[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 843 Enrolled Bill (ENR)]
S.843
One Hundred Ninth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Tuesday,
the third day of January, two thousand and six
An Act
To amend the Public Health Service Act to combat autism through
research, screening, intervention and education.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Combating Autism Act of 2006''.
SEC. 2. CENTERS OF EXCELLENCE; IMPROVING AUTISM-RELATED RESEARCH.
(a) Centers of Excellence Regarding Research on Autism.--Section
409C of the Public Health Service Act (42 U.S.C.284g) is amended--
(1) in the section heading, by striking ``autism'' and
inserting ``autism spectrum disorder'';
(2) by striking the term ``autism'' each place such term
appears (other than the section heading) and inserting ``autism
spectrum disorder''; and
(3) in subsection (a)--
(A) by redesignating paragraph (2) as paragraph (3); and
(B) by striking paragraph (1) and inserting the following:
``(1) Expansion of activities.--The Director of NIH (in this
section referred to as the `Director') shall, 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 basic and clinical
research in fields including pathology, developmental neurobiology,
genetics, epigenetics, pharmacology, nutrition, immunology,
neuroimmunology, neurobehavioral development, endocrinology,
gastroenterology, and toxicology. Such research shall investigate
the cause (including possible environmental causes), diagnosis or
rule out, early detection, prevention, services, supports,
intervention, and treatment of autism spectrum disorder.
``(2) Consolidation.--The Director may consolidate program
activities under this section if such consolidation would improve
program efficiencies and outcomes.''.
(b) Centers of Excellence Generally.--Part A of title IV of the
Public Health Service Act (42 U.S.C. 281 et seq.) is amended by adding
at the end the following:
``SEC. 404H. REVIEW OF CENTERS OF EXCELLENCE.
``(a) In General.--Not later than April 1, 2008, and periodically
thereafter, the Secretary, acting through the Director of NIH, shall
conduct a review and submit a report to the appropriate committees of
the Congress on the centers of excellence.
``(b) Report Contents.--Each report under subsection (a) shall
include the following:
``(1) Evaluation of the performance and research outcomes of
each center of excellence.
``(2) Recommendations for promoting coordination of information
among centers of excellence.
``(3) Recommendations for improving the effectiveness,
efficiency, and outcomes of the centers of excellence.
``(c) Definition.--In this section, the term `center of excellence'
means an entity receiving funding under this title in its capacity as a
center of excellence.''.
SEC. 3. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH PROGRAM.
(a) In General.--Title III of the Public Health Service Act (42
U.S.C. 241 et seq.) is amended by adding at the end the following:
``PART R--PROGRAMS RELATING TO AUTISM
``SEC. 399AA. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH
PROGRAM.
``(a) Autism Spectrum Disorder and Other Developmental
Disabilities.--
``(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, may award grants
or cooperative agreements to eligible entities for the collection,
analysis, and reporting of State epidemiological data on autism
spectrum disorder and other developmental disabilities. An eligible
entity shall assist with the development and coordination of State
autism spectrum disorder and other developmental disability
surveillance efforts within a region. In making such awards, the
Secretary may provide direct technical assistance in lieu of cash.
``(2) Data standards.--In submitting epidemiological data to
the Secretary pursuant to paragraph (1), an eligible entity shall
report data according to guidelines prescribed by the Director of
the Centers for Disease Control and Prevention, after consultation
with relevant State and local public health officials, private
sector developmental disability researchers, and advocates for
individuals with autism spectrum disorder or other developmental
disabilities.
``(3) Eligibility.--To be eligible to receive an award under
paragraph (1), an entity shall be a public or nonprofit private
entity (including a health department of a State or a political
subdivision of a State, a university, or any other educational
institution), and submit to the Secretary an application at such
time, in such manner, and containing such information as the
Secretary may require.
``(b) Centers of Excellence in Autism Spectrum Disorder
Epidemiology.--
``(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall, subject
to the availability of appropriations, award grants or cooperative
agreements for the establishment of regional centers of excellence
in autism spectrum disorder and other developmental disabilities
epidemiology for the purpose of collecting and analyzing
information on the number, incidence, correlates, and causes of
autism spectrum disorder and other developmental disabilities.
``(2) Requirements.--To be eligible to receive a grant or
cooperative agreement under paragraph (1), an entity shall submit
to the Secretary an application containing such agreements and
information as the Secretary may require, including an agreement
that the center to be established under the grant or cooperative
agreement shall operate in accordance with the following:
``(A) The center will collect, analyze, and report autism
spectrum disorder and other developmental disability data
according to guidelines prescribed by the Director of the
Centers for Disease Control and Prevention, after consultation
with relevant State and local public health officials, private
sector developmental disability researchers, and advocates for
individuals with developmental disabilities.
``(B) The center will develop or extend an area of special
research expertise (including genetics, epigenetics, and
epidemiological research related to environmental exposures),
immunology, and other relevant research specialty areas.
``(C) The center will identify eligible cases and controls
through its surveillance system and conduct research into
factors which may cause or increase the risk of autism spectrum
disorder and other developmental disabilities.
``(c) Federal Response.--The Secretary shall coordinate the Federal
response to requests for assistance from State health, mental health,
and education department officials regarding potential or alleged
autism spectrum disorder or developmental disability clusters.
``(d) Definitions.--In this part:
``(1) Other developmental disabilities.--The term `other
developmental disabilities' has the meaning given the term
`developmental disability' in section 102(8) of the Developmental
Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C.
15002(8)).
``(2) State.--The term `State' means each of the several
States, the District of Columbia, the Commonwealth of Puerto Rico,
American Samoa, Guam, the Commonwealth of the Northern Mariana
Islands, the Virgin Islands, and the Trust Territory of the Pacific
Islands.
``(e) Sunset.--This section shall not apply after September 30,
2011.
``SEC. 399BB. AUTISM EDUCATION, EARLY DETECTION, AND INTERVENTION.
``(a) Purpose.--It is the purpose of this section--
``(1) to increase awareness, reduce barriers to screening and
diagnosis, promote evidence-based interventions for individuals
with autism spectrum disorder or other developmental disabilities,
and train professionals to utilize valid and reliable screening
tools to diagnose or rule out and provide evidence-based
interventions for children with autism spectrum disorder and other
developmental disabilities; and
``(2) to conduct activities under this section with a focus on
an interdisciplinary approach (as defined in programs developed
under section 501(a)(2) of the Social Security Act) that will also
focus on specific issues for children who are not receiving an
early diagnosis and subsequent interventions.
``(b) In General.--The Secretary shall, subject to the availability
of appropriations, establish and evaluate activities to--
``(1) provide information and education on autism spectrum
disorder and other developmental disabilities to increase public
awareness of developmental milestones;
``(2) promote research into the development and validation of
reliable screening tools for autism spectrum disorder and other
developmental disabilities and disseminate information regarding
those screening tools;
``(3) promote early screening of individuals at higher risk for
autism spectrum disorder and other developmental disabilities as
early as practicable, given evidence-based screening techniques and
interventions;
``(4) increase the number of individuals who are able to
confirm or rule out a diagnosis of autism spectrum disorder and
other developmental disabilities;
``(5) increase the number of individuals able to provide
evidence-based interventions for individuals diagnosed with autism
spectrum disorder or other developmental disabilities; and
``(6) promote the use of evidence-based interventions for
individuals at higher risk for autism spectrum disorder and other
developmental disabilities as early as practicable.
``(c) Information and Education.--
``(1) In general.--In carrying out subsection (b)(1), the
Secretary, in collaboration with the Secretary of Education and the
Secretary of Agriculture, shall, subject to the availability of
appropriations, provide culturally competent information regarding
autism spectrum disorder and other developmental disabilities, risk
factors, characteristics, identification, diagnosis or rule out,
and evidence-based interventions to meet the needs of individuals
with autism spectrum disorder or other developmental disabilities
and their families through--
``(A) Federal programs, including--
``(i) the Head Start program;
``(ii) the Early Start program;
``(iii) the Healthy Start program;
``(iv) programs under the Child Care and Development
Block Grant Act of 1990;
``(v) programs under title XIX of the Social Security
Act (particularly the Medicaid Early and Periodic
Screening, Diagnosis and Treatment Program);
``(vi) the program under title XXI of the Social
Security Act (the State Children's Health Insurance
Program);
``(vii) the program under title V of the Social
Security Act (the Maternal and Child Health Block Grant
Program);
``(viii) the program under parts B and C of the
Individuals with Disabilities Education Act;
``(ix) the special supplemental nutrition program for
women, infants, and children established under section 17
of the Child Nutrition Act of 1966 (42 U.S.C. 1786); and
``(x) the State grant program under the Rehabilitation
Act of 1973.
``(B) State licensed child care facilities; and
``(C) other community-based organizations or points of
entry for individuals with autism spectrum disorder and other
developmental disabilities to receive services.
``(2) Lead agency.--
``(A) Designation.--As a condition on the provision of
assistance or the conduct of activities under this section with
respect to a State, the Secretary may require the Governor of
the State--
``(i) to designate a public agency as a lead agency to
coordinate the activities provided for under paragraph (1)
in the State at the State level; and
``(ii) acting through such lead agency, to make
available to individuals and their family members,
guardians, advocates, or authorized representatives;
providers; and other appropriate individuals in the State,
comprehensive culturally competent information about State
and local resources regarding autism spectrum disorder and
other developmental disabilities, risk factors,
characteristics, identification, diagnosis or rule out,
available services and supports, and evidence-based
interventions.
``(B) Requirements of agency.--In designating the lead
agency under subparagraph (A)(i), the Governor shall--
``(i) select an agency that has demonstrated experience
and expertise in--
``(I) autism spectrum disorder and other
developmental disability issues; and
``(II) developing, implementing, conducting, and
administering programs and delivering education,
information, and referral services (including
technology-based curriculum-development services) to
individuals with developmental disabilities and their
family members, guardians, advocates or authorized
representatives, providers, and other appropriate
individuals locally and across the State; and
``(ii) consider input from individuals with
developmental disabilities and their family members,
guardians, advocates or authorized representatives,
providers, and other appropriate individuals.
``(C) Information.--Information under subparagraph (A)(ii)
shall be provided through--
``(i) toll-free telephone numbers;
``(ii) Internet websites;
``(iii) mailings; or
``(iv) such other means as the Governor may require.
``(d) Tools.--
``(1) In general.--To promote the use of valid and reliable
screening tools for autism spectrum disorder and other
developmental disabilities, the Secretary shall develop a
curriculum for continuing education to assist individuals in
recognizing the need for valid and reliable screening tools and the
use of such tools.
``(2) Collection, storage, coordination, and availability.--The
Secretary, in collaboration with the Secretary of Education, shall
provide for the collection, storage, coordination, and public
availability of tools described in paragraph (1), educational
materials and other products that are used by the Federal programs
referred to in subsection (c)(1)(A), as well as--
``(A) programs authorized under the Developmental
Disabilities Assistance and Bill of Rights Act of 2000;
``(B) early intervention programs or interagency
coordinating councils authorized under part C of the
Individuals with Disabilities Education Act; and
``(C) children with special health care needs programs
authorized under title V of the Social Security Act.
``(3) Required sharing.--In establishing mechanisms and
entities under this subsection, the Secretary, and the Secretary of
Education, shall ensure the sharing of tools, materials, and
products developed under this subsection among entities receiving
funding under this section.
``(e) Diagnosis.--
``(1) Training.--The Secretary, in coordination with activities
conducted under title V of the Social Security Act, shall, subject
to the availability of appropriations, expand existing
interdisciplinary training opportunities or opportunities to
increase the number of sites able to diagnose or rule out
individuals with autism spectrum disorder or other developmental
disabilities and ensure that--
``(A) competitive grants or cooperative agreements are
awarded 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) trainees under such training programs--
``(i) receive an appropriate balance of academic,
clinical, and community opportunities;
``(ii) are culturally competent;
``(iii) are ethnically diverse;
``(iv) demonstrate a capacity to evaluate, diagnose or
rule out, develop, and provide evidence-based interventions
to individuals with autism spectrum disorder and other
developmental disabilities; and
``(v) demonstrate an ability to use a family-centered
approach; and
``(C) program sites provide culturally competent services.
``(2) Technical assistance.--The Secretary may award one or
more grants under this section to provide technical assistance to
the network of interdisciplinary training programs.
``(3) Best practices.--The Secretary shall promote research
into additional valid and reliable tools for shortening the time
required to confirm or rule out a diagnosis of autism spectrum
disorder or other developmental disabilities and detecting
individuals with autism spectrum disorder or other developmental
disabilities at an earlier age.
``(f) Intervention.--The Secretary shall promote research, through
grants or contracts, to determine the evidence-based practices for
interventions for individuals with autism spectrum disorder or other
developmental disabilities, develop guidelines for those interventions,
and disseminate information related to such research and guidelines.
``(g) Sunset.--This section shall not apply after September 30,
2011.
``SEC. 399CC. INTERAGENCY AUTISM COORDINATING COMMITTEE.
``(a) Establishment.--The Secretary shall establish a committee, to
be known as the `Interagency Autism Coordinating Committee' (in this
section referred to as the `Committee'), to coordinate all efforts
within the Department of Health and Human Services concerning autism
spectrum disorder.
``(b) Responsibilities.--In carrying out its duties under this
section, the Committee shall--
``(1) develop and annually update a summary of advances in
autism spectrum disorder research related to causes, prevention,
treatment, early screening, diagnosis or rule out, intervention,
and access to services and supports for individuals with autism
spectrum disorder;
``(2) monitor Federal activities with respect to autism
spectrum disorder;
``(3) make recommendations to the Secretary regarding any
appropriate changes to such activities, including recommendations
to the Director of NIH with respect to the strategic plan developed
under paragraph (5);
``(4) make recommendations to the Secretary regarding public
participation in decisions relating to autism spectrum disorder;
``(5) develop and annually update a strategic plan for the
conduct of, and support for, autism spectrum disorder research,
including proposed budgetary requirements; and
``(6) submit to the Congress such strategic plan and any
updates to such plan.
``(c) Membership.--
``(1) In general.--The Committee shall be composed of--
``(A) the Director of the Centers for Disease Control and
Prevention;
``(B) the Director of the National Institutes of Health,
and the Directors of such national research institutes of the
National Institutes of Health as the Secretary determines
appropriate;
``(C) the heads of such other agencies as the Secretary
determines appropriate;
``(D) representatives of other Federal Governmental
agencies that serve individuals with autism spectrum disorder
such as the Department of Education; and
``(E) the additional members appointed under paragraph (2).
``(2) Additional members.--Not fewer than 6 members of the
Committee, or 1/3 of the total membership of the Committee,
whichever is greater, shall be composed of non-Federal public
members to be appointed by the Secretary, of which--
``(A) at least one such member shall be an individual with
a diagnosis of autism spectrum disorder;
``(B) at least one such member shall be a parent or legal
guardian of an individual with an autism spectrum disorder; and
``(C) at least one such member shall be a representative of
leading research, advocacy, and service organizations for
individuals with autism spectrum disorder.
``(d) Administrative Support; Terms of Service; Other Provisions.--
The following provisions shall apply with respect to the Committee:
``(1) The Committee shall receive necessary and appropriate
administrative support from the Secretary.
``(2) Members of the Committee appointed under subsection
(c)(2) shall serve for a term of 4 years, and may be reappointed
for one or more additional 4 year term. Any member appointed to
fill a vacancy for an unexpired term shall be appointed for the
remainder of such term. A member may serve after the expiration of
the member's term until a successor has taken office.
``(3) The Committee shall meet at the call of the chairperson
or upon the request of the Secretary. The Committee shall meet not
fewer than 2 times each year.
``(4) All meetings of the Committee shall be public and shall
include appropriate time periods for questions and presentations by
the public.
``(e) Subcommittees; Establishment and Membership.--In carrying out
its functions, the Committee may establish subcommittees and convene
workshops and conferences. Such subcommittees shall be composed of
Committee members and may hold such meetings as are necessary to enable
the subcommittees to carry out their duties.
``(f) Sunset.--This section shall not apply after September 30,
2011, and the Committee shall be terminated on such date.
``SEC. 399DD. REPORT TO CONGRESS.
``(a) In General.--Not later than 4 years after the date of
enactment of the Combating Autism Act of 2006, the Secretary, in
coordination with the Secretary of Education, shall prepare and submit
to the Health, Education, Labor, and Pensions Committee of the Senate
and the Energy and Commerce Committee of the House of Representatives a
progress report on activities related to autism spectrum disorder and
other developmental disabilities.
``(b) Contents.--The report submitted under subsection (a) shall
contain--
``(1) a description of the progress made in implementing the
provisions of the Combating Autism Act of 2006;
``(2) a description of the amounts expended on the
implementation of the particular provisions of Combating Autism Act
of 2006;
``(3) information on the incidence of autism spectrum disorder
and trend data of such incidence since the date of enactment of the
Combating Autism Act of 2006;
``(4) information on the average age of diagnosis for children
with autism spectrum disorder and other disabilities, including how
that age may have changed over the 4-year period beginning on the
date of enactment of this Act;
``(5) information on the average age for intervention for
individuals diagnosed with autism spectrum disorder and other
developmental disabilities, including how that age may have changed
over the 4-year period beginning on the date of enactment of this
Act;
``(6) information on the average time between initial screening
and then diagnosis or rule out for individuals with autism spectrum
disorder or other developmental disabilities, as well as
information on the average time between diagnosis and evidence-
based intervention for individuals with autism spectrum disorder or
other developmental disabilities;
``(7) information on the effectiveness and outcomes of
interventions for individuals diagnosed with autism spectrum
disorder, including by various subtypes, and other developmental
disabilities and how the age of the child may affect such
effectiveness;
``(8) information on the effectiveness and outcomes of
innovative and newly developed intervention strategies for
individuals with autism spectrum disorder or other developmental
disabilities; and
``(9) information on services and supports provided to
individuals with autism spectrum disorder and other developmental
disabilities who have reached the age of majority (as defined for
purposes of section 615(m) of the Individuals with Disabilities
Education Act (20 U.S.C. 1415(m)).''.
(b) Repeals.--The following sections of the Children's Health Act
of 2000 (Public Law 106-310) are repealed:
(1) Section 102 (42 U.S.C. 247b-4b), relating to the
Developmental Disabilities Surveillance and Research Program.
(2) Section 103 (42 U.S.C. 247b-4c), relating to information
and education.
(3) Section 104 (42 U.S.C. 247b-4d), relating to the Inter-
Agency Autism Coordinating Committee.
(4) Section 105 (42 U.S.C. 247b-4e), relating to reports.
SEC. 4. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--Part R of title III of the Public Health Service
Act, as added by section 3, is amended by adding at the end the
following:
``SEC. 399EE. AUTHORIZATION OF APPROPRIATIONS.
``(a) Developmental Disabilities Surveillance and Research
Program.--To carry out section 399AA, there are authorized to be
appropriated the following:
``(1) For fiscal year 2007, $15,000,000.
``(2) For fiscal year 2008, $16,500,000.
``(3) For fiscal year 2009, $18,000,000.
``(4) For fiscal year 2010, $19,500,000.
``(5) For fiscal year 2011, $21,000,000.
``(b) Autism Education, Early Detection, and Intervention.--To
carry out section 399BB, there are authorized to be appropriated the
following:
``(1) For fiscal year 2007, $32,000,000.
``(2) For fiscal year 2008, $37,000,000.
``(3) For fiscal year 2009, $42,000,000.
``(4) For fiscal year 2010, $47,000,000.
``(5) For fiscal year 2011, $52,000,000.
``(c) Interagency Autism Coordinating Committee; Certain Other
Programs.--To carry out section 399CC, 409C, and section 404H, there
are authorized to be appropriated the following:
``(1) For fiscal year 2007, $100,000,000.
``(2) For fiscal year 2008, $114,500,000.
``(3) For fiscal year 2009, $129,000,000.
``(4) For fiscal year 2010, $143,500,000.
``(5) For fiscal year 2011, $158,000,000.''.
(b) Conforming Amendment.--Section 409C of the Public Health
Service Act (42 U.S.C. 284g) is amended by striking subsection (e)
(relating to funding).
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.