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H.R. 1058 — what changed

Autism Collaboration, Accountability, Research, Education, and Support Act of 2019

From Introduced in House to Reported in House. 2 sections amended and 4 removed between Introduced in House and Reported in House.

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)
changed in the first sentence, by inserting after striking “and toxicology” the following: “, and inserting “toxicology, and interventions to maximize outcomes for persons individuals with autism spectrum disorder”;disorder”; and
(B)
changed by striking the second sentence and inserting after “early” the following: “and ongoing”; and“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.”;
(C)
removed by inserting after “treatment of autism spectrum disorder” the following: “, including dissemination and implementation of clinical care, supports, intervention, and treatment”; and
(2)
in subsection (b)—
(A)
changed by amending in paragraph (2) to read as follows:(2)—
(i)
added 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)
added 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

removed “(2) Research—Each center under paragraph (1) shall conduct basic and clinical research into autism spectrum disorder. Such research should include investigations into the causes, diagnosis, and early and ongoing detection, prevention, and treatment of autism spectrum disorder across the lifespan. The centers, as a group, shall conduct research including in the fields of developmental neurobiology, genetics, psychopharmacology, ge­nom­ics, and developmental, behavioral, and clinical psychology.”

(B)
changed in paragraph (3), by adding at the end the following new subparagraph:following:

changed “(D) Reducing disparities—In awarding grants to applicants which meet the scientific criteria for funding under this section, the disparities—The Director may consider, as appropriate, the extent to which a center can demonstrate availability and access to clinical services for youth and adults from diverse racial, ethnic, geographic, or linguistic backgrounds.”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)
added Developmental disabilities surveillance and research program— Section 399AA of the Public Health Service Act (42 U.S.C. 280i) is amended—
(1)
added in subsection (a)(1), by striking “adults on autism spectrum disorder” and inserting “adults with autism spectrum disorder”;
(2)
added in subsection (a)(2)—
(A)
added by striking “State and local public health officials” and inserting “State, local, and Tribal public health officials”;
(B)
added by striking “or other developmental disabilities” and inserting “and other developmental disabilities”;
(3)
added 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)
added 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)
added in subsection (d)—
(A)
added by redesignating paragraphs (1) and (2) as paragraphs (2) and (3), respectively; and
(B)
added by inserting before paragraph (2), as so redesignated, the following new paragraph:

added “(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.”

(6)
added in subsection (e), by striking “2019” and inserting “2024”.
(b)
added Autism education, early detection, and intervention— Section 399BB of the Public Health Service Act (42 U.S.C. 280i–1) is amended—
(1)
added in subsection (a)(1)—
(A)
added by striking “individuals with autism spectrum disorder or other developmental disabilities” and inserting “individuals with autism spectrum disorder and other developmental disabilities”; and
(B)
added 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)
added in subsection (b)—
(A)
added in paragraph (2), by inserting “individuals with” before “autism spectrum disorder”;
(B)
added by redesignating paragraphs (4) through (6) as paragraphs (5) through (7), respectively; and
(C)
added by inserting after paragraph (3) the following:

added “(4) promote evidence-based screening techniques and interventions for individuals with autism spectrum disorder and other developmental disabilities across their lifespan;”

(3)
added in subsection (c)—
(A)
added 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)
added in paragraph (2)—
(i)
added 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)
added in subparagraph (B)(i)(II), by inserting “autism spectrum disorder and” after “individuals with”; and
(iii)
added in subparagraph (B)(ii), by inserting “autism spectrum disorder and” after “individuals with”;
(4)
added in subsection (e)—
(A)
added in paragraph (1)—
(i)
added in the matter preceding subparagraph (A), by inserting “across their lifespan” before “and ensure”; and
(ii)
added in subparagraph (B)(iv), by inserting “across their lifespan” after “other developmental disabilities”;
(B)
added by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and
(C)
added by inserting after paragraph (1) the following:

added “(2) Developmental-behavioral pediatrician training programs

added “(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.

added “(B) Definition of underserved area—In this paragraph, the term underserved area means—

added “(i) a health professional shortage area (as defined in section 332(a)(1)(A)); and

added “(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)
added in subsection (f), by inserting “across the lifespan of such individuals” after “other developmental disabilities”; and
(6)
added in subsection (g), by striking “2019” and inserting “2024”.
(c)
added Interagency autism coordinating committee— Section 399CC of the Public Health Service Act (42 U.S.C. 280i–2) is amended—
(1)
added in subsection (b)—
(A)
added in paragraph (2), by inserting “across the lifespan of such individuals” before the semicolon; and
(B)
added in paragraph (5), by inserting “across the lifespan of such individuals” before “and the families”;
(2)
added in subsection (c)—
(A)
added 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)
added 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)
added in paragraph (3)(A), by striking “one or more additional 4-year terms” and inserting “one additional 4-year term”; and
(3)
added in subsection (f), by striking “2019” and inserting “2024”.
(d)
added Reports to Congress— Section 399DD of the Public Health Service Act (42 U.S.C. 280i–3) is amended—
(1)
added in subsection (a)—
(A)
added in paragraph (1), by striking “Autism CARES Act of 2014” and inserting “Autism CARES Act of 2019”; and
(B)
added in paragraph (2)—
(i)
added 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)
added in subparagraph (G), by striking “age of the child” and inserting “age of the individual”;
(iii)
added in subparagraph (H), by striking “; and” and inserting “;”;
(iv)
added in subparagraph (I), by striking the period and inserting “; and”; and
(v)
added by adding at the end the following:

added “(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.”

(2)
added in subsection (b)—
(A)
added 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)
added by amending paragraph (1) to read as follows:

added “(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.”

(C)
added in paragraph (2)—
(i)
added by amending subparagraph (A) to read as follows:

added “(A) demographic factors associated with the health and well-being of individuals with autism spectrum disorder;”

(ii)
added in subparagraph (B), by striking “young adults” and all that follows through the semicolon and inserting “the health and well-being of individuals with autism spectrum disorder, including an identification of existing Federal laws, regulations, policies, research, and programs;”; and
(iii)
added by amending subparagraphs (C), (D), and (E) to read as follows:

added “(C) recommendations on establishing best practices guidelines to ensure interdisciplinary coordination between all relevant service providers receiving Federal funding;

added “(D) comprehensive approaches to improving health outcomes and well-being for individuals with autism spectrum disorder, including—

added “(i) community-based behavioral supports and interventions;

added “(ii) nutrition, recreational, and social activities; and

added “(iii) personal safety services related to public safety agencies or the criminal justice system for such individuals; and

added “(E) recommendations that seek to improve health outcomes for such individuals, including across their lifespan, by addressing—

added “(i) screening and diagnosis of children and adults;

added “(ii) behavioral and other therapeutic approaches;

added “(iii) primary and preventative care;

added “(iv) communication challenges;

added “(v) aggression, self-injury, elopement, and other behavioral issues;

added “(vi) emergency room visits and acute care hospitalization;

added “(vii) treatment for co-occurring physical and mental health conditions;

added “(viii) premature mortality;

added “(ix) medical practitioner training; and

added “(x) caregiver mental health.”

(e)
added Authorization of appropriations— Section 399EE of the Public Health Service Act (42 U.S.C. 280i–4) is amended—
(1)
added 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)
added 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)
added in subsection (c), by striking “there is authorized to be appropriated $190,000,000 for each of fiscal years 2015 through 2019” and inserting “there are authorized to be appropriated $296,000,000 for each of fiscal years 2020 through 2024”.

removed Section 399AA(e) of the Public Health Service Act (42 U.S.C. 280i(e)) is amended by striking “2019” and inserting “2024”.

Sec. 4 Autism education, early detection, and intervention

removed

removed Section 399BB of the Public Health Service Act (42 U.S.C. 280i–1) is amended—

(1)
removed in subsection (a)(1), by striking “for children” and inserting “for individuals”;
(2)
removed in subsection (b)—
(A)
removed by redesignating paragraphs (4) through (6) as paragraphs (5) through (7), respectively; and
(B)
removed by inserting after paragraph (3) the following new paragraph:

removed “(4) promote evidence-based screening techniques and interventions for individuals with autism spectrum disorder across their lifespans;”

(3)
removed in subsection (c)(1), in the matter preceding subparagraph (A), by inserting after “needs of individuals with autism spectrum disorder or other developmental disabilities” the following: “across the lifespan of such individuals”;
(4)
removed in subsection (e), by adding at the end the following new paragraph:

removed “(4) Prioritization

removed “(A) In general—In awarding grants and agreements under paragraphs (1) and (2), the Secretary may prioritize awards to training programs described in paragraph (1) that are developmental-behavioral pediatrician training programs located in rural areas or underserved areas.

removed “(B) Underserved area defined—In this paragraph, the term underserved area means—

removed “(i) an area described in section 332(a)(1)(A); and

removed “(ii) a medically underserved population (as defined in section 330(b)(3)(A)).”

(5)
removed in subsection (f), by inserting after “individuals with autism spectrum disorder or other developmental disabilities” the following: “across the lifespan of such individuals”; and
(6)
removed in subsection (g), by striking “2019” and inserting “2024”.

Sec. 5 Interagency Autism Coordinating Committee

removed

removed Section 399CC of the Public Health Service Act (42 U.S.C. 280i–2) is amended—

(1)
removed in subsection (b)—
(A)
removed in paragraph (2), by inserting after “services and supports for individuals with autism spectrum disorder” the following: “across the lifespan of such individuals”; and
(B)
removed in paragraph (5), by inserting after “individuals with an autism spectrum disorder” the following: “across the lifespan of such individuals”;
(2)
removed in subsection (c)—
(A)
removed in paragraph (1)(D), by inserting after “the Department of Education” the following: “, the Department of Labor, the Department of Justice, the Department of Housing and Urban Development,”; and
(B)
removed in paragraph (3)(A), by striking “one or more additional 4-year terms” and inserting “one additional 4-year term”; and
(3)
removed in subsection (f), by striking “2019” and inserting “2024”.

Sec. 6 Reports to Congress

removed

removed Section 399DD of the Public Health Service Act (42 U.S.C. 280i–3) is amended—

(1)
removed in subsection (a)—
(A)
removed in paragraph (1), by striking “of 2014” and inserting “of 2019”; and
(B)
removed in paragraph (2)—
(i)
removed by striking “of 2014” each place it appears and inserting “of 2019”;
(ii)
removed in subparagraph (G), striking “age of the child” and inserting “age of the individual”;
(iii)
removed in subparagraph (H), by striking “and” at the end;
(iv)
removed in subparagraph (I), by striking the period at the end and inserting “; and”; and
(v)
removed by adding at the end the following new subparagraph:

removed “(J) information on how States use home and community-based services and other supports to ensure that individuals with autism spectrum disorder or other developmental disabilities are living, working, and participating in the community.”

(2)
removed by amending subsection (b) to read as follows:

removed “(b) Report on health and well-Being of individuals with autism spectrum disorder

removed “(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.

removed “(2) Contents—The report submitted under paragraph (1) shall contain—

removed “(A) demographic factors associated with the health and well-being of individuals with autism spectrum disorder;

removed “(B) an overview of policies and programs relevant to the health and well-being of individuals with autism spectrum disorder, including an identification of existing Federal laws, regulations, policies, research, and programs;

removed “(C) proposals on establishing best practices guidelines to ensure interdisciplinary coordination between all relevant service providers receiving Federal funding;

removed “(D) comprehensive approaches to improving health outcomes and well-being for individuals with autism spectrum disorder, including—

removed “(i) community-based behavioral supports and interventions;

removed “(ii) nutrition, recreational, and social activities; and

removed “(iii) personal safety services for individuals with autism spectrum disorder related to public safety agencies or the criminal justice system; and

removed “(E) recommendations that seek to improve health outcomes for individuals with autism spectrum disorder by addressing—

removed “(i) screening and diagnosis of individuals of all ages;

removed “(ii) behavioral and other therapeutic approaches;

removed “(iii) primary and preventative care;

removed “(iv) communication challenges;

removed “(v) aggression, self-injury, elopement, and other behavioral issues;

removed “(vi) emergency room visits and acute care hospitalization;

removed “(vii) treatment for co-occurring physical and mental health conditions;

removed “(viii) premature mortality;

removed “(ix) medical practitioner training; and

removed “(x) caregiver mental health.”

Sec. 7 Authorization of appropriations

removed

removed Section 399EE of the Public Health Service Act (42 U.S.C. 280i–4) is amended—

(1)
removed 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)
removed 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)
removed in subsection (c), by striking “there is authorized to be appropriated $190,000,000 for each of fiscal years 2015 through 2019” and inserting “there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2020 through 2024”.