S 1838 United States Senate · 119th Congress

DeOndra Dixon INCLUDE Project Act of 2026

This bill establishes the "INCLUDE Project" at the National Institutes of Health (NIH) to advance research on Down syndrome. It directs NIH to coordinate and expand research into co-occurring health conditions (like Alzheimer's, heart disease, and autoimmune disorders) affecting individuals with Down syndrome, while avoiding duplication of existing efforts. The law requires NIH to build large study populations, support inclusive clinical trials, identify biomarkers, and improve quality of life for people with Down syndrome and their families. NIH must submit biennial reports to Congress detailing research progress and findings. The bill directly affects NIH research programs and future medical care for people with Down syndrome.
Bill status passed 3 of 5 stages cleared
Introduction
May 2025
Committee Review
Aug 2026
Senate Passage
Aug 2026
House Passage
President
Introduced May 21, 2025 Last action Aug 10, 2026
Maddy AI version diff · 1 comparison

What changed between versions

Introduced in Senate Engrossed in Senate · 9 edits · Aug 6, 2026
MAJOR
The engrossed version of S 1838 makes several substantive changes: it removes the entire congressional findings section, shifts authority from the Secretary of HHS (acting through NIH) to the Director of NIH directly, narrows the scope of coordinating entities from all NIH institutes, centers, agencies, and offices down to just institutes and centers, removes the technical assistance provision, adds a new stakeholder consultation requirement, and broadens some research elements while tightening others. The bill also moves its placement in the Public Health Service Act from Part A to Part B of title IV.
SCOPE

The entire Section 2 (Congressional Findings) was deleted, removing all six findings about Down syndrome prevalence, life expectancy, and research rationale.

The bill now amends Part B of title IV of the Public Health Service Act (new section 409K) instead of Part A (former section 404P), changing where the program sits in federal law.

Program element (1) broadened from 'high-risk, high reward basic science studies' to 'high-risk, high-reward research,' removing the limitation to basic science only, and changed terminology from 'chromosome 21' to 'trisomy 21.'

Program element (2) changed from 'assembling and maintaining a large study population of individuals with Down syndrome' to 'promoting research for participants with Down syndrome across the lifespan, including cohort studies,' broadening the scope beyond just building a study population.

REQUIREMENT

Authority shifted from 'the Secretary, acting through the Office of the Director of NIH, and in consultation with other Federal agencies and partners' to simply 'the Director of NIH,' removing the Secretary's role and interagency consultation requirement.

Coordination responsibility narrowed from 'institutes, centers, agencies, and offices' to just 'institutes and centers,' and the coordination mechanism changed from the Division of Program Coordination, Planning, and Strategic Initiatives to the Office of the Director of NIH and priority-setting reviews under section 402(b)(3).

The technical assistance provision (former subsection d) requiring the Secretary to provide technical assistance to grantees was removed entirely.

A new subsection (d) requires the Director of NIH to consult with relevant stakeholders, including patient advocates, to ensure activities take into consideration the needs of individuals with Down syndrome.

DEFINITION

Program element (6) added 'related dementias' alongside Alzheimer's disease when listing co-occurring conditions, expanding the condition coverage.

Floor votes

How they voted

This bill passed the Senate by voice vote (no roll call recorded).
Full legislative history

Actions timeline

Total actions
9
Key actions
3
Committee
2
Aug 6, 2026
Upper · Passed
Passed Senate with an amendment by Voice Vote. (text of amendment in the nature of a substitute: CR S4495-4496)
upper
Aug 6, 2026
Upper · Passed
Passed/agreed to in Senate: Passed Senate with an amendment by Voice Vote. (text of amendment in the nature of a substitute: CR S4495-4496)
upper
Aug 6, 2026
Upper · Passed
Senate Committee on Health, Education, Labor, and Pensions discharged by Unanimous Consent.
upper
May 21, 2025
Committee
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
upper
May 21, 2025
Introduced
Introduced in Senate
upper
1 primary · 9 co-sponsors

Sponsors