Autism CARES Act Of 2014
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The Combating Autism Reauthorization Act of 2014 or Autism Collaboration, Accountability, Research, Education, and Support Act of 2014 or Autism CARES Act of 2014 (; ) is a United States federal law that amended the
Public Health Service Act The Public Health Service Act is a United States federal law enacted in 1944. The full act is codified in Title 42 of the United States Code (The Public Health and Welfare), Chapter 6A (Public Health Service). Contents The act clearly establis ...
to reauthorize research, surveillance, and education activities related to autism spectrum disorders (autism) conducted by various agencies within the
United States Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
(HHS). The bill authorizes $1.3 billion in funding for fiscal years 2015–2019. The bill was introduced and passed in the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
during the
113th United States Congress The 113th United States Congress was a meeting of the legislative branch of the United States federal government, from January 3, 2013, to January 3, 2015, during the fifth and sixth years of Presidency of Barack Obama, Barack Obama's presiden ...
. On August 8, 2014, President
Barack Obama Barack Hussein Obama II ( ; born August 4, 1961) is an American politician who served as the 44th president of the United States from 2009 to 2017. A member of the Democratic Party, Obama was the first African-American president of the U ...
signed the bill into law. The program and funding was once again reauthorized in 2019 with revisions.


Background

The "autism spectrum" or "autistic spectrum" describes a range of conditions classified as
neurodevelopmental disorder Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affect emotion, learning ability, self-control, and memory. The effects of neurodevelopmental ...
s in the fifth revision of the American Psychiatric Association's ''Diagnostic and Statistical Manual of Mental Disorders 5th edition'' (
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...
). The DSM-5, published in 2013, redefined the autism spectrum to encompass the previous (
DSM-IV-TR The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
) diagnoses of
autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
, Asperger syndrome,
pervasive developmental disorder not otherwise specified A pervasive developmental disorder not otherwise specified (Including atypical autism) (PDD-NOS) is one of four disorders which were collapsed into the diagnosis of autism spectrum disorder in the DSM-5 and also was one of the five disorders clas ...
(PDD-NOS), childhood disintegrative disorder, and
Rett syndrome Rett syndrome (RTT) is a genetic disorder that typically becomes apparent after 6–18 months of age and almost exclusively in females. Symptoms include impairments in language and coordination, and repetitive movements. Those affected often h ...
. These disorders are characterized by social deficits and communication difficulties, stereotyped or repetitive behaviors and interests, and in some cases, cognitive delays. A
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
study found that 1 in every 59 American children have autism. The first federal autism research programs were created by the Autism Statistics, Surveillance, Research and Epidemiology Act ().


Provisions of the law

The law reauthorizes for five years existing federal autism research and assistance programs that would otherwise expire on October 1, 2014. The law requires the Secretary of Health and Human Services to assign a deputy to be in charge of organizing and monitoring all federal research and autism services to ensure that they do not overlap and duplicate each other. This provision was written in reaction to a "
Government Accountability Office The U.S. Government Accountability Office (GAO) is a legislative branch government agency that provides auditing, evaluative, and investigative services for the United States Congress. It is the supreme audit institution of the federal govern ...
finding last year that 84 percent of current autism research projects have potential to overlap."


Congressional Budget Office report

''This summary is based largely on the summary provided by the Congressional Budget Office, as ordered reported by the House Committee on Energy and Commerce on June 10, 2014 and then revised on June 20, 2014 to correct an error in the previous estimate. This is a
public domain The public domain (PD) consists of all the creative work A creative work is a manifestation of creative effort including fine artwork (sculpture, paintings, drawing, sketching, performance art), dance, writing (literature), filmmaking, ...
source.'' The law amends the
Public Health Service Act The Public Health Service Act is a United States federal law enacted in 1944. The full act is codified in Title 42 of the United States Code (The Public Health and Welfare), Chapter 6A (Public Health Service). Contents The act clearly establis ...
to reauthorize research, surveillance, and education activities related to autism spectrum disorders (autism) conducted by various agencies within the
United States Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
(HHS). Those activities are conducted by the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
, the
Health Resources and Services Administration The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services located in North Bethesda, Maryland. It is the primary federal agency for improving access to health care services for peop ...
, and the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
. The law authorizes appropriations for autism activities at HHS of $260 million in 2015 and $1.3 billion over the 2015–2019 period. The Congressional Budget Office (CBO) estimates that it would cost $1.1 billion over the 2015–2019 period, assuming appropriation of the authorized amounts. Pay-as-you-go procedures do not apply to this legislation because it would not affect direct spending or revenues. The law contains no intergovernmental or private-sector mandates as defined in the
Unfunded Mandates Reform Act The Unfunded Mandates Reform Act of 1995 (UMRA''(pdf)https://www.govinfo.gov/content/pkg/USCODE-1995-title2/html/USCODE-1995-title2-chap25.htm (text)] restricts the federal government of the United States, federal imposition of unfunded mandates on ...
.


Procedural history

The Combating Autism Reauthorization Act of 2014 was introduced into the
United States House of Representatives The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
on May 9, 2014, by Chris Smith (New Jersey politician), Rep. Christopher H. Smith (R, NJ-4). It was referred to the
United States House Committee on Energy and Commerce The Committee on Energy and Commerce is one of the oldest standing committees of the United States House of Representatives. Established in 1795, it has operated continuously—with various name changes and jurisdictional changes—for more tha ...
and the United States House Energy Subcommittee on Health. It was reported (amended) alongside House Report 113–490 on June 23, 2014, with a title change to "Autism Collaboration, Accountability, Research, Education, and Support Act of 2014". On June 24, 2014, the House voted to pass the bill in a
voice vote In parliamentary procedure, a voice vote (from the Latin ''viva voce'', meaning "live voice") or acclamation is a voting method in deliberative assemblies (such as legislatures) in which a group vote is taken on a topic or motion by responding vo ...
. The
United States Senate The United States Senate is the upper chamber of the United States Congress, with the House of Representatives being the lower chamber. Together they compose the national bicameral legislature of the United States. The composition and pow ...
voted with unanimous consent to pass the bill on July 31, 2014. President
Barack Obama Barack Hussein Obama II ( ; born August 4, 1961) is an American politician who served as the 44th president of the United States from 2009 to 2017. A member of the Democratic Party, Obama was the first African-American president of the U ...
signed the bill into law on August 8, 2014.


Debate and discussion

Rep.
Michael F. Doyle Michael F. Doyle Jr. (born August 5, 1953) is an American politician who is the United States House of Representatives, U.S. representative for , serving since 1995. He is a member of the Democratic Party (United States), Democratic Party. The ...
(D-PA), who co-sponsored the bill, said that "every time new data is realized on autism spectrum disorders, the numbers become more and more troubling... this is why passage of the Autism Cares Act today is so important to continue research into the causes of autism." Rep. Chris Smith, who introduced the bill, argued that "this is a critical investment that is working to determine the cause of ASD, identify autistic children as early as possible to begin treatment, and producing better awareness, new therapies and effective services. The quality of life of many children is at stake, as it is with young adults who age out of the support services in educational systems." Liz Feld, the President of Autism Speaks, spoke in favor of the bill saying that the group "commends Representatives Smith and Doyle for their bipartisan leadership in spearheading this more aggressive federal response to autism." The
Autism Society of America The Autism Society of America (ASA) was founded in 1965 by Bernard Rimland and Ivar Lovaas together with Ruth C. Sullivan and a small group of other parents of children with autism. Its original name was the National Society for Autistic Childre ...
also supported the bill. Rep.
Bill Posey William Joseph Posey (born December 18, 1947) is an American businessman and politician serving as the U.S. representative for , in Congress since 2009. A member of the Republican Party, he formerly served in the Florida Senate and the Florida ...
(R-FL) wrote an op-ed in '' The Hill'' arguing that the bill needed to be rewritten and improved. Posey argued that, after a federal program spent eight years and $1.7 billion trying to address the autism crisis and failed to do so, Washington was "on a path to rush through a five-year reauthorization, raise spending 20 percent and hope for better results without addressing fundamental structural flaws in the current program." According to Posey, one flaw with the current system is that while the
Interagency Autism Coordinating Committee The Interagency Autism Coordinating Committee (IACC) is a United States federal advisory panel within the Department of Health and Human Services (HHS). It coordinates all efforts within HHS concerning autism spectrum disorder (ASD). The IACC was ...
is charged with writing a strategic plan for organizing the research and spending on autism, the federal government ignores that strategy to have the National Institutes of Health instead, resulting in money being spend in a disjointed manner. Posey argued that he would like to take the time to improve this bill, possibly using some of the improvements suggested by the Autism Reform Policy Coalition, instead of moving forward too hastily with this bill.


Reauthorization in 2019

In 2019, H.R. 1058, the ''Autism CARES Act of 2019'' (aka. the ''Autism Collaboration, Accountability, Research, Education, and Support Act of 2019'' or the ''Autism CARES Act of 2019 Autism Collaboration, Accountability, Research, Education, and Support Act of 2019'') once again reauthorized the program and funding. Specifically, the bill reauthorized provisions relating to expanded ASD research at the National Institutes of Health; the collection of state-level ASD data by the Centers for Disease Control and Prevention; ASD education, early detection, and intervention activities supported by the Health Resources and Services Administration; and the Interagency Autism Coordinating Committee. The bill also generally revises the scope of those programs and activities to encompass ASD individuals of all ages, rather than only youth; focus funding on programs in areas with a shortage of personal health services; and reduce health-outcome disparities across diverse populations.


See also

* List of bills in the 113th United States Congress


References


External links


Library of Congress – Thomas H.R. 4631beta.congress.gov H.R. 4631GovTrack.us H.R. 4631OpenCongress.org H.R. 4631Congressional Budget Office's report on H.R. 4631
{{DEFAULTSORT:Autism CARES Act of 2014 (H.R. 4631 113th Congress) United States federal health legislation Acts of the 113th United States Congress Autism in the United States