---
kind: "diff"
citation: "H.R. 7213"
bill: "118-hr-7213"
heading: "Autism Collaboration, Accountability, Research, Education, and Support Act of 2024"
from: "rh"
from_label: "Reported in House"
to: "eh"
to_label: "Engrossed in House"
sections_amended: 2
sections_added: 1
sections_removed: 0
url: "https://uscodex.org/bills/118/hr/7213/changes/eh"
---
# H.R. 7213 — what changed
H.R. 7213, Autism Collaboration, Accountability, Research, Education, and Support Act of 2024 — 2 sections amended and 1 added between Reported in House and Engrossed in House.
Edits are marked `struck` and `inserted`.
## Sec. 2 National Institutes of Health activities
- (a) Expansion of activities— Paragraph (1) of section 409C(a) Section 409C(a)(1) of the Public Health Service Act (42 U.S.C. 284g(a)) 284g(a)(1)) is amended to read as follows:amended—
- (1) by striking “) shall, subject to the availability” and inserting the following:
- “(A) subject to the availability”
- (2) by striking “basic and clinical research in fields including pathology” and inserting the following:
- “(i) in fields, such as pathology”
- (3) by striking “toxicology, and interventions” and inserting the following:
- “(ii) on interventions”
- (4) by striking “disorder. Such research shall investigate” and inserting the following:
- “(1) Expansion of activities—The Director of NIH (in this section referred to as the “Director”), in coordination and consultation with the Administrator of the Administration for Community Living, and other agencies as appropriate, shall—
- “(A) 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—
- “(i) basic and clinical research in fields including pathology, developmental neurobiology, genetics, epigenetics, pharmacology, nutrition, immunology, neuroimmunology, neurobehavioral development, endocrinology, gastroenterology, toxicology, speech, language and hearing science, psychiatry, psychology, developmental behavioral pediatrics, and gerontology; and
- “(ii) research on interventions to maximize outcomes for individuals with autism spectrum disorder; and
- “(B) ensure that research referred to in subparagraph (A)—
- “(i) investigates”
- (5) by striking “prevention, services across the lifespan, supports, intervention, and treatment of autism spectrum disorder” and inserting “prevention, services and supports across the lifespan, intervention, and treatment of autism spectrum disorder and co-occurring conditions”; and
- (6) by striking “treatments.” and inserting the following:
- “(ii) examines supports for caregivers; and
- “(iii) reflects the entire population of individuals with autism spectrum disorder, including those individuals with co-occurring conditions and the full range of needs for supports and services, including such supports and services to ensure the safety, and promote the well-being, of such individuals.”
- “(i) investigates the causes (including possible environmental causes), diagnosis or ruling out, early and ongoing detection, prevention, intervention, services, supports across the lifespan for autistic individuals and caregivers, and treatment for autism spectrum disorder and co-occurring conditions, including dissemination and implementation of clinical care, supports, interventions, and treatments; and
- “(ii) reflects the entire population of individuals with autism spectrum disorder, including the full range of cognitive, communicative, behavioral, and adaptive functioning, as well as co-occurring conditions and needs for support and services, including care necessary for physical safety.”
- (b) Centers of excellence— Section 409C(b) of the Public Health Service Act (42 U.S.C. 284g(b)) is amended—
- (1) in paragraph (2)—
- (A) by striking “prevention, and treatment” “including the fields of” and inserting “prevention, services, and treatment”;“in fields such as”; and
- (B) by striking “including the fields” and inserting “including in the fields”; and
- (B) [was (3)(3)(4)] by striking “behavioral psychology, and clinical psychology” and inserting “behavioral psychology, clinical psychology, and gerontology”;
- (2) in paragraph (5)(A), by striking “not less than five centers” “five” and inserting “not fewer than six centers”; “seven”; and
- (3) in paragraph (5)(B), by striking “period of not to exceed” and inserting “period not to exceed”.
- (c) Public input— Section 409C(d) of the Public Health Service Act (42 U.S.C. 284g(d)) is amended to read as follows:
- “(d) Public input
- “(1) In general—The Director shall under subsection (a)(1) provide for means through which the public can obtain information on the existing and planned programs and activities of the National Institutes of Health with respect to autism spectrum disorder and through which the Director can receive comments from the public regarding such programs and activities.
- “(2) Opportunities—Such public input opportunities Guidance—The Director may include encouraging the provide guidance to centers under subsection (b)(1) to establish an external advisory board or adopting a comprehensive plan on strategies, activities, and opportunities to ensure promote engagement with, and solicit input from, individuals with various backgrounds autism spectrum disorder and perspectives are represented, among their family members, guardians, advocates or authorized representatives, providers, or other activities. appropriate individuals to inform the activities of the center. Such strategies, activities, and opportunities should consider including, as appropriate, individuals, family members, and caregivers of individuals with autism spectrum disorder who represent the entire population of individuals with autism spectrum disorder, including those individuals with co-occurring conditions and the full range of cognitive, communicative, behavioral, needs for supports and adaptive functioning, services, including such supports and services to better inform research findings ensure the safety, and future studies.”promote the well-being, of such individuals, to inform the activities of the center.”
- (d) Budget estimate— Section 409C of the Public Health Service Act (42 U.S.C. 284g) is amended by adding at the end the following:
- “(e) Budget estimate—For each of fiscal years 2026 through 2029, the Director shall prepare and submit, directly to the President for review and transmittal to Congress, an annual budget estimate for the initiatives of the National Institutes of Health pursuant to the strategic plan developed under section 399CC(b)(5) and updated under section 399CC(b)(6)(B), after reasonable opportunity for comment (but without change) by the Secretary and the Interagency Autism Coordinating Committee established under section 399CC.”
## 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 (b)(1), (a)(3), by striking “and causes” “an Indian tribe, or a tribal organization” and inserting “causes, and life course”; and“an Indian Tribe, or a Tribal organization”;
- (2) in subsection (b)(1), by inserting “across the lifespan” before the period at the end;
- (3) in subsection (d)(1)—
- (A) in the paragraph heading, by striking “tribe; tribal” and inserting “Tribe; Tribal”;
- (B) by striking “tribe” and inserting “Tribe”; and
- (C) by striking “tribal” and inserting “Tribal”; and
- (4) [was (2)(4)] in subsection (e), by striking “2024” and inserting “2029”.
- (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)(2), (b)(1), by striking “subsequent interventions” “culturally competent information” and inserting “subsequent interventions “culturally and services”;linguistically appropriate information”;
- (2) in subsection (b)(1), by striking “culturally competent information” and inserting “culturally and linguistically responsive information”;
- (2) [was (3)(5)] in subsection (b)(2)—
- (A) by striking “promote research” and inserting “promote research, which may include research that takes a community-based approach,”; and
- (A) by striking “promote research” and inserting “promote research, which may include community-based participatory research,”; and
- (B) [was (3)(5)(3)] by striking “screening tools” each place it appears and inserting “screening and diagnostic tools”;
- (3) [was (3)(6)] in subsection (b)(3), by striking “at higher risk” and inserting “at increased likelihood”;
- (4) in subsection (b)(4), by inserting “, which may give consideration to the perspectives of parents and guardians” before the semicolon at the end;
- (5) in subsection (b)(4), (b)(7), by inserting “, which may include such individuals utilizing parents and guardians trained to provide interventions, services, striking “at higher risk” and supports” before the semicolon at the end;inserting “at increased likelihood”;
- (6) in subsection (c)(1), by striking “culturally competent information” and inserting “culturally and linguistically responsive appropriate information”;
- (7) in subsection (c)(2)(A)(ii)—(c)(2)(A)(ii), by striking “culturally competent information” and inserting “culturally and linguistically appropriate information”;
- (A) by striking “advocates,” and inserting “advocates, self-advocates,”; and
- (B) by striking “culturally competent information” and inserting “culturally and linguistically responsive information”;
- (8) by amending paragraph (1) of subsection (e) to read as follows:
- (9) in subsection (e)(1)—
- (A) in the matter preceding subparagraph (A), by inserting “, and strengthen the capacity of, ” after “expand”; and
- (B) in subparagraph (A)—
- (i) by striking “expand existing or develop new” and inserting “expand and strengthen the capacity of existing, or, in States that do not have such a program, develop new,”; and
- (ii) by striking “Act) in States that do not have such a program” and inserting “Act)”;
- (C) in subparagraph (B)(v), by inserting “or other providers, as applicable” before the semicolon at the end; and
- (D) by amending subparagraph (C) to read as follows:
- “(C) program sites—
- “(i) provide culturally and linguistically appropriate services;
- “(ii) take a multidisciplinary approach and have experience working with underserved populations; and
- “(iii) identify opportunities to partner with community-based organizations to expand the capacity of communities to serve individuals with autism spectrum disorder or other developmental disabilities.”
- “(1) Training—The Secretary, in coordination with activities conducted under title V of the Social Security Act, shall, subject to the availability of appropriations, strengthen the capacity of existing training programs and expand existing interdisciplinary training opportunities or opportunities to increase the number of programs that address the health and well-being of individuals who have or are at increased likelihood for autism spectrum disorder and other neurodevelopmental disabilities across their lifespan. Activities under the preceding sentence shall include—
- “(A) awarding competitive grants or cooperative agreements 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) ensuring that trainees under such training programs—
- “(i) receive an appropriate balance of academic, clinical, and community opportunities;
- “(ii) are culturally and linguistically responsive;
- “(iii) are from various backgrounds;
- “(iv) demonstrate a capacity to evaluate, diagnose or rule out, develop, and provide evidence-based interventions and programs to individuals with autism spectrum disorder and other developmental disabilities across their lifespan; and
- “(v) demonstrate an ability to use a person- and family-centered approach, which may include collaborating with research centers or networks to provide training for providers of respite care (as defined in section 2901);
- “(C) ensuring that program sites provide culturally and linguistically responsive services; and
- “(D) encouraging training programs to partner with appropriate entities to build community capacity.”
- (10) [was (3)(11)] in subsection (e)(2), by adding at the end the following new subparagraph:
- “(C) Report—Not later than 2 years after the date of the enactment of the Autism CARES Act of 2024, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report that examines the need for, and feasibility of, expanding the developmental-behavioral pediatrician training programs described in subparagraph (A).”
- (11) by amending subsection (f) to read as follows:
- “(f) Intervention—The Secretary shall promote research through grants or contracts, which may include grants or contracts to research centers or networks, to—
- “(1) develop and evaluate evidence-based practices and interventions to improve outcomes for individuals with autism spectrum disorder or other developmental disabilities by addressing physical and behavioral health and communication needs of such individuals across the lifespan;
- “(2) develop guidelines for such evidence-based practices and interventions; and
- “(3) disseminate information related to such evidence-based practices and interventions and guidelines.”
- “(C) Report—Not later than 2 years after September 30, 2024, the Comptroller General of the United States shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report examining how to increase the number of developmental-behavioral pediatricians, including through the developmental behavioral pediatrician training program.”
- (10) in subsection (f)—
- (A) by striking “promote research” and inserting “promote research, including community-based participatory research,”;
- (B) by striking “physical and behavioral health of individuals” and inserting “physical and behavioral health, and communication needs, of individuals”; and
- (C) by striking “disseminate information related to such research and guidelines” and inserting “disseminate information relating to such research and guidelines to improve the quality of life and long-term outcomes”; and
- (12) [was (3)(13)] in subsection (g), by striking “2024” and inserting “2029”.
- (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 the matter preceding paragraph (2), (1), by striking “develop a summary” and inserting “develop and update “, on a summary”;regular basis” after “shall”;
- (B) in paragraphs (3) and (4), paragraph (2), by striking “make recommendations” “develop a summary” and inserting “make and update recommendations”; “summarize”; and
- (C) by striking paragraphs (5) and (6) and inserting the following:
- “(5) develop and update a strategic plan for the conduct of, and support for, autism spectrum disorder research, including as practicable for services and supports, for individuals with an autism spectrum disorder across the lifespan of such individuals and the families of such individuals, and across the entire population of individuals with autism spectrum disorder, including the full range of cognitive, communicative, behavioral, and adaptive functioning, as well as co-occurring conditions and needs for support and services, including care necessary for physical safety, described in section 409C(a)(1), which such plan shall include proposed budgetary requirements and recommendations to ensure that autism spectrum disorder research, and services and support activities to the extent practicable, of the Department of Health and Human Services and of other Federal departments and agencies are not unnecessarily duplicative; andinclude—
- “(6) submit to the Congress and President—“(A) proposed budgetary requirements; and
- “(B) recommendations to ensure that autism spectrum disorder research, and services and support activities to the extent practicable, of the Department of Health and Human Services and of other Federal departments and agencies are not unnecessarily duplicative; and
- “(6) submit to the Congress and the President—
- “(A) an annual update on the summary of advances described in paragraph (2); and
- “(B) a biennial update on the strategic plan described in paragraph (5), including progress made in achieving the goals outlined in such strategic plan and any specific measures taken pursuant to such strategic plan.”
- “(B) each update to the strategic plan described in paragraph (5), including any steps that have already been taken to implement the recommendations in such updated strategic plan and progress made in achieving the goals outlined in such updated strategic plan.”
- (2) in subsection (f), by striking “2024” and inserting “2029”.
- (d) Reports to Congress— Section 399DD of the Public Health Service Act (42 U.S.C. 280i–3) is amended—
- (1) by striking “Autism CARES Act of 2019” “2019” each place it appears and inserting “Autism CARES Act of 2024”;“2024”; and
- (2) in subsection (a), by amending paragraph (1) to read as follows:
- “(1) In general—Not later than 4 years after September 30, 2024, the Secretary, in consultation and coordination with other relevant Federal departments and agencies that serve individuals with autism spectrum disorder, agencies, 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, and make publicly available, including through posting on the internet website of the Department of Health and Human Services, a progress report on activities related to autism spectrum disorder and other developmental disabilities. Such report shall include activities and research related to the entire population of individuals with autism spectrum disorder, including those individuals with co-occurring conditions and the full range of cognitive, communicative, behavioral, and adaptive functioning, as well as co-occurring conditions and needs for support supports and services, including care necessary for physical safety.”such supports and services to ensure the safety, and promote the well-being, of such individuals.”
- (3) in subsection (b)—
- (A) in the heading of subsection (b), by striking “Health and Well-Being” and inserting “Mental Health Needs”;
- (B) in paragraph (1), by striking “health and well-being” and inserting “mental health needs”; and
- (C) by amending paragraph (2) to read as follows:
- “(2) Contents—The report submitted under paragraph (1) shall contain—
- “(A) an overview of policies and programs relevant to the mental health of individuals with autism spectrum disorder across their lifespan, including an identification of existing Federal laws, regulations, policies, research, and programs; and
- “(B) recommendations to improve mental health outcomes and address related disparities in mental health care for individuals with autism spectrum disorder, including prevention, care coordination, and community-based services.”
- (4) [was (5)(5)] by adding at the end the following:
- “(c) Update on young adults and youth transitioning to adulthood—Not later than 2 years after the date of enactment of the Autism CARES Act of 2024, the Secretary, in coordination with other relevant Federal departments and agencies, as appropriate, shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate an update to the report required pursuant to subsection (b) of this section, as added by section 6 of the Autism Cares Act of 2014 (Public Law 113–157), and in effect before the date of enactment of the Autism CARES Act of 2019 (Public Law 116–60), 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.”
- “(c) Update on young adults and youth transitioning to adulthood—Not later than 2 years after the date of enactment of the Autism CARES Act of 2024, the Secretary, in coordination with other Federal departments and agencies that serve individuals with autism spectrum disorder, shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate an update to the report required pursuant to section 6 of the Autism Cares Act of 2014 (Public Law 113–157) 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.
- “(d) Professional judgment budget—For each fiscal year through fiscal year 2029, the Director of the National Institutes of Health, in coordination with other relevant agencies, as appropriate, shall prepare and submit, directly to the President for review and transmittal to Congress, after reasonable opportunity for comment, but without change, by the Secretary and the Interagency Autism Coordinating Committee established under section 399CC(a), an annual budget estimate for carrying out the strategic plan developed and updated under section 399CC(b)(5).”
- (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 “$23,100,000 for each of fiscal years 2020 through 2024” and inserting “$28,100,000 for each of fiscal years 2025 through 2029”;
- (2) in subsection (b), by striking “$50,599,000 for each of fiscal years 2020 through 2024” and inserting “$56,344,000 for each of fiscal years 2025 through 2029”; and
- (3) in subsection (c), by striking “there are authorized to be appropriated $296,000,000 for each of fiscal years 2020 through 2024” and inserting “there is authorized to be appropriated $341,000,000 $306,000,000 for each of fiscal years 2025 through 2029”.
## Sec. 4 Technical assistance to improve access to communication tools — added
- (a) In general— The Secretary of Health and Human Services (referred to in this section as the “Secretary”) may, at the request of a State, Indian Tribe, Tribal organization, locality, or territory, provide training and technical assistance to such jurisdiction on the manner in which Federal funding administered by the Secretary may be used to provide individuals with autism spectrum disorder and other developmental disabilities with access to evidence-based services, tools, and technologies that support communication needs.
- (b) Annual report— The Secretary shall annually 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 summarizing any technical assistance provided by the Secretary in the preceding fiscal year under subsection (a) and any advancements in the development or evaluation of such evidence-based services, tools, and technologies.