Combating Autism Act

The Combating Autism Act of 2006, Pub. Law No. 109-416, is an Act of Congress (Senate Bill 843) that was signed into law by President George W. Bush on December 19, 2006. It authorizes nearly one billion dollars in expenditures, over five years beginning in 2007, to combat the autism spectrum disorders of autism, Aspergers syndrome, Rett syndrome, childhood disintegrative disorder, and PDD-NOS through screening, education, early intervention, prompt referrals for treatment and services, and research.

Legislative history
The bill was introduced in the Senate by Senators Rick Santorum, R-PA and Christopher Dodd, D-CT and passed the upper chamber unanimously in August 2006.

The House version, H.R. 2421, was introduced by Congresswomen Mary Bono, R-CA and Diana DeGette, D-CO and was passed by the lower chamber on December 6, 2006. The House version differed slightly from the Senate version, directing funds for research to the Secretary of Health and Human Services, rather than directly to the National Institutes of Health.

"By passing this landmark single-disease legislation, the House has recognized the daily plight of the thousands of families struggling every day with autism, and has once and for all acknowledged autism as a national healthcare crisis," said Bob Wright, co-founder of Autism Speaks and chairman and CEO of NBC Universal.

The House passed a version that would grant more authority to scientists to determine research priorities, whereas the Senate's original measure would have included funds for expansion of research into the causes of autism. Over the objections of many parents and some researchers, these provisions were eventually stripped from the bill by the House.

The revised bill, ultimately approved by the Senate, did not include the provisions that would have specified funding for investigating possible environmental causes. Medical authorities have shunned attempts, advocated primarily by the parents of children with autism and a minority of autism researchers, to expand autism research that may detect environmental causes. Citing what critics describe as flawed or inconclusive epidemiological studies beset by conflict of interest shortcomings, government health agencies have blocked the funding of some research into possible environmental causes of autism, such as thimerosal (a vaccine preservative) and the rapid expansion of vaccination schedules in recent years.

"This bill is a federal declaration of war on the epidemic of autism", said Jon Shestack, co-founder of Cure Autism Now. "It creates a congressionally mandated roadmap for a federal assault on autism, including requirements for strategic planning, budget transparency, Congressional oversight, and a substantial role for parents of children with autism in the federal decision-making process."

Until early December of 2006, House Energy and Commerce Committee Chairman Joe Barton (R-Texas) had refused to release the Combating Autism Act from his committee for consideration by the full House of Representatives this session.

Provisions
The Act provides money for the Centers for Disease Control (CDC) to conduct epidemiological surveillance programs and would re-authorize the Interagency Autism Coordinating Committee (IACC) to coordinate all efforts within the Department of Health and Human Services concerning autism, including activities carried out through the National Institutes of Health (NIH) and the CDC.

The Combating Autism Act allocates approximately $950 million in spending on autism over five years, approximately doubling expenditures on existing programs; this includes a significant increase in spending for biomedical research in autism.

The Act requires the director of NIH to develop and implement a strategic plan for autism research and a budget to fund this plan. The plan and budget would have to take into account recommendations of a public/private committee, the Interagency Autism Coordinating Committee, which itself would have to include at least one-third public members, a person with autism, and a person who is the parent of a child with autism. The act provides grant programs for states to develop autism screening, early diagnosis, and intervention programs for children.

The act also authorizes:


 * The Director of the NIH to create an “Autism Czar”, who would coordinate NIH based-research and oversee development and budgeting of autism research and would increase the number of Centers of Excellence on Autism from eight to ten.
 * An information and education program and its risk factors to be provided by the Department of Health and Human Services (HHS) to health professionals and the general public.
 * Commitment of $75 million a year by the Health Resources and Services Administration (HRSA), for each of the next five years, for grants for states to develop autism screening, diagnosis, and intervention programs, and to create statewide screening systems to ensure all children are screened for autism by the age of two.
 * $25 million a year, for five years, for technical assistance and data management to states for autism screening, diagnosis and intervention programs.

The Act reauthorizes, for five years, the $12 million annual funding for the epidemiological surveillance program for autism, overseen by the Centers for Disease Control’s (CDC).

Provision removed from Senate version
The final version of the Combating Autism Act passed by the House and Senate eliminated a provision, originally included in the Senate bill, that would have created a legal requirement for the Centers of Excellence in Environmental Health and Autism to research "a broad array of environmental factors that may have a possible role in autism spectrum disorders." These Centers would have authorized with funding of $45 million over the five-year life of the bill.

Opposition
The Combating Autism Act was opposed by many in the autism rights movement, some of whom view its provisions aimed at eliminating autism as one more step toward genocide or eugenics directed at autistic people. Such advocates believe that autism should be accommodated, not combated.