Autism CARES Act Hits Hiccups in Congress

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Alright, so if you follow national autism news then you probably heard this. I think it is sad that while millions of Autism families depend on this act – few have decided to just hijack it without offering alternatives. 

First, I think the amended version of HR 4631 which passed necessary committees and passed the house floor has everything possible the autism community needs. It increased the IACC public membership to include people from the majority and minority leadership in Congress, it includes a specific person designated for autism within HHS, it has language specific for adults with autism, it has more comprehensive language for education, work, housing, safety and treatments. It even has language stating awareness, training and treatment should be culturally competent. I mean what the heck more do we need – really? Well – I would not mind adding more research on why autism racial disparity is prevalent and solutions on fixing that, plus cost of autism racial disparity. Imagine if Sen Franken actually spoke for his Somali voters and added an amendment asking for that. Don’t hold your breath waiting for it though. It ain’t going to happen which is why we need to vote Franken out.
HR 4631 needs a Senate version which is S2449 and is very similar, and passed through HELP committee – but on its way to the Senate floor was derailed by few autism groups and parents. Now, I know autism is complicated, complex and confusing and as parents we are tired and frustrated beyond words can express, but as an IACC public member – I try to see issues from other’s perspective. For example, some are always saying the last autism act did not help and CDC did not prevent one single autism case. Let’s think through this for a minute – the rate now is 1 in 68 nationally. Maybe CDC’s Learn the signs and act early assured some kids to get diagnosed early and get early intervention whereby they did not develop full blown autism symptoms. Couldn’t one then argue CDC has prevented severe autism cases. Because if they didn’t would the rate be higher? 
It is easy to blame CDC, but I am not sure what else they can do. They count numbers and tell us what they are. They are getting much better with their awareness campaign and they are even realizing they need more diverse staff/leadership in their autism area. What more do we want from them. Really I am asking because it is easier to blame a government agency without real questions.
And in terms of NIH doing research. Let’s think through this rationally because if you look at other chronic medical conditions such as diabetes, aids or cancer which all have much more funding than autism, there is still no known prevention or cure that is 100% correct. And, these conditions have more research under their belt in comparison to autism which as Dr. Insel always says is infantile stage of research. For autism – we know there is a genetic and an environmental component, but if we confuse the already confused and short term memory congress members by bombarding them with calls to not approve what little we have – then how can autism research move forward. 
I understand again the level of frustration and worry that comes with our kiddos with more severe autism, but we can’t keep biting the hand that is helping us without any specific ideas. For example, what exactly are these groups looking to accomplish other than eliminate the whole autism research and services funding? I ask them in a gentle and friendly manner to send specific questions and concerns to the Senate authors rather than just telling their readers to call Congress asking to not vote for the whole bill because that does not help anyone including the families they are fighting for. 
Anyway, I hope this bill gets passed out of the Senate floor and goes to the President for signature before the current Act expires Sept 30, 2014, then we have nothing. Is that what we want?
Below is some of the language of the current version of this legislation: I have highlighted issues that are important to me
   2015     2016     2017     2018     2019   2015-2019
—————————————————————————————————————-
                                 CHANGES IN SPENDING SUBJECT TO APPROPRIATION

CDC:
   Authorization Level……………………………       22       22       22       22       22       110
   Estimated Outlays……………………………..       10       20       20       20       20        90
HRSA:
 &
nbsp; Authorization Level……………………………       48       48       48       48       48       240

   Estimated Outlays……………………………..       25       45       45       50       50       215
NIH:
   Authorization Level……………………………      190      190      190      190      190       950
   Estimated Outlays……………………………..       50      150      180      185      190       755
   Total Changes:
       Authorization Level………………………..      260      260      260      260      260     1,300
       Estimated Outlays………………………….       85      215      245      255      260    1,060

The CDC currently administers several surveillance and
research programs directed at determining the prevalence of
autism and the risk factors for developing autism, as well as
raising awareness of the signs of autism for families, health
care providers, and childcare educators. Congress
appropriated approximately $22 million for those activities in
fiscal year 2014. The bill would authorize the appropriation of
$22 million annually over the 2015-2019 period for such
programs. CBO estimates that implementing those provisions
would cost $90 million over the 2015-2019 period.
   HRSA currently operates several programs to train health
care providers in the delivery of care to children with autism
and other developmental disabilities. Congress appropriated
approximately $47 million for those activities in fiscal year
2014. The legislation would authorize the appropriation of $48
million for each of fiscal years 2015 through 2019 for HRSA to
continue such activities. CBO estimates that implementing those
provisions would cost $215 million over the 2015-2019 period.
   H.R. 4631 also would reauthorize programs and activities
carried out by NIH to advance autism research and treatment
including the Autism Centers of Excellence program. The
Congress appropriated $190 million for those activities in
fiscal year 2014. The bill would authorize the appropriation of
$190 million for each of fiscal years 2015 through 2019 for NIH
to continue such activities. CBO estimates that implementing
those provisions would cost $755 million over the 2015-2019
period.

   Section
2 would require the Secretary to appoint an

existing official to oversee the activities related to autism
including the strategic plan and ensure the elimination of
unnecessary duplication in activities.

Section 4. Autism intervention

   Section 4 would require that activities related to autism
early education, early detection, and intervention be
culturally competent.
The bill also would provide for the
identification of evidence-based practices and the training of
respite caregivers.

Section 5. Interagency Autism Coordinating Committee

   Section 5 would require the IACC, as part of its
responsibilities, to include school and community-based
interventions in the summary of advances; monitor research,
services, and support activities across Federal departments and
agencies; and include a plan for the conduct of and support for
ASD research and services and supports for individuals with ASD
and their families in the strategic plan.

SEC. 399BB. AUTISM EDUCATION, EARLY DETECTION, AND INTERVENTION.

 (a) * * *
 (b) In General.–The Secretary shall, subject to the
availability of appropriations, establish and evaluate
activities to–
         (1) provide culturally competent information and
       education on autism spectrum disorder and other
       developmental disabilities to increase public awareness
       of developmental milestones;


 (f) Intervention.–The Secretary shall promote research,
through [grants or contracts, to determine the evidence-based
practices for interventions for individuals with] grants or
contracts, which may include grants or contracts to research
centers or networks, to determine the evidence-based practices
for interventions to improve the physical and behavioral health
of individuals with autism spectrum disorder or other
developmental disabilities, develop guidelines for those
interventions, and disseminate information related to such
research and guidelines.

(6) submit to Congress and the President–
                 (A) an annual update on the summary of
               advances described in paragraph (2); and
                 ( an annual update to the strategic plan
               described in paragraph (5), including any
               progress made in achieving the goals outlined
               in such strategic plan

(b) Report on Young Adults and Transitioning Youth.–
         (1) In general.–Not later than 2 years after the
       date of enactment of the Autism CARES Act of 2014, the
       Secretary, in coordination with the Secretary of
       Education and in collaboration with the Secretary of
       Transportation, the Secretary of Labor, the Secretary
       of Housing and Urban Development, and the Attorney
       General, 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 young adults
       with autism spectrum disorder and the challenges
       related to the transition from existing school-based
       services to those services available during adulthood.
         (2) Contents.–The report submitted under paragraph
       (1) shall contain–
                 (A) demographic characteristics of youth
               transitioning from school-based to community-
               based supports;
                 ( an overview of policies and programs
               relevant to young adults with autism spectrum
               disorder relating to post-secondary school
               transitional services, including an
               identification of existing Federal laws,
               regulations, policies, research, and programs;

(D) comprehensive approaches to transitioning
               from existing school-based services to those
               services available during adulthood,
               including–
                         (i) services that increase access to,
                       and improve integration and completion
                       of, post-secondary education, peer
                       support, vocational training (as
                       defined in section 103 of the
                       Rehabilitation Act of 1973 (29 U.S.C.
                       723)), rehabilitation, self-advocacy
                       skills, and competitive, integrated
                       employment;
                         (ii) community-based behavioral
                       supports and interventions;
                         (iii) community-based integrated
                       residential services, housing, and
                       transportation;
                         (iv) nutrition, health and wellness,
                       recreational, and social activities;
                         (v) personal safety services for
                       individuals with autism spectrum
                       disorder related to public safety
                       agencies or the criminal justice
                       system

If
you want to read the whole bill click here.
Above words do not reflect any committee, agency or candidate.
Thanks!
Idil – Somali Autism Mom & Minority Advocate

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