Office of Congressional and Government Affairs (OCGA)
The Office of Congressional and Government Affairs (OCGA) is the principal liaison office between the National Academies of Sciences, Engineering, and Medicine and Capitol Hill.
The Office of Congressional and Government Affairs (OCGA) is the principal liaison office between the National Academies of Sciences, Engineering, and Medicine and Capitol Hill.
Consensus
Military families raising children with autism often face unique challenges in accessing consistent, high-quality care across frequent moves and deployments. Applied behavior analysis, or ABA, is widely recognized as an effective intervention for many autistic individuals, yet military families report barriers that delay or restrict their access to these services.
The report The Comprehensive Autism Care Demonstration: Solutions for Military Families examines how the Department of Defense's autism care demonstration program is serving families and whether ABA should be covered as a TRICARE Basic benefit. Drawing on a careful review of the scientific literature, the report finds that ABA meets the Department's own standards for reliable medical evidence and should be formally authorized as a TRICARE Basic benefit.
The report identifies key areas where current demonstration policies differ from clinical standards. These include restrictive rules around assessments, limited flexibility in treatment goals and settings, and administrative requirements that impose unnecessary burdens on both families and ABA providers.
336 pages
·
6 x 9
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paperback
ISBN Paperback: 0-309-99314-8
ISBN Ebook: 0-309-99315-6
DOI:
https://doi.org/10.17226/29139
National Academies of Sciences, Engineering, and Medicine. 2025. The Comprehensive Autism Care Demonstration: Solutions for Military Families. Washington, DC: The National Academies Press.
Import this citation to:
James M. Inhofe National Defense Authorization Act for Fiscal Year
2023
Public Law 117-263
The following are excerpts, highlighted in red, from the final legislation and/or conference report which contain references to and studies for The National Academies of Sciences, Engineering, and Medicine. (Pound signs [##] between passages denote the deletion of unrelated text.)
HR7776 DeFazio
(D-Ore.) 12/20/22
Enrolled
(finally passed both houses)
To authorize appropriations for
fiscal year 2023 for military activities of the Department of
Defense, for military construction, and for defense activities of
the Department of Energy, to prescribe military personnel strengths
for such fiscal year, and for other purposes..
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SEC. 223. REPORT AND PILOT PROGRAM BASED ON RECOMMENDATIONS REGARDING DEFENSE RESEARCH CAPACITY AT HISTORICALLY BLACK COLLEGES AND UNIVERSITIES AND OTHER MINORITY-SERVING INSTITUTIONS
(a) REPORT REQUIRED
(1) IN GENERAL.—Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall submit to the congressional defense committees a report on the recommendations set forth in the publication of the National Academies of Sciences, Engineering, and Medicine titled “Defense Research Capacity at Historically Black Colleges and Universities and Other Minority Institutions: Transitioning from Good Intentions to Measurable Outcomes” and dated April 28, 2022.
(2) CONTENTS.—The report required under paragraph (1) shall include the following:
(A) With respect to the recommendations and subrecommendations set forth in the publication described in paragraph (1)—
(i) a description of each recommendation and subrecommendation the
Secretary has implemented as of the date of the report;
(ii) a
description of each recommendation and subrecommendation the
Secretary has commenced implementing as of the date of the report,
including a justification for determining to commence implementing
the recommendation; and
(iii) a description of each
recommendation and subrecommendation the Secretary has not
implemented or commenced implementing as of the date of the report
and a determination as to whether or not to implement the
recommendation.
(B) For each recommendation or subrecommendation the Secretary determines to implement under subparagraph (A)(iii)—
(i) a timeline for implementation;
(ii) a description of any
additional resources or authorities required for implementation;
and
(iii) the plan for implementation.
(C) For each recommendation or subrecommendation the Secretary determines not to implement under subparagraph (A)(iii), a justification for the determination not to implement the recommendation.
(3) FORMAT.—The report required under paragraph (1) shall be submitted in unclassified form, but may include a classified annex.
######
SEC. 239. REPORT ON RECOMMENDATIONS FROM ARMY FUTURES COMMAND RESEARCH PROGRAM REALIGNMENT STUDY
(a) REPORT REQUIRED.—Not later than 180 days after the date of the enactment of this Act, the Secretary of the Army shall submit to the congressional defense committees a report on the recommendations set forth in the publication of the National Academies of Sciences, Engineering, and Medicine titled “Consensus Study Report: U.S. Army Futures Command Research Program Realignment” and dated April 23, 2022.
(b) CONTENTS.—The report submitted under subsection (a) shall include the following:
(1) A description of each recommendation described in such
subsection that has already been implemented.
(2) A description
of each recommendation described in such subsection that the
Secretary has commenced implementing, including a justification for
determining to commence implementing the recommendation.
(3) A
description of each recommendation described in such subsection that
the Secretary has not implemented or commenced implementing and a
determination as to whether or not to implement the
recommendation.
(4) .—For each recommendation under paragraph
(3) the Secretary determines to implement, the following:
(A) A timeline for implementation.
(B) A description of any
additional resources or authorities required for implementation.
(C)
The plan for implementation.
(5) For each recommendation under paragraph (3) the Secretary determines not to implement, a justification for the determination not to implement.
(c) FORMAT.—The report required by subsection (a) shall be submitted in unclassified form, but may include a classified annex.
######
SEC. 732. INDEPENDENT ANALYSIS OF DEPARTMENT OF DEFENSE COMPREHENSIVE AUTISM CARE DEMONSTRATION PROGRAM
Section 737 of the National Defense Authorization Act for Fiscal Year 2022 (Public Law 117-81; 135 Stat. 1800) is amended—
(1) .—in subsection (b)(2)—
(A) in subparagraph (A)—
(i) by inserting “broadly” after “disorder”; and
(ii) by
striking “demonstration project” and inserting “demonstration
program”;
(B) in subparagraph (B), by striking “demonstration project” and inserting “demonstration program”;
(C) in subparagraph (C), by inserting “parental involvement in applied behavioral analysis treatment, and” after “including”;
(D) in subparagraph (D), by striking “for an individual who has” and inserting “, including mental health outcomes, for individuals who have”;
(E) in subparagraph (E), by inserting “since its inception” after “demonstration program”;
(F) in subparagraph (F), by inserting “cost effectiveness, program effectiveness, and clinical” after “measure the”;
(G) in subparagraph (G), by inserting “than in the general population” after “families”;
(H) by redesignating subparagraph (H) as subparagraph (I); and
(I) by inserting after subparagraph (G) the following new subparagraph (H):
“(H) An analysis of whether the diagnosis and treatment of autism is higher among the children of military families than in the general population.
(2) in subsection (c), in the matter preceding paragraph (1), by striking “nine” and inserting “31”.
######
SEC. 735. BRAIN HEALTH INITIATIVE OF DEPARTMENT OF DEFENSE
(a) IN GENERAL.—The Secretary of Defense, in consultation with the Secretaries concerned, shall establish a comprehensive initiative for brain health to be known as the “Warfighter Brain Health Initiative” (in this section referred to as the “Initiative”) for the purpose of unifying efforts and programs across the Department of Defense to improve the cognitive performance and brain health of members of the Armed Forces.
(b) OBJECTIVES.—The objectives of the Initiative shall be the following:
(1) .—To enhance, maintain, and restore the cognitive performance of members of the Armed Forces through education, training, prevention, protection, monitoring, detection, diagnosis, treatment, and rehabilitation, including through the following activities:
(A) The establishment of a program to monitor cognitive brain
health across the Department of Defense, with the goal of detecting
any need for cognitive enhancement or restoration resulting from
potential brain exposures of members of Armed Forces, to mitigate
possible evolution of injury or disease progression.
(B) The
identification and dissemination of thresholds for blast pressure
safety and associated emerging scientific evidence.
(C) The
modification of high-risk training and operational activities to
mitigate the negative effects of repetitive blast exposure.
(D)
The identification of individuals who perform high-risk training or
occupational activities, for purposes of increased monitoring of the
brain health of such individuals.
(E) The development and
operational fielding of non-invasive, portable, point-of-care
medical devices, to inform the diagnosis and treatment of traumatic
brain injury.
(F) The establishment of a standardized
monitoring program that documents and analyzes blast exposures that
may affect the brain health of members of the Armed Forces.
(G) The consideration of the findings and recommendations of
the report of the National Academies of Science, Engineering,
and Medicine titled “Traumatic Brain Injury: A Roadmap for
Accelerating Progress” and published in 2022 (relating to the
acceleration of progress in traumatic brain injury research and
care), or any successor report, in relation to the activities of
the Department relating to brain health, as applicable.
(2) To harmonize and prioritize the efforts of the Department of Defense into a single approach to brain health.
(c) ANNUAL BUDGET JUSTIFICATION DOCUMENTS.—In the budget justification materials submitted to Congress in support of the Department of Defense budget for each of fiscal years 2025 through 2029 (as submitted with the budget of the President under section 1105(a) of title 31, United States Code), the Secretary of Defense shall include a budget justification display that includes all activities of the Department relating to the Initiative.
######
SEC. 744. CAPABILITY ASSESSMENT AND ACTION PLAN WITH RESPECT TO EFFECTS OF EXPOSURE TO OPEN BURN PITS AND OTHER ENVIRONMENTAL HAZARDS
(a) IN GENERAL.—Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall—
######
(5) .—With respect to the conduct of research, the following:
(A) An assessment of the potential use of the Airborne Hazards and
Open Burn Pit Registry for research on monitoring and identifying
the health consequences of exposure to open burn pits.
(B) An
analysis of options for increasing the amount and the relevance of
additional research into the health effects of open burn pits and
effective treatments for such health effects.
(C) An evaluation
of potential research of biomarker monitoring to document
environmental exposures during deployment or throughout the military
career of a member of the Armed Forces.
(D) An analysis of
potential organizational strengthening with respect to the
management of research on environmental exposure hazards, including
the establishment of a joint program executive office for such
management.
(E) An assessment of the findings and recommendations of the
2020 report by the National Academies of Science, Engineering,
and Medicine titled “Respiratory Health Effects of Airborne
Hazards Exposures in the Southwest Asia Theater of Military
Operations”.
(6) An evaluation of such other matters as the Secretary of Defense determines appropriate to ensure a comprehensive review of activities relating to the effects of exposure to open burn pits and other environmental hazards.
######
SEC. 3526. GAO REVIEW OF FEDERAL EFFORTS TO ENHANCE PORT INFRASTRUCTURE RESILIENCY AND DISASTER PREPAREDNESS
(a) REVIEW.—The Comptroller General of the United States shall conduct a review of Federal efforts to assist ports in enhancing the resiliency of key intermodal connectors to weather-related disasters. The review shall include an analysis of the following:
(1) Actions being undertaken at various ports to better identify
critical land-side connectors that may be vulnerable to disruption
in the event of a natural disaster, including how to communicate
such information during a disaster when communications systems may
be compromised, and the level of Federal involvement in such
actions.
(2) The extent to which the Department of Transportation and
other Federal agencies are working in line with recent
recommendations from key resiliency reports, including the
National Academies of Science study on strengthening supply
chain resilience, to establish a framework for ports to follow
to increase resiliency to major weather-related disruptions
before such disruptions happen.
(3) The extent to which the Department of Transportation or other
Federal agencies have provided funds to ports for resiliency-related
projects.
(4) The extent to which Federal agencies have a
coordinated approach to helping ports and the multiple State, local,
Tribal, and private stakeholders involved, to improve resiliency
prior to weather-related disasters.
(b) REPORT.—Not later than 18 months after the date of the enactment of this Act, the Comptroller General shall submit to the Committee on Commerce, Science, and Transportation of the Senate and the Committee on Transportation and Infrastructure of the House of Representatives a report containing the results of the review required under subsection (a).
######
SEC. 5305. FAIRNESS FOR FEDERAL FIREFIGHTERS
######
“(B) BASIS FOR DETERMINATION.—The Secretary shall add an illness or disease to the list established under paragraph (2) based on the weight of the best available scientific evidence that there is a significant risk to employees in fire protection activities of developing that illness or disease.
“(C) AVAILABLE EXPERTISE.—In determining significant risk for purposes of subparagraph (B), the Secretary may accept as authoritative, and may rely upon, recommendations, risk assessments, and scientific studies (including analyses of National Firefighter Registry data pertaining to Federal firefighters) by the National Institute for Occupational Safety and Health, the National Toxicology Program, the National Academies of Sciences, Engineering, and Medicine, and the International Agency for Research on Cancer.
######
SEC. 5913. NATIONAL RESEARCH AND DEVELOPMENT STRATEGY FOR DISTRIBUTED LEDGER TECHNOLOGY
######
(b) NATIONAL DISTRIBUTED LEDGER TECHNOLOGY RESEARCH AND DEVELOPMENT STRATEGY
(1) IN GENERAL.—The Director, or a designee of the Director, shall, in coordination with the National Science and Technology Council, and the heads of such other relevant Federal agencies and entities as the Director considers appropriate, which may include the National Academies, and in consultation with such nongovernmental entities as the Director considers appropriate, develop a national strategy for the research and development of distributed ledger technologies and their applications, including applications of public and permissionless distributed ledgers. In developing the national strategy, the Director shall consider the following:
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DIVISION K - DON YOUNG COAST GUARD AUTHORIZATION ACT OF 2022
######
SEC. 11225. ESTABLISHMENT OF UNMANNED SYSTEM PROGRAM AND AUTONOMOUS CONTROL AND COMPUTER VISION TECHNOLOGY PROJECT
######
(c) SUBMISSION TO CONGRESS.—Not later than 180 days after the date of enactment of this Act, the Commandant shall submit to the Committee on Transportation and Infrastructure of the House of Representatives and the Committee on Commerce, Science, and Transportation of the Senate a detailed description of the strategy of the Coast Guard to implement unmanned systems across mission areas, including—
(1) the steps taken to implement actions recommended in the
consensus study report of the National Academies of Sciences,
Engineering, and Medicine titled “Leveraging Unmanned Systems for
Coast Guard Missions: A Strategic Imperative”, published on November
12, 2020;
(2) the strategic goals and acquisition strategies for
proposed uses and procurements of unmanned systems;
(3) a
strategy to sustain competition and innovation for procurement of
unmanned systems and services for the Coast Guard, including
defining opportunities for new and existing technologies; and
(4)
an estimate of the timeline, costs, staff resources, technology, or
other resources necessary to accomplish the strategy.
######
Subtitle H-Sexual Assault and Sexual Harassment Response and Prevention
SEC. 11272. ADMINISTRATION OF SEXUAL ASSAULT FORENSIC EXAMINATION KITS
######
“564. Administration of sexual assault forensic examination kits.
(c) STUDY
(1) IN GENERAL.—Not later than 1 year after the date of the enactment of this Act, the Secretary shall seek to enter into an agreement with the National Academy of Sciences under which the National Academy of Sciences shall conduct a study to assess challenges and prospective solutions associated with sexual assault at sea, to include the provision of survivor care, forensic examination of the victim, and evidence collection.
(2) CONTENTS.—The study under paragraph (1) shall, at a minimum, address the feasibility of crisis response services and physical evaluation through telemedicine and other options concerning immediate access to care whether onboard the vessel or at the nearest shore side facility, including best practices for administering sexual assault forensic examinations.
(3) ELEMENTS.—The study under paragraph (1) shall—
(A) take into account—
(i) the safety and security of the alleged victim of sexual
assault;
(ii) the ability to properly identify, document, and
preserve any evidence relevant to the allegation of sexual
assault;
(iii) the applicable criminal procedural laws relating
to authenticity, relevance, preservation of evidence, chain of
custody, and any other matter relating to evidentiary admissibility;
and
(iv) best practices of conducting sexual assault forensic
examinations, as such term is defined in section 40723 of title 34,
United States Code;
(B) provide any appropriate recommendation for changes to existing laws, regulations, or employer policies;
(C) solicit public stakeholder input from individuals and organizations with relevant expertise in sexual assault response including healthcare, advocacy services, law enforcement, and prosecution;
(D) evaluate the operational capabilities of the Coast Guard since 2013 in providing alleged victims of sexual assault immediate access to care onboard a vessel undertaking a prescheduled voyage that, at any point during such voyage, would require the vessel to travel 3 consecutive days or longer to reach a land-based or afloat medical facility, including—
(i) the average of and range in the reported hours taken to
evacuate an individual with any medical emergency to a land-based or
afloat medical facility; and
(ii) the number of alleged
victims, subjects, and total incidents of sexual assault and sexual
harassment occurring while underway reported annually; and
(E) summarize the financial cost, required operational adjustments, and potential benefits to the Coast Guard to provide sexual assault forensic examination kits onboard Coast Guard vessels undertaking a prescheduled voyage that, at any point during such voyage, would require the vessel to travel 3 consecutive days or longer to reach a land-based or afloat medical facility.
(4) REPORT.—Upon completion of the study under paragraph (1), the National Academy of Sciences shall submit to the Committee on Commerce, Science, and Transportation of the Senate, the Committee on Transportation and Infrastructure of the House of Representatives, and the Secretary a report on the findings of the study.
(5) ANNUAL REPORT.—The Commandant shall submit to the Transportation and Infrastructure Committee of the House and the Commerce, Science, and Transportation Committee of the Senate a report containing the number of sexual assault forensic examinations that were requested by, but not administered within 3 days to, alleged victims of sexual assault when such victims were onboard a vessel.
(6) SAVINGS CLAUSE.—In collecting the information required under paragraphs (2) and (3), the Commandant shall collect such information in a manner which protects the privacy rights of individuals who are subjects of such information.
######
SEC. 11319. STUDY ON IMPACTS ON SHIPPING AND COMMERCIAL, TRIBAL, AND RECREATIONAL FISHERIES FROM DEVELOPMENT OF RENEWABLE ENERGY ON WEST COAST
(a) STUDY.—Not later than 180 days after the date of enactment of this Act, the Secretary, the Secretary of the Interior, and the Under Secretary of Commerce for Oceans and Atmosphere, shall seek to enter into an agreement with the National Academies of Science, Engineering, and Medicine under which the National Academy of Sciences, Engineering, and Medicine shall carry out a study to—
(1) .—identify, document, and analyze—
(A) historic and current, as of the date of the study, Tribal,
commercial, and recreational fishing grounds, as well as areas where
fish stocks are likely to shift in the future in all covered
waters;
(B) usual and accustomed fishing areas in all covered
waters;
(C) historic, current, and potential future shipping
lanes, based on projected growth in shipping traffic in all covered
waters;
(D) current and expected Coast Guard operations
relevant to commercial fishing activities, including search and
rescue, radar, navigation, communications, and safety within and
near renewable energy sites; and
(E) key types of data needed
to properly site renewable energy sites on the West Coast, with
regard to assessing and mitigating conflicts;
(2) .—analyze—
(A) methods used to manage fishing, shipping, and other maritime
activities; and
(B) potential future interactions between such
activities and the placement of renewable energy infrastructure and
the associated construction, maintenance, and operation of such
infrastructure, including potential benefits and methods of
mitigating adverse impacts; and
(3) .—review the current decision-making process for offshore wind in covered waters, and outline recommendations for governmental consideration of all impacted coastal communities, particularly Tribal governments and fisheries communities, in the decision-making process for offshore wind in covered waters, including recommendations for—
(A) ensuring the appropriate governmental consideration of
potential benefits of offshore wind in covered waters; and
(B)
risk reduction and mitigation of adverse impacts on Coast Guard
operations relevant to commercial fishing activities.
(b) SUBMISSION.—Not later than 1 year after commencing the study under subsection (a), the Secretary shall—
(1) submit the study to the Committees on Commerce, Science, and Transportation, and Energy and Natural Resources of the Senate and the Committees on Transportation and Infrastructure, Natural Resources, and Energy and Commerce of the House of Representatives, including the review and outline provided under subsection (a)(3); and
(2) make the study publicly available
(c) DEFINITIONS.—In this section:
(1) COVERED WATERS.—The term “covered waters” means Federal or
State waters off of the Canadian border and out to the furthest
extent of the exclusive economic zone along the West Coast of the
United States.
(2) EXCLUSIVE ECONOMIC ZONE.—The term “exclusive
economic zone” has the meaning given such term in section 107 of
title 46, United States Code.
######
SEC. 11606. ALCOHOL AT SEA
(a) IN GENERAL.—The Commandant shall seek to enter into an agreement with the National Academy of Sciences not later than 1 year after the date of enactment of this Act under which the National Academy of Sciences shall prepare an assessment to determine safe levels of alcohol consumption and possession by crew members aboard vessels of the United States engaged in commercial service, except when such possession is associated with the commercial sale to individuals aboard the vessel who are not crew members.
(b) ASSESSMENT.—The assessment prepared pursuant to subsection (a) shall—
(1) take into account the safety and security of every individual
on the vessel;
(2) take into account reported incidences of
sexual harassment or sexual assault, as defined in section 2101 of
title 46, United States Code; and
(3) provide any appropriate
recommendations for any changes to laws, regulations, or employer
policies.
(c) SUBMISSION.—Upon completion of the assessment under this section, the National Academy of Sciences shall submit to the Committee on Commerce, Science, and Transportation of the Senate, the Committee on Transportation and Infrastructure of the House of Representatives, the Commandant, and the Secretary the assessment prepared pursuant to subsection (a).
(d) REGULATIONS.—The Commandant—
(1) shall, not later than 180 days after receiving the submission of the assessment under subsection (c), review the changes to regulations recommended in such assessment; and
(2) taking into account the safety and security of every individual on vessels of the United States engaged in commercial service, may issue regulations relating to alcohol consumption on such vessels.
(e) SAVINGS CLAUSE.—To the extent the Commandant issues regulations establishing safe levels of alcohol consumption in accordance with subsection (d), the Commandant may not issue regulations which prohibit—
(1) the owner or operator of a vessel from imposing additional restrictions on the consumption of alcohol, including the prohibition of the consumption of alcohol on such vessels; and
(2) possession of alcohol associated with the commercial sale to individuals aboard the vessel who are not crew members.
(f) REPORT REQUIRED.—If, by the date that is 2 years after the receipt of the assessment under subsection (c), the Commandant does not issue regulations under subsection (d), the Commandant shall provide a report by such date to the committees described in subsection (c)—
(1) containing the rationale for not issuing such regulations; and
(2) providing other recommendations as necessary to ensure safety at sea.
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Consensus
·2025
Military families raising children with autism often face unique challenges in accessing consistent, high-quality care across frequent moves and deployments. Applied behavior analysis, or ABA, is widely recognized as an effective intervention for many autistic individuals, yet military families repo...
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