Autism CARES Act of 2019

II 116TH CONGRESS 1ST SESSION S. 427 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. IN THE SENATE OF THE UNITED STATES FEBRUARY 7, 2019 Mr. MENENDEZ (for himself and Mr. ENZI) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To amend the Public Health Service Act to enhance activities of the National Institutes of Health with respect to re- search on autism spectrum disorder and enhance pro- grams relating to autism, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Autism Collaboration, 4 Accountability, Research, Education, and Support Act of 5 2019’’ or the ‘‘Autism CARES Act of 2019’’. 6 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 2 •S 427 IS SEC. 2. EXPANSION, INTENSIFICATION, AND COORDINA- 1 TION OF ACTIVITIES OF THE NIH WITH RE- 2 SPECT TO RESEARCH ON AUTISM SPECTRUM 3 DISORDER. 4 Section 409C of the Public Health Service Act (42 5 U.S.C. 284g) is amended— 6 (1) in subsection (a)(1)— 7 (A) in the first sentence, by striking ‘‘and 8 toxicology’’ and inserting ‘‘toxicology, and inter- 9 ventions to maximize outcomes for persons with 10 autism spectrum disorder’’; and 11 (B) by striking the second sentence and in- 12 serting the following: ‘‘Such research shall in- 13 vestigate the causes (including possible environ- 14 mental causes), diagnosis or rule out, early and 15 ongoing detection, prevention, services across 16 the lifespan, supports, intervention, and treat- 17 ment of autism spectrum disorder, including 18 dissemination and implementation of clinical 19 care, supports, interventions, and treatments.’’; 20 (2) in subsection (b)— 21 (A) in paragraph (2)— 22 (i) in the second sentence, by striking 23 ‘‘cause’’ and all that follows through ‘‘dis- 24 order’’ and inserting ‘‘causes, diagnosis, 25 early and ongoing detection, prevention, 26 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 3 •S 427 IS and treatment of autism spectrum disorder 1 across the lifespan’’; and 2 (ii) in the third sentence, by striking 3 ‘‘neurobiology’’ and all that follows 4 through the period and inserting ‘‘neurobi- 5 ology, genetics, genomics, psychopharma- 6 cology, developmental psychology, behav- 7 ioral psychology, and clinical psychology.’’; 8 and 9 (B) in paragraph (3), by adding at the end 10 the following: 11 ‘‘(D) REDUCING DISPARITIES.—The Direc- 12 tor may consider, as appropriate, the extent to 13 which a center can demonstrate availability and 14 access to clinical services for youth and adults 15 from diverse racial, ethnic, geographic, or lin- 16 guistic backgrounds in decisions about awarding 17 grants to applicants which meet the scientific 18 criteria for funding under this section.’’. 19 SEC. 3. PROGRAMS RELATING TO AUTISM. 20 (a) DEVELOPMENTAL DISABILITIES SURVEILLANCE 21 AND RESEARCH PROGRAM.—Section 399AA(e) of the 22 Public Health Service Act (42 U.S.C. 280i(e)) is amended 23 by striking ‘‘2019’’ and inserting ‘‘2024’’. 24 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 4 •S 427 IS (b) AUTISM EDUCATION, EARLY DETECTION, AND 1 INTERVENTION.—Section 399BB of the Public Health 2 Service Act (42 U.S.C. 280i–1) is amended— 3 (1) in subsection (a)(1), by striking ‘‘children 4 with autism spectrum disorder’’ and all that follows 5 through ‘‘disabilities;’’ and inserting ‘‘individuals 6 with autism spectrum disorder and other develop- 7 mental disabilities across their lifespan;’’; 8 (2) in subsection (b)— 9 (A) in paragraph (2), by inserting ‘‘indi- 10 viduals with’’ before ‘‘autism spectrum dis- 11 order’’; 12 (B) by redesignating paragraphs (4) 13 through (6) as paragraphs (5) through (7), re- 14 spectively; and 15 (C) by inserting after paragraph (3) the 16 following: 17 ‘‘(4) promote evidence-based screening tech- 18 niques and interventions for individuals with autism 19 spectrum disorder and other developmental disabil- 20 ities across their lifespan;’’; 21 (3) in subsection (c)(1), in the matter preceding 22 subparagraph (A), by inserting ‘‘across their life- 23 span’’ before ‘‘and their families’’; 24 (4) in subsection (e)— 25 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 5 •S 427 IS (A) in paragraph (1)— 1 (i) in the matter preceding subpara- 2 graph (A), by inserting ‘‘across their life- 3 span’’ before ‘‘and ensure’’; and 4 (ii) in subparagraph (B)(iv), by in- 5 serting ‘‘across their lifespan’’ after ‘‘other 6 developmental disabilities’’; 7 (B) by redesignating paragraphs (2) and 8 (3) as paragraphs (3) and (4), respectively; and 9 (C) by inserting after paragraph (1) the 10 following: 11 ‘‘(2) DEVELOPMENTAL-BEHAVIORAL PEDIATRI- 12 CIAN TRAINING PROGRAMS.— 13 ‘‘(A) IN GENERAL.—In making awards 14 under this subsection, the Secretary may 15 prioritize awards to applicants that are develop- 16 mental-behavioral pediatrician training pro- 17 grams located in rural or underserved areas. 18 ‘‘(B) DEFINITION OF UNDERSERVED 19 AREA.—In this paragraph, the term ‘under- 20 served area’ means— 21 ‘‘(i) a health professional shortage 22 area (as defined in section 332(a)(1)(A)); 23 and 24 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 6 •S 427 IS ‘‘(ii) an urban or rural area des- 1 ignated by the Secretary as an area with 2 a shortage of personal health services as 3 described in section 330(b)(3)(A)).’’; 4 (5) in subsection (f), by inserting ‘‘across the 5 lifespan of such individuals’’ after ‘‘other develop- 6 mental disabilities’’; and 7 (6) in subsection (g), by striking ‘‘2019’’ and 8 inserting ‘‘2024’’. 9 (c) INTERAGENCY AUTISM COORDINATING COM- 10 MITTEE.—Section 399CC of the Public Health Service Act 11 (42 U.S.C. 280i–2) is amended— 12 (1) in subsection (b)— 13 (A) in paragraph (2), by inserting ‘‘across 14 the lifespan of such individuals’’ before the 15 semicolon; and 16 (B) in paragraph (5), by inserting ‘‘across 17 the lifespan of such individuals’’ before ‘‘and 18 the families’’; 19 (2) in subsection (c)— 20 (A) in paragraph (1)(D), by inserting ‘‘, 21 the Department of Labor, the Department of 22 Justice, the Department of Housing and Urban 23 Development,’’ after ‘‘Department of Edu- 24 cation’’; and 25 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 7 •S 427 IS (B) in paragraph (3)(A), by striking ‘‘one 1 or more additional 4-year terms’’ and inserting 2 ‘‘one additional 4-year term’’; and 3 (3) in subsection (f), by striking ‘‘2019’’ and 4 inserting ‘‘2024’’. 5 (d) REPORTS TO CONGRESS.—Section 399DD of the 6 Public Health Service Act (42 U.S.C. 280i–3) is amend- 7 ed— 8 (1) in subsection (a)— 9 (A) in paragraph (1), by striking ‘‘Autism 10 CARES Act of 2014’’ and inserting ‘‘Autism 11 CARES Act of 2019’’; and 12 (B) in paragraph (2)— 13 (i) in subparagraphs (A), (B), (D), 14 and (E), by striking ‘‘Autism CARES Act 15 of 2014’’ each place it appears and insert- 16 ing ‘‘Autism CARES Act of 2019’’; 17 (ii) in subparagraph (G), by striking 18 ‘‘age of the child’’ and inserting ‘‘age of 19 the individual’’; 20 (iii) in subparagraph (H), by striking 21 ‘‘; and’’ and inserting ‘‘;’’; 22 (iv) in subparagraph (I), by striking 23 the period and inserting ‘‘; and’’; and 24 (v) by adding at the end the following: 25 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 8 •S 427 IS ‘‘(J) information on how States use home- 1 and community-based services and other sup- 2 ports to ensure that individuals with autism 3 spectrum disorder and other developmental dis- 4 abilities are living, working, and participating in 5 their community.’’; and 6 (2) in subsection (b)— 7 (A) in the heading, by striking ‘‘YOUNG 8 ADULTS AND TRANSITIONING YOUTH’’ and in- 9 serting ‘‘THE HEALTH AND WELL-BEING OF 10 INDIVIDUALS WITH AUTISM SPECTRUM DIS- 11 ORDER ACROSS THEIR LIFESPAN’’; 12 (B) by amending paragraph (1) to read as 13 follows: 14 ‘‘(1) IN GENERAL.—Not later than 2 years 15 after the date of enactment of the Autism CARES 16 Act of 2019, the Secretary shall prepare and submit, 17 to the Committee on Health, Education, Labor, and 18 Pensions of the Senate and the Committee on En- 19 ergy and Commerce of the House of Representa- 20 tives, a report concerning the health and well-being 21 of individuals with autism spectrum disorder.’’; and 22 (C) in paragraph (2)— 23 (i) by amending subparagraph (A) to 24 read as follows: 25 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 9 •S 427 IS ‘‘(A) demographic factors associated with 1 the health and well-being of individuals with au- 2 tism spectrum disorder;’’; 3 (ii) in subparagraph (B), by striking 4 ‘‘young adults’’ and all that follows 5 through the semicolon and inserting ‘‘the 6 health and well-being of individuals with 7 autism spectrum disorder, including an 8 identification of existing Federal laws, reg- 9 ulations, policies, research, and pro- 10 grams;’’; and 11 (iii) by amending subparagraphs (C), 12 (D), and (E) to read as follows: 13 ‘‘(C) recommendations on establishing best 14 practices guidelines to ensure interdisciplinary 15 coordination between all relevant service pro- 16 viders receiving Federal funding; 17 ‘‘(D) comprehensive approaches to improv- 18 ing health outcomes and well-being for individ- 19 uals with autism spectrum disorder, including— 20 ‘‘(i) community-based behavioral sup- 21 ports and interventions; 22 ‘‘(ii) nutrition, recreational, and social 23 activities; and 24 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 10 •S 427 IS ‘‘(iii) personal safety services related 1 to public safety agencies or the criminal 2 justice system for such individuals; and 3 ‘‘(E) recommendations that seek to im- 4 prove health outcomes for such individuals, in- 5 cluding across their lifespan, by addressing— 6 ‘‘(i) screening and diagnosis of chil- 7 dren and adults; 8 ‘‘(ii) behavioral and other therapeutic 9 approaches; 10 ‘‘(iii) primary and preventative care; 11 ‘‘(iv) communication challenges; 12 ‘‘(v) aggression, self-injury, elope- 13 ment, and other behavioral issues; 14 ‘‘(vi) emergency room visits and acute 15 care hospitalization; 16 ‘‘(vii) treatment for co-occurring phys- 17 ical and mental health conditions; 18 ‘‘(viii) premature mortality; 19 ‘‘(ix) medical practitioner training; 20 and 21 ‘‘(x) caregiver mental health.’’. 22 (e) AUTHORIZATION OF APPROPRIATIONS.—Section 23 399EE of the Public Health Service Act (42 U.S.C. 280i– 24 4) is amended— 25 VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS 11 •S 427 IS (1) in subsection (a), by striking ‘‘$22,000,000 1 for each of fiscal years 2015 through 2019’’ and in- 2 serting ‘‘$23,100,000 for each of fiscal years 2020 3 through 2024’’; 4 (2) in subsection (b), by striking ‘‘$48,000,000 5 for each of fiscal years 2015 through 2019’’ and in- 6 serting ‘‘$50,599,000 for each of fiscal years 2020 7 through 2024’’; and 8 (3) in subsection (c), by striking ‘‘there is au- 9 thorized to be appropriated $190,000,000 for each 10 of fiscal years 2015 through 2019’’ and inserting 11 ‘‘there are authorized to be appropriated such sums 12 as may be necessary for each of fiscal years 2020 13 through 2024’’. 14 Æ VerDate Sep 11 2014 22:16 Feb 20, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\S427.IS S427 pbinns on DSK79D2C42PROD with BILLS