280i–1) is amended— - (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 — added - 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 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) 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— - “(A) proposed budgetary requirements; and - “(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 - “(6) submit to Congress and the President— - “(A) an annual update on the summary of advances described in paragraph (2); and - “(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 ½, 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 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.” - (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 — added - 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 populations 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 Autism CARES Act of 2014 and, as appropriate, how this age varies across populations subgroups”; - (F) 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; - (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).” - (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, 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— - “(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 — added - 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 - (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”.