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<dc:title>116 HR 1058 ENR: 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.</dc:title>
<dc:type>House Bill</dc:type>
<docNumber>1058</docNumber>
<citableAs>116 HR 1058 ENR</citableAs>
<citableAs>116hr1058enr</citableAs>
<citableAs>116 H. R. 1058 ENR</citableAs>
<docStage>Enrolled Bill</docStage>
<processedBy>GPO XPub Bill to USLM Generator, version 0.5 + manual changes</processedBy>
<processedDate>2024-09-09</processedDate>
<dc:publisher>United States Government Publishing Office</dc:publisher>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
<congress>116</congress>
<session>1</session>
<publicPrivate>public</publicPrivate></meta>
<preface>
<distributionCode display="no">I</distributionCode>
<dc:type>H. R. </dc:type>
<docNumber>1058</docNumber>
<congress value="116">One Hundred Sixteenth Congress of the United States of America</congress>
<session value="1">AT THE FIRST SESSION</session>
<enrolledDateline>Begun and held at the City of Washington on Thursday, the third day of January, two thousand and nineteen</enrolledDateline></preface>
<main styleType="OLC" id="H670D5A827847475FB9ABBE09CB410661"><longTitle><docTitle>An Act</docTitle><officialTitle>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.</officialTitle></longTitle><enactingFormula><i>Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, </i></enactingFormula>
<section identifier="/us/bill/116/hr/1058/s1" id="H556762AB638D46A6A6FFBA0FF75A797F"><num value="1">SECTION 1. </num><heading>SHORT TITLE.</heading><content class="block">This Act may be cited as the “<shortTitle role="act">Autism Collaboration, Accountability, Research, Education, and Support Act of 2019</shortTitle>” or the “<shortTitle role="act">Autism CARES Act of 2019</shortTitle>”.</content></section>
<section role="instruction" identifier="/us/bill/116/hr/1058/s2" id="HF3C13D2BA09C4C84AEDFF1A60308C940"><num value="2">SEC. 2. </num><heading>EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF THE NIH WITH RESPECT TO RESEARCH ON AUTISM SPECTRUM DISORDER.</heading>
<chapeau class="indent0">Section 409C of the Public Health Service Act (<ref href="/us/usc/t42/s284g">42 U.S.C. 284g</ref>) <amendingAction type="amend">is amended</amendingAction>—</chapeau>
<paragraph identifier="/us/bill/116/hr/1058/s2/1" id="H9DD4A55FE45D48CCA72EBABF0C69DB89" class="indent1"><num value="1">(1) </num><chapeau>in subsection (a)(1)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s2/1/A" id="H42AEA8F5FC894EFA9266EA0622AF9193" class="indent2"><num value="A">(A) </num><content>in the first sentence, by <amendingAction type="delete">striking</amendingAction> “<quotedText>and toxicology</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>toxicology, and interventions to maximize outcomes for individuals with autism spectrum disorder</quotedText>”; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s2/1/B" id="H4CFE8CFC4AFB430DB27567E4BFA7B490" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="delete">striking</amendingAction> the second sentence and <amendingAction type="insert">inserting</amendingAction> the following: “<quotedText>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.</quotedText>”;</content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s2/2" id="HD7CE1A104E184D7CB7C6FC796BD22135" class="indent1"><num value="2">(2) </num><chapeau>in subsection (b)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s2/2/A" id="H4CCCD2A4E510464CB3B2EEE6831071E9" class="indent2"><num value="A">(A) </num><chapeau>in paragraph (2)—</chapeau>
<clause identifier="/us/bill/116/hr/1058/s2/2/A/i" id="HCB8B724F323C48229B05CD31AB63776D" class="indent3"><num value="i">(i) </num><content>in the second sentence, by <amendingAction type="delete">striking</amendingAction> “<quotedText>cause</quotedText>” and all that follows through “<quotedText>disorder</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>causes, diagnosis, early and ongoing detection, prevention, and treatment of autism spectrum disorder across the lifespan</quotedText>”; and</content></clause>
<clause identifier="/us/bill/116/hr/1058/s2/2/A/ii" id="H02DDEC65373443D8B7D1E509A08E8A9E" class="indent3"><num value="ii">(ii) </num><content>in the third sentence, by <amendingAction type="delete">striking</amendingAction> “<quotedText>neurobiology</quotedText>” and all that follows through the period and <amendingAction type="insert">inserting</amendingAction> “<quotedText>neurobiology, genetics, genomics, psychopharmacology, developmental psychology, behavioral psychology, and clinical psychology.</quotedText>”; and</content></clause></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s2/2/B" id="HCAA5AC5129D447F1ABA491940D4EB43F" class="indent2"><num value="B">(B) </num><content>in paragraph (3), by <amendingAction type="add">adding</amendingAction> at the end the following:
<quotedContent id="H84049804809A49549F554539AA51C4B9" styleType="OLC">
<subparagraph id="H40CA0DBF1D9945D4819C9526FF67F99E" class="indent2"><num value="D">“(D) </num><heading><inline class="smallCaps">Reducing disparities</inline>.—</heading><content>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 in decisions about awarding grants to applicants which meet the scientific criteria for funding under this section.”</content></subparagraph></quotedContent><inline role="after-quoted-block">.</inline></content></subparagraph></paragraph></section>
<section identifier="/us/bill/116/hr/1058/s3" id="HF86461D06B1E485B89A874AF803A6826"><num value="3">SEC. 3. </num><heading>PROGRAMS RELATING TO AUTISM.</heading>
<subsection role="instruction" identifier="/us/bill/116/hr/1058/s3/a" id="H34A6CE28EB70489DA369DB142AC39E4D" class="indent0"><num value="a">(a) </num><heading><inline class="smallCaps">Developmental Disabilities Surveillance and Research Program</inline>.—</heading><chapeau>Section 399AA of the Public Health Service Act (<ref href="/us/usc/t42/s280i">42 U.S.C. 280i</ref>) <amendingAction type="amend">is amended</amendingAction>—</chapeau>
<paragraph identifier="/us/bill/116/hr/1058/s3/a/1" id="H4B881DC5569E42FDBA1C058E27974051" class="indent1"><num value="1">(1) </num><content>in subsection (a)(1), by <amendingAction type="delete">striking</amendingAction> “<quotedText>adults on autism spectrum disorder</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>adults with autism spectrum disorder</quotedText>”;</content></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/a/2" id="H8B47BD412BCA4F118CB7F79F6E7E9D0A" class="indent1"><num value="2">(2) </num><chapeau>in subsection (a)(2)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/a/2/A" id="H7C7494B3AB2F4C909F9485654A8D68CB" class="indent2"><num value="A">(A) </num><content>by <amendingAction type="delete">striking</amendingAction> “<quotedText>State and local public health officials</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>State, local, and Tribal public health officials</quotedText>”;</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/a/2/B" id="HA1CD9519C60F4F43B17B8A0DE9DA70A7" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="delete">striking</amendingAction> “<quotedText>or other developmental disabilities</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>and other developmental disabilities</quotedText>”;</content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/a/3" id="H435C5E626A7642919B0B6080D69A87BD" class="indent1"><num value="3">(3) </num><content>in subsection (a)(3), by <amendingAction type="delete">striking</amendingAction> “<quotedText>a university, or any other educational institution</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>a university, any other educational institution, an Indian tribe, or a tribal organization</quotedText>”;</content></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/a/4" id="H344758424DC2447C804E1610600A8357" class="indent1"><num value="4">(4) </num><content>in subsection (b)(2)(A), by <amendingAction type="delete">striking</amendingAction> “<quotedText>relevant State and local public health officials, private sector developmental disability researchers, and advocates for individuals with developmental disabilities</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>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</quotedText>”;</content></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/a/5" id="HCC03ABC83837409F9D92DC93FAA93D7D" class="indent1"><num value="5">(5) </num><chapeau>in subsection (d)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/a/5/A" id="H175410C49FBE4551BE35C6019318C79F" class="indent2"><num value="A">(A) </num><content>by <amendingAction type="redesignate">redesignating</amendingAction> paragraphs (1) and (2) as paragraphs (2) and (3), respectively; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/a/5/B" id="HDB37BE37064247209A69EC5B78CC6FEC" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="insert">inserting</amendingAction> before paragraph (2), as so redesignated, the following new paragraph:
<quotedContent styleType="OLC" id="H3C42358EFC584D6888672482F87B683D">
<paragraph id="H8C747C585D8C4FF39EA4FA09447B0293" class="indent1"><num value="1">“(1) </num><heading><inline class="smallCaps">Indian tribe; tribal organization</inline>.—</heading><content>The terms ‘Indian tribe’ and ‘tribal organization’ have the meanings given such terms in section 4 of the Indian Health Care Improvement Act.”</content></paragraph></quotedContent><inline role="after-quoted-block">; and</inline></content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/a/6" id="HF5F1C863516E4D7991F5FA391AF41DDD" class="indent1"><num value="6">(6) </num><content>in subsection (e), by <amendingAction type="delete">striking</amendingAction> “<quotedText>2019</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>2024</quotedText>”.</content></paragraph></subsection>
<subsection role="instruction" identifier="/us/bill/116/hr/1058/s3/b" id="H08C6865C14A642958EC199F1210D7BC8" class="indent0"><num value="b">(b) </num><heading><inline class="smallCaps">Autism Education, Early Detection, and Intervention</inline>.—</heading><chapeau>Section 399BB of the Public Health Service Act (<ref href="/us/usc/t42/s280i–1">42 U.S.C. 280i–1</ref>) <amendingAction type="amend">is amended</amendingAction>—</chapeau>
<paragraph identifier="/us/bill/116/hr/1058/s3/b/1" id="H4777BCB50D9A4AD6AE9616C4025FE880" class="indent1"><num value="1">(1) </num><chapeau>in subsection (a)(1)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/1/A" id="HE4926C197316404D9313BA9404BF1F21" class="indent2"><num value="A">(A) </num><content>by <amendingAction type="delete">striking</amendingAction> “<quotedText>individuals with autism spectrum disorder or other developmental disabilities</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>individuals with autism spectrum disorder and other developmental disabilities</quotedText>”; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/1/B" id="H35DA7D30DBD946CCA87AC1FC5B68D207" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="delete">striking</amendingAction> “<quotedText>children with autism spectrum disorder</quotedText>” and all that follows through “<quotedText>disabilities;</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>individuals with autism spectrum disorder and other developmental disabilities across their lifespan;</quotedText>”;</content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/b/2" id="H32E7631D764A4345A4983F7E1D190587" class="indent1"><num value="2">(2) </num><chapeau>in subsection (b)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/2/A" id="H6344AE34D68D4369A2367036A921057B" class="indent2"><num value="A">(A) </num><content>in paragraph (2), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>individuals with</quotedText>” before “<quotedText>autism spectrum disorder</quotedText>”;</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/2/B" id="H40D7C074F8A145DEA0490F0F7E14923D" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="redesignate">redesignating</amendingAction> paragraphs (4) through (6) as paragraphs (5) through (7), respectively; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/2/C" id="H450CCEC085604F80879DFCB82A1D3FB9" class="indent2"><num value="C">(C) </num><content>by <amendingAction type="insert">inserting</amendingAction> after paragraph (3) the following:
<quotedContent id="HD6BED7FB9FD5470D952079553452A2D0" styleType="OLC">
<paragraph id="H479024DD07C14AF5A3876AE3E209E1A5" class="indent1"><num value="4">“(4) </num><content>promote evidence-based screening techniques and interventions for individuals with autism spectrum disorder and other developmental disabilities across their lifespan;”</content></paragraph></quotedContent><inline role="after-quoted-block">;</inline></content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/b/3" id="HCD48E72898E248DA9663991A2B568D25" class="indent1"><num value="3">(3) </num><chapeau>in subsection (c)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/3/A" id="HF6D43A6F64BA4D61A11DAF38D9D25939" class="indent2"><num value="A">(A) </num><content>in paragraph (1), in the matter preceding subparagraph (A), by <amendingAction type="delete">striking</amendingAction> “<quotedText>the needs of individuals with autism spectrum disorder or other developmental disabilities and their families</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>the needs of individuals with autism spectrum disorder and other developmental disabilities across their lifespan and the needs of their families</quotedText>”; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/3/B" id="H7AD56C41BA9A4391B7E2B73430D06A79" class="indent2"><num value="B">(B) </num><chapeau>in paragraph (2)—</chapeau>
<clause identifier="/us/bill/116/hr/1058/s3/b/3/B/i" id="H58A602D1A7C548F1865744F230C95286" class="indent3"><num value="i">(i) </num><content>in subparagraph (A)(ii), by <amendingAction type="delete">striking</amendingAction> “<quotedText>caregivers of individuals with an autism spectrum disorder</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>caregivers of individuals with autism spectrum disorder or other developmental disabilities</quotedText>”; </content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/b/3/B/ii" id="HCBECECF3009D4A3EA9D11EF9342FEE82" class="indent3"><num value="ii">(ii) </num><content>in subparagraph (B)(i)(II), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>autism spectrum disorder and</quotedText>” after “<quotedText>individuals with</quotedText>”; and</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/b/3/B/iii" id="H22E2C2B5C1ED424AACF72A8C1C9722D5" class="indent3"><num value="iii">(iii) </num><content>in subparagraph (B)(ii), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>autism spectrum disorder and</quotedText>” after “<quotedText>individuals with</quotedText>”;</content></clause></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/b/4" id="HEBEEC7889B824913B6484DFCBA1A4DC0" class="indent1"><num value="4">(4) </num><chapeau>in subsection (e)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/4/A" id="HEF0E7BA30637422DB6D903D99F149E9F" class="indent2"><num value="A">(A) </num><chapeau>in paragraph (1)—</chapeau>
<clause identifier="/us/bill/116/hr/1058/s3/b/4/A/i" id="H1F4406FA19784208BCF445ABC7D1D08F" class="indent3"><num value="i">(i) </num><content>in the matter preceding subparagraph (A), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>across their lifespan</quotedText>” before “<quotedText>and ensure</quotedText>”; and</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/b/4/A/ii" id="H294292584FB740EB807DC59CE83F4F79" class="indent3"><num value="ii">(ii) </num><content>in subparagraph (B)(iv), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>across their lifespan</quotedText>” after “<quotedText>other developmental disabilities</quotedText>”;</content></clause></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/4/B" id="H5B2D2E5AEE154507AF7D3F17D2BF8D83" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="redesignate">redesignating</amendingAction> paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/b/4/C" id="H70AFC068CC31433D9D25169C2A0C90FF" class="indent2"><num value="C">(C) </num><content>by <amendingAction type="insert">inserting</amendingAction> after paragraph (1) the following:
<quotedContent id="HFDE453107A574E31A10189A7698DCB0D" styleType="OLC">
<paragraph id="HC5CB0E791D66495D8F27E1D8CB59C64F" class="indent1"><num value="2">“(2) </num><heading><inline class="smallCaps">Developmental-behavioral pediatrician training programs</inline>.—</heading>
<subparagraph id="H95D0BC56AC6A451388F95ECCCF74E388" class="indent2"><num value="A">“(A) </num><heading><inline class="smallCaps">In general</inline>.—</heading><content>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.</content></subparagraph>
<subparagraph role="definitions" id="H12850DDD6B4B4213989AEBF1C72437A1" class="indent2"><num value="B">“(B) </num><heading><inline class="smallCaps">Definition of underserved area</inline>.—</heading><chapeau>In this paragraph, the term ‘<term>underserved area</term>’ means—</chapeau>
<clause id="HE82D9CECE478474D8A8D509826F20D72" class="indent3"><num value="i">“(i) </num><content>a health professional shortage area (as defined in section 332(a)(1)(A)); and</content></clause>
<clause id="HA224BD8E19714B228F8E303BB2A8A073" class="indent3"><num value="ii">“(ii) </num><content>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)).”</content></clause></subparagraph></paragraph></quotedContent><inline role="after-quoted-block">;</inline></content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/b/5" id="H7ABE07B027D742A0BD56566F78CB4F87" class="indent1"><num value="5">(5) </num><content>in subsection (f), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>across the lifespan of such individuals</quotedText>” after “<quotedText>other developmental disabilities</quotedText>”; and</content></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/b/6" id="H87A6FBCC47124E989D44D85BD2FE2152" class="indent1"><num value="6">(6) </num><content>in subsection (g), by <amendingAction type="delete">striking</amendingAction> “<quotedText>2019</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>2024</quotedText>”.</content></paragraph></subsection>
<subsection role="instruction" identifier="/us/bill/116/hr/1058/s3/c" id="H7D4962376020489ABC02BE5F9A0D3875" class="indent0"><num value="c">(c) </num><heading><inline class="smallCaps">Interagency Autism Coordinating Committee</inline>.—</heading><chapeau>Section 399CC of the Public Health Service Act (<ref href="/us/usc/t42/s280i–2">42 U.S.C. 280i–2</ref>) <amendingAction type="amend">is amended</amendingAction>—</chapeau>
<paragraph identifier="/us/bill/116/hr/1058/s3/c/1" id="H3E477575D7C7427FBD5F21B2444CC78F" class="indent1"><num value="1">(1) </num><chapeau>in subsection (b)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/c/1/A" id="HDEBAE893CC8C49069A4C53B829E64BE4" class="indent2"><num value="A">(A) </num><content>in paragraph (2), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>across the lifespan of such individuals</quotedText>” before the semicolon; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/c/1/B" id="H41C8590DBED947CA941F0450CD912704" class="indent2"><num value="B">(B) </num><content>in paragraph (5), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>across the lifespan of such individuals</quotedText>” before “<quotedText>and the families</quotedText>”;</content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/c/2" id="H9BD04C0494284E479A812F3437140EB3" class="indent1"><num value="2">(2) </num><chapeau>in subsection (c)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/c/2/A" id="H88F48DF8755E4AE4B1799B642E322F02" class="indent2"><num value="A">(A) </num><content>in paragraph (1)(D), by <amendingAction type="insert">inserting</amendingAction> “<quotedText>, the Department of Labor, the Department of Justice, the Department of Veterans Affairs, the Department of Housing and Urban Development,</quotedText>” after “<quotedText>Department of Education</quotedText>”;</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/c/2/B" id="H7379F7C069C040D4A13FC4575B9CD95C" class="indent2"><num value="B">(B) </num><content>in subparagraphs (A), (B), and (C) of paragraph (2), by <amendingAction type="delete">striking</amendingAction> “<quotedText>at least two such members</quotedText>” each place it appears and <amendingAction type="insert">inserting</amendingAction> “<quotedText>at least three such members</quotedText>”;</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/c/2/C" id="HCC358F45A9E140F7906D3764396A4DDC" class="indent2"><num value="C">(C) </num><content>in paragraph (3)(A), by <amendingAction type="delete">striking</amendingAction> “<quotedText>one or more additional 4-year terms</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>one additional 4-year term</quotedText>”; and</content></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/c/3" id="H8ADE9CDE29C049E484C24686EF4401BC" class="indent1"><num value="3">(3) </num><content>in subsection (f), by <amendingAction type="delete">striking</amendingAction> “<quotedText>2019</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>2024</quotedText>”.</content></paragraph></subsection>
<subsection role="instruction" identifier="/us/bill/116/hr/1058/s3/d" id="HEC378E6BB64847C6AB934328A3336990" class="indent0"><num value="d">(d) </num><heading><inline class="smallCaps">Reports to Congress</inline>.—</heading><chapeau>Section 399DD of the Public Health Service Act (<ref href="/us/usc/t42/s280i–3">42 U.S.C. 280i–3</ref>) <amendingAction type="amend">is amended</amendingAction>—</chapeau>
<paragraph identifier="/us/bill/116/hr/1058/s3/d/1" id="H6CC980846264440FA63E53E806402798" class="indent1"><num value="1">(1) </num><chapeau>in subsection (a)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/d/1/A" id="H28E820A98FC544E88C00B9D385964A84" class="indent2"><num value="A">(A) </num><content>in paragraph (1), by <amendingAction type="delete">striking</amendingAction> “<quotedText>Autism CARES Act of 2014</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>Autism CARES Act of 2019</quotedText>”; and</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/d/1/B" id="H2491B9A97F114C2AA176108EB63591BD" class="indent2"><num value="B">(B) </num><chapeau>in paragraph (2)—</chapeau>
<clause identifier="/us/bill/116/hr/1058/s3/d/1/B/i" id="HDB40B31A14674C99A5B570B1FD1861AA" class="indent3"><num value="i">(i) </num><content>in subparagraphs (A), (B), (D), and (E), by <amendingAction type="delete">striking</amendingAction> “<quotedText>Autism CARES Act of 2014</quotedText>” each place it appears and <amendingAction type="insert">inserting</amendingAction> “<quotedText>Autism CARES Act of 2019</quotedText>”;</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/d/1/B/ii" id="H2CC3BD4F2EA449508DF7368B28263798" class="indent3"><num value="ii">(ii) </num><content>in subparagraph (G), by <amendingAction type="delete">striking</amendingAction> “<quotedText>age of the child</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>age of the individual</quotedText>”;</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/d/1/B/iii" id="H8939C030FB2942B48B2DAC14C5D9E122" class="indent3"><num value="iii">(iii) </num><content>in subparagraph (H), by <amendingAction type="delete">striking</amendingAction> “<quotedText>; and</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>;</quotedText>”;</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/d/1/B/iv" id="H75FA67DDF31F41458597EEC49A557E18" class="indent3"><num value="iv">(iv) </num><content>in subparagraph (I), by <amendingAction type="delete">striking</amendingAction> the period and <amendingAction type="insert">inserting</amendingAction> “<quotedText>; and</quotedText>”; and</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/d/1/B/v" id="H027AC9A303DF43B59DD185E977DF0570" class="indent3"><num value="v">(v) </num><content>by <amendingAction type="add">adding</amendingAction> at the end the following:
<quotedContent id="H9D7BDAD41E0E4531B9A2611CFD0D4963" styleType="OLC">
<subparagraph id="H6B7A3ECBBCDF42ADBBC0A03C771ADF5B" class="indent2"><num value="J">“(J) </num><content>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.”</content></subparagraph></quotedContent><inline role="after-quoted-block">; and</inline></content></clause></subparagraph></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/d/2" id="H26A8403708C9452E9445C46BCC7342C9" class="indent1"><num value="2">(2) </num><chapeau>in subsection (b)—</chapeau>
<subparagraph identifier="/us/bill/116/hr/1058/s3/d/2/A" id="HA64543CEA8B24E9B8FBD1B975ECF9B76" class="indent2"><num value="A">(A) </num><content>in the heading, by <amendingAction type="delete">striking</amendingAction> “<headingText role="subsection" styleType="OLC" class="smallCaps">Young Adults and Transitioning Youth</headingText>” and <amendingAction type="insert">inserting</amendingAction> “<headingText role="subsection" styleType="OLC" class="smallCaps">the Health and Well-Being of Individuals With Autism Spectrum Disorder Across Their Lifespan</headingText>”;</content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/d/2/B" id="HA37A614D0D3F4373B2B9A95EBFFE5794" class="indent2"><num value="B">(B) </num><content>by <amendingAction type="amend">amending</amendingAction> paragraph (1) to read as follows:
<quotedContent id="HAF7892004A1244D2BC6C30F7C870F47D" styleType="OLC">
<paragraph id="H49CCD88377744E40BAD62E0A17F82CE5" class="indent1"><num value="1">“(1) </num><heading><inline class="smallCaps">In general</inline>.—</heading><content>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.”</content></paragraph></quotedContent><inline role="after-quoted-block">; and</inline></content></subparagraph>
<subparagraph identifier="/us/bill/116/hr/1058/s3/d/2/C" id="HF8D5266DE5A44D5792AC3CE41F083C8D" class="indent2"><num value="C">(C) </num><chapeau>in paragraph (2)—</chapeau>
<clause identifier="/us/bill/116/hr/1058/s3/d/2/C/i" id="HFF5A46CF7457445BA0EDA5B71A5E9498" class="indent3"><num value="i">(i) </num><content>by <amendingAction type="amend">amending</amendingAction> subparagraph (A) to read as follows:
<quotedContent id="HC0840C6393DA438CB6EDD5D0F1A1C6F1" styleType="OLC">
<subparagraph id="H11D98F3E016E485FABFA2DD7E108632B" class="indent2"><num value="A">“(A) </num><content>demographic factors associated with the health and well-being of individuals with autism spectrum disorder;”</content></subparagraph></quotedContent><inline role="after-quoted-block">;</inline></content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/d/2/C/ii" id="H987BFF4E40DD4F16AC5726DB27255E11" class="indent3"><num value="ii">(ii) </num><content>in subparagraph (B), by <amendingAction type="delete">striking</amendingAction> “<quotedText>young adults</quotedText>” and all that follows through the semicolon and <amendingAction type="insert">inserting</amendingAction> “<quotedText>the health and well-being of individuals with autism spectrum disorder, including an identification of existing Federal laws, regulations, policies, research, and programs;</quotedText>”; and</content></clause>
<clause identifier="/us/bill/116/hr/1058/s3/d/2/C/iii" id="HB6F995A7044742909C43B16139ED04FC" class="indent3"><num value="iii">(iii) </num><content>by <amendingAction type="amend">amending</amendingAction> subparagraphs (C), (D), and (E) to read as follows:
<quotedContent id="HCA4CBAEAD2594DAC8373C7F2188899AE" styleType="OLC">
<subparagraph id="H0FD9EA8BC96247D7864ADCC0E34A3543" class="indent2"><num value="C">“(C) </num><content>recommendations on establishing best practices guidelines to ensure interdisciplinary coordination between all relevant service providers receiving Federal funding;</content></subparagraph>
<subparagraph id="H77DC40423FE9491C8BF3314F56196017" class="indent2"><num value="D">“(D) </num><chapeau>comprehensive approaches to improving health outcomes and well-being for individuals with autism spectrum disorder, including—</chapeau>
<clause id="H84DB9976C2724B889F85AD3CB8B6F5A6" class="indent3"><num value="i">“(i) </num><content>community-based behavioral supports and interventions;</content></clause>
<clause id="H70EE7248D54C4ED8BB778BCBBAA06F6D" class="indent3"><num value="ii">“(ii) </num><content>nutrition, recreational, and social activities; and</content></clause>
<clause id="H407FF82AAF834F01B2251759406D318B" class="indent3"><num value="iii">“(iii) </num><content>personal safety services related to public safety agencies or the criminal justice system for such individuals; and</content></clause></subparagraph>
<subparagraph id="H2AA3B9CA977540EFAA95A5B6A76A200D" class="indent2"><num value="E">“(E) </num><chapeau>recommendations that seek to improve health outcomes for such individuals, including across their lifespan, by addressing—</chapeau>
<clause id="H872579DDFA5F4EA99DE3C68C69DE2B1E" class="indent3"><num value="i">“(i) </num><content>screening and diagnosis of children and adults;</content></clause>
<clause id="H46B19F9AE5C149FCBB30A57E275E24E9" class="indent3"><num value="ii">“(ii) </num><content>behavioral and other therapeutic approaches;</content></clause>
<clause id="HA5E9144A4A93429F82F5FBDF904E4B47" class="indent3"><num value="iii">“(iii) </num><content>primary and preventative care;</content></clause>
<clause id="H2864E858537E4B859B1FB66ADB4D6A5F" class="indent3"><num value="iv">“(iv) </num><content>communication challenges;</content></clause>
<clause id="HF4E157267A204563BD86C430B22109BE" class="indent3"><num value="v">“(v) </num><content>aggression, self-injury, elopement, and other behavioral issues;</content></clause>
<clause id="H34C3789C4C2042B893D0C4A979522D8E" class="indent3"><num value="vi">“(vi) </num><content>emergency room visits and acute care hospitalization;</content></clause>
<clause id="HBB3B50859C794AB38430F8D0ED5C52C4" class="indent3"><num value="vii">“(vii) </num><content>treatment for co-occurring physical and mental health conditions;</content></clause>
<clause id="H551A4A5CBE8E406EBE6F7D4AFC039D05" class="indent3"><num value="viii">“(viii) </num><content>premature mortality;</content></clause>
<clause id="HD2F7FFCEC75541678FC96F1BEF33562F" class="indent3"><num value="ix">“(ix) </num><content>medical practitioner training; and</content></clause>
<clause id="H52DE1795F90640B4B0D5A0A819EB4464" class="indent3"><num value="x">“(x) </num><content>caregiver mental health.”</content></clause></subparagraph></quotedContent><inline role="after-quoted-block">.</inline></content></clause></subparagraph></paragraph></subsection>
<subsection role="instruction" identifier="/us/bill/116/hr/1058/s3/e" id="H974385F96FB742B6A9312F465FFD96A1" class="indent0"><num value="e">(e) </num><heading><inline class="smallCaps">Authorization of Appropriations</inline>.—</heading><chapeau>Section 399EE of the Public Health Service Act (<ref href="/us/usc/t42/s280i–4">42 U.S.C. 280i–4</ref>) <amendingAction type="amend">is amended</amendingAction>—</chapeau>
<paragraph identifier="/us/bill/116/hr/1058/s3/e/1" id="HCFB7A6736D514072AA8331E2EC2C9BF6" class="indent1"><num value="1">(1) </num><content>in subsection (a), by <amendingAction type="delete">striking</amendingAction> “<quotedText>$22,000,000 for each of fiscal years 2015 through 2019</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>$23,100,000 for each of fiscal years 2020 through 2024</quotedText>”;</content></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/e/2" id="H8992872BAD424D99BD7D5AC2F31C54E2" class="indent1"><num value="2">(2) </num><content>in subsection (b), by <amendingAction type="delete">striking</amendingAction> “<quotedText>$48,000,000 for each of fiscal years 2015 through 2019</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>$50,599,000 for each of fiscal years 2020 through 2024</quotedText>”; and</content></paragraph>
<paragraph identifier="/us/bill/116/hr/1058/s3/e/3" id="H58E3CA66B426420E852C0C7244561485" class="indent1"><num value="3">(3) </num><content>in subsection (c), by <amendingAction type="delete">striking</amendingAction> “<quotedText>there is authorized to be appropriated $190,000,000 for each of fiscal years 2015 through 2019</quotedText>” and <amendingAction type="insert">inserting</amendingAction> “<quotedText>there are authorized to be appropriated $296,000,000 for each of fiscal years 2020 through 2024</quotedText>”.</content></paragraph></subsection></section></main>
<signatures>
<signature><role>Speaker of the House of Representatives.</role></signature></signatures>
<signatures>
<signature><role>Vice President of the United States and President of the Senate.</role></signature></signatures></bill>