Under the authority of the 2006 Combating Autism Act (CAA) (P.L. 109–416), the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) introduced the Combating Autism Act Initiative (CAAI) in September 2008. The goal of the CAAI is to enable all children to reach their full potential by developing a system of services that includes a) screening children early for possible autism spectrum disorders (ASD) and other developmental disorders (DD); b) conducting early, interdisciplinary evaluations to confirm or rule out ASD and other DD; and c) if a diagnosis is confirmed, providing evidence-based, early interventions. As part of the CAAI, MCHB awarded State Implementation grants to nine States for the purpose of improving access to comprehensive, coordinated health care and related services for children and youth with ASD and other developmental disabilities. This report presents the results of a 3-year study to assess the State Grantee’s performance in meeting the goals and objectives of the CAAI.

In accordance with the CAAI, the State Implementation grantees worked to fulfill the following objectives:

• Create State service systems that will improve access to comprehensive, coordinated health care and related services for children with ASD and other DD
• Increase awareness of ASD
• Reduce barriers to screening and diagnosis
• Train professionals to use valid and reliable screening and diagnostic tools and provide evidence-based interventions

This study collected and analyzed qualitative and quantitative data to assess the grantees’ performance and their progress in meeting the goals and objectives of the CAAI during the grant period.

The grantees were expected to implement State plans that encompassed six system components: 1) partnerships among professionals and families with children and youth with ASD; 2) access to culturally competent, family centered medical homes; 3) access to adequate health insurance and financing of services; 4) early and continuous screening for ASD and other developmental disabilities; 5) community services organized for easy use by families; 6) and transition to adult health care.

In this report, we have cross-referenced the CAAI’s goals, six system components and numerous infrastructure building activities and created six overarching areas of system capacity: 1) collaborative statewide planning structures and partnerships; 2) regional and community-based service networks; 3) integrated, family-centered medical homes; 4) statewide data systems for system planning and improvement; 5) funded access to high-quality services; and 6) communication tools and channels for ASD awareness building and training. This report documents the grantees’ achievements in these six overarching areas of system capacity, highlighting innovative practices that proved particularly effective and that have potential for becoming best practices in other States. We also note where system gaps continue to exist and what more can be done to fill those gaps through future CAAI grants.