117 HR 10448 IH: Combating Loneliness Act
U.S. House of Representatives
2024-12-17
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EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents(a)This Act may be cited as the Combating Loneliness Act
.(b)The table of contents for this Act is as follows:Sec. 1. Short title; table of contents.Sec. 2. Findings.Sec. 3. Sense of Congress.Title I—Community-based programsSec. 101. Grants for third-spaces.Sec. 102. Grants for social infrastructure.Sec. 103. Grants for Outreach and Intervention to address loneliness.Title II—Public healthSec. 201. Support group demonstration program.Sec. 202. Building communities of recovery program reauthorization.Sec. 203. Mental health provider student loan forgiveness.Sec. 204. Health workforce resiliency program.Sec. 205. Task force to prevent health care worker burnout.Title III—Measurements of lonelinessSec. 301. Addition of loneliness to the Older Americans Act of 1965.Sec. 302. HHS working group on measurements of loneliness and isolation.Sec. 303. GAO study and report on impact of social isolation.Title IV—Community health workersSec. 401. Coverage of Community Health Worker services under Medicare and Increased FMAP for Community Health Worker services.Sec. 402. Community Health Workers in NHSC loan repayment program.Title V—EducationSec. 501. School-based services under Medicaid and CHIP.Sec. 502. Support for Project AWARE.Sec. 503. Support for the 21st Century Community Learning Centers program and the Full-Service Community Schools Program.Title VI—DefinitionsSec. 601. Definitions.2.The Congress finds the following:(1)36 percent of individuals in the United States report serious loneliness.(2)61 percent of young adults and over 50 percent of mothers with young children in the United States report serious loneliness.(3)61 percent of disabled individuals in the United States experience chronic loneliness, with an even higher prevalence of 70 percent among young disabled people in the United States.(4)LGBTQI+ youth, particularly transgender and Black individuals, experience higher levels of loneliness, depression, and anxiety than their straight or cisgender counterparts.(5)Black individuals, Indigenous individuals, and individuals of color are disproportionately affected by social loneliness and isolation, with 75 percent of Latinx and Hispanic adults and 68 percent of Black and African American adults categorized as lonely.(6)Due to fragmented social networks, loneliness is especially pervasive with people experiencing homelessness, with 1 in 5 reporting to have no friends.(7)Farmers and agricultural workers, predominantly based in rural areas, face heightened risks to mental well-being due to social and geographical isolation.(8)Older adults face heightened vulnerability to loneliness and social isolation due to factors including living alone, loss of familial and social ties, chronic illness, and impaired hearing.(9)Elderly individuals are increasingly affected by homelessness and loneliness as their social circles shrink, lifespans increase, and economic challenges grow, making them one of the fastest-growing segments of the homeless population.(10)Veterans often experience feelings of isolation due to losing touch with their military community, physical or mental health issues, and difficulties adjusting to civilian life.(11)1 out of every 5 veterans reports that they often feel lonely, leading to higher rates of mental and physical health, as well as suicidal ideation.(12)Climate-related disasters are associated with negative impacts on mental health nationwide.(13)People who use social media for more than 2 hours a day are twice as likely to report increased feelings of social isolation than those who were using it for less than 30 minutes a day.(14)Students with low academic performance may turn to social networking sites to cope with feelings of loneliness and isolation, finding online interactions less stressful than face-to-face relationships.(15)A shortage of 139,000 primary care physicians is projected by 2033, with particularly concerning deficits anticipated rural areas.(16)Burnout rates reported by health care workers nationally are higher than in any other industry.(17)Nearly half of health workers reported often feeling burned out in 2022, up from 32 percent in 2018.(18)Rural clinics report the highest rates of burnout.(19)Increased feeling of loneliness and social isolation can lead to an increase in susceptibility to radicalization and violence.(20)Increased feelings of loneliness lead to a reduced sense of civic duty and lower voter turnout.(21)Positive relationships with peers, parents, and teachers during childhood and adolescence correlate with improved academic outcomes and predict higher rates of college graduation and attainment of four-year degrees in early adulthood.(22)Building design incorporating elements that promote physical activity and social interaction enhances health and reduces loneliness among older adults.(23)Housing with care is effective at reducing loneliness and social isolation in later life, providing better outcomes than living in the general community.3.It is the sense of the Congress that it is the duty of the Federal Government to—(1)create a national health insurance program that provides comprehensive and essential care to all individuals in the United States, which is critical to building healthier communities;(2)establish a national paid family and medical leave program that allows every worker to take care of their own health and their families’ health, which creates healthy and vibrant communities;(3)encourage participation in the arts and the humanities, which provides communities with a foundation to engage in our democracy and fosters an appreciation for our shared cultural heritage;(4)establish universal early education that supports early childhood development and sets children up for academic success, which is an investment in our children, their families, and future generations;(5)provide safe, affordable housing that provides working families with stability, which is critical to building vibrant communities;(6)provide affordable and quality child care that is a lifeline for working families, which is critical to building a stronger economy, workforce, and communities;(7)address the climate crisis by transitioning to renewable energy, promoting environmental justice, and conserving public and wild lands, which is essential to building resilient communities and a sustainable future;(8)reduce gun violence through common-sense gun safety reform, which will protect families from senseless gun violence, which is critical to creating safer communities;(9)build a tax code that works for working families and small businesses, and ensure the wealthy pay their fair share, which is essential in order to invest in critical resources such as housing and mental health care; and(10)encourage States, counties, and local municipalities to develop policies that have a focus on connection and social connectivity. <enum>I</enum><header>Community-based programs</header><section id="HD18B2E8D58C04165B78F5456454F2A49" section-type="subsequent-section"><enum>101.</enum><header>Grants for third-spaces</header><subsection id="H0DB0BB7ACB524D3FA54B4093E213EFB1"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>), in consultation with the appropriate Federal officials, shall establish a program to award grants, on a competitive basis, to State or local governments to support eligible entities to create and scale community connection programs and local institutions that bring people together at community facilities.</text></subsection><subsection id="H2449C3124809452DABFEFA0D17BCED0A"><enum>(b)</enum><header>Applications</header><text display-inline="yes-display-inline">To be eligible to receive a grant under this section, a State or local government shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.</text></subsection><subsection id="H24DFA7D8D5C44BCD80FBFE8D34C86276"><enum>(c)</enum><header>Use of funds</header><text>A grant awarded under this section—</text><paragraph id="H59E8E122E2794062864CC1D2C6352A00"><enum>(1)</enum><text>may be used to pay the salary or wages of appropriate staff of the community connection programs and local institutions referred to in subsection (a); and</text></paragraph><paragraph id="HFADAC5288DDA47BE918FF0ABA0F45D5B"><enum>(2)</enum><text>may not be used for the construction of any facility.</text></paragraph></subsection><subsection id="H53FF79F09587488C8407C2D336DD35B9"><enum>(d)</enum><header>Priority</header><text>In awarding grants under this section, the Secretary shall prioritize—</text><paragraph id="H182CFD830B5E4325B36E82100E993690"><enum>(1)</enum><text>underserved communities; and</text></paragraph><paragraph id="HDD5035968A78415DAC75A5CA507BFBC7"><enum>(2)</enum><text>communities with high percentages of children or elderly individuals.</text></paragraph></subsection><subsection id="HD6671779BC8F48A3BDE9E9AD0982550D"><enum>(e)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H3A9FEFD07F8349BB9299AF65FD8C0521"><enum>(1)</enum><header>Appropriate Federal officials</header><text>The term <term>appropriate Federal officials</term> means—</text><subparagraph id="HDC71F45D99D749178534ECB7D94BBB64"><enum>(A)</enum><text display-inline="yes-display-inline">the Administrator of the Administration for Community Living;</text></subparagraph><subparagraph id="HE36BA9B58CAF442B9DC7B607BC8D1BE1"><enum>(B)</enum><text>the Secretary of Education;</text></subparagraph><subparagraph id="H51F8B9DEEDB247C79E52274A18E57188"><enum>(C)</enum><text>the Secretary of Veterans Affairs;</text></subparagraph><subparagraph id="H61EA31C2AC52470DA2B81CABE6011827"><enum>(D)</enum><text>the Secretary of Labor; and</text></subparagraph><subparagraph id="H91E613EC391F41F386D385058FFC01F3"><enum>(E)</enum><text>the Director of the Institute of Museum and Library Services.</text></subparagraph></paragraph><paragraph id="H958F91876A0D47B488C48B755AFDA0E5"><enum>(2)</enum><header>Eligible entity</header><text>The term <term>eligible entity</term> means a governmental or nonprofit entity that is—</text><subparagraph id="HD9DCE44A46D54E1280483F14ACE88175"><enum>(A)</enum><text display-inline="yes-display-inline">a library;</text></subparagraph><subparagraph id="H5F05BC79C79C46DEBE44812E338CE8B9"><enum>(B)</enum><text>a senior center;</text></subparagraph><subparagraph id="HED16D701EC2F4ABDA9A45F4B59BD40FD"><enum>(C)</enum><text>a childcare center or after-school program;</text></subparagraph><subparagraph id="H4E4318E157E04CB4BFD657ECF5056CE3"><enum>(D)</enum><text>a recreation center;</text></subparagraph><subparagraph id="H2C2C76036B154348BEEDC43E188BD491"><enum>(E)</enum><text>a teen center;</text></subparagraph><subparagraph id="H050F570705D3475C99F5C9F5BE5A7CFE"><enum>(F)</enum><text>a veteran service organization; or</text></subparagraph><subparagraph id="H947EF1F7627A41E090C2DB1D49C34A1D"><enum>(G)</enum><text>any other entity, as the relevant State or local government determines appropriate.</text></subparagraph></paragraph></subsection><subsection id="H99162EC8CF7E4329A8FB07E1E7FC8417"><enum>(f)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $200,000,000 for each of fiscal years 2025 through 2029.</text></subsection></section><section id="H5F8335B3349644AAA9963CD8DE2151DA"><enum>102.</enum><header>Grants for social infrastructure</header><subsection id="H1806665BB502478A843E6E90B5F3C72D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Housing and Urban Development (in this section referred to as the <quote>Secretary</quote>) shall establish a competitive grant program to award grants to eligible entities to plan and build infrastructure that encourages social connection.</text></subsection><subsection id="H0332AD63527242ECB26EEA0B5818102E"><enum>(b)</enum><header>Eligible entities</header><text>To be eligible for a grant under this section, an entity shall be—</text><paragraph id="H26F621223D1F4FD192043F858CE06B07" commented="no"><enum>(1)</enum><text>a State government;</text></paragraph><paragraph id="HD753F3BB01E949A380D651DF9EE2B04A"><enum>(2)</enum><text>a local government;</text></paragraph><paragraph id="HCD653B64668B4B8D8C176CFDA9CB7284" commented="no"><enum>(3)</enum><text>a metropolitan planning organization; or</text></paragraph><paragraph id="HD7ABD34F009B43FDB01022C0788D75AA" commented="no"><enum>(4)</enum><text>a multijurisdictional group of entities described in paragraphs (1) through (3).</text></paragraph></subsection><subsection id="H63B1CACCADC14330B686D62F03599965"><enum>(c)</enum><header>Eligible uses</header><text>An eligible entity may use amounts awarded under this section to—</text><paragraph id="H24667CC1747A4033AEF29BCD17B7F5AB"><enum>(1)</enum><text>plan infrastructure projects that encourage social connection, including—</text><subparagraph id="HF257BA3D9C8B4F33833CCA11473F3D6F"><enum>(A)</enum><text>parks;</text></subparagraph><subparagraph id="HD4194646BA824170B8FF033418D47ECC"><enum>(B)</enum><text>playgrounds;</text></subparagraph><subparagraph id="H7F12A0F850234442A72932003983D9A3"><enum>(C)</enum><text>recreation spaces; and</text></subparagraph><subparagraph id="HDB8643257BA64FAE97325EE9A76792E3"><enum>(D)</enum><text>access to natural areas;</text></subparagraph></paragraph><paragraph id="HC76004C287224CD99AAE324641E63125"><enum>(2)</enum><text>build such projects; and</text></paragraph><paragraph id="H8C023E5B16864B31B192E820A05D5AF2"><enum>(3)</enum><text>preserve such projects.</text></paragraph></subsection><subsection id="H3CC1D7756DFE47E899659AB3E9EA341D"><enum>(d)</enum><header>Applicant preference</header><text>The Secretary shall give preference to eligible entities that—</text><paragraph id="H243AE9ED80DB4865931145A59A47022E"><enum>(1)</enum><text>demonstrate environmentally conscious operations;</text></paragraph><paragraph id="H281B02A8E0A647089CFE49D1888467B7"><enum>(2)</enum><text>emphasize accessibility for disabled individuals; or</text></paragraph><paragraph id="H69C840A7CFCD45E08BA4AAF81D283919"><enum>(3)</enum><text display-inline="yes-display-inline">are located in or represent underserved communities.</text></paragraph></subsection><subsection id="H8006D3F085EE4B4DA1C4A01E1E1D555E"><enum>(e)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There are authorized to be appropriated to the Secretary to carry out this section $170,000,000 for each of fiscal years 2025 through 2029.</text></subsection></section><section id="H1BBEA92FBB404B579028CFA07E599231"><enum>103.</enum><header>Grants for Outreach and Intervention to address loneliness</header><subsection id="HC5571ED315984B399A35C39552D12A4D"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services (in this section referred to as the <quote>Secretary</quote>) shall establish a program to make grants, on a competitive basis, to covered entities for the purposes described in subsection (c).</text></subsection><subsection id="H952E1271140648BA9787F5C99AF3AC2F" commented="no"><enum>(b)</enum><header>Applications</header><text>To be eligible to receive a grant under this section, a covered entity shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.</text></subsection><subsection id="H65B5FE96CC81459FAACDF503156DA419"><enum>(c)</enum><header>Purposes described</header><text>The purposes described in this subsection are the following:</text><paragraph id="H4467345CEFBC45739ED001F8A4B8EAB6"><enum>(1)</enum><text display-inline="yes-display-inline">To conduct outreach, through established screening tools or other methods, as the Secretary determines appropriate, to at-risk individuals regarding the health effects of loneliness and social isolation.</text></paragraph><paragraph id="H85DB870475914ACBAF095AD12BCC968E"><enum>(2)</enum><text>To develop and implement community-based interventions for the purpose of mitigating loneliness or social isolation in at-risk individuals, including evidence-based programs, as determined by the Secretary, developed with multi-stakeholder input.</text></paragraph><paragraph id="H4AF5FE754CF94DE4B5251E028825769E"><enum>(3)</enum><text>To connect at-risk individuals with community social or clinical support.</text></paragraph></subsection><subsection id="H0F85817A4D3E41C59A9D4EFA11CFCDE8"><enum>(d)</enum><header>Definitions</header><text>In this section:</text><paragraph id="H726DF9ABD7684397ACC1A9D959C54A45"><enum>(1)</enum><header>At-risk individual</header><text>The term <term>at-risk individual</term> means an individual who—</text><subparagraph id="H10661F515455400091E639BD98206082"><enum>(A)</enum><text display-inline="yes-display-inline">is—</text><clause id="H8F7DDFA698464AA5AB5B215C7DBBC444"><enum>(i)</enum><text display-inline="yes-display-inline">between the ages of 18 and 25 years old; or</text></clause><clause id="H5C0868B075994E7CBEC71F05CA755C03"><enum>(ii)</enum><text>60 years of age or older;</text></clause></subparagraph><subparagraph id="H8401F2F375BC4D139B534AB380776A4E"><enum>(B)</enum><text>has a disability;</text></subparagraph><subparagraph id="HD67370D6986C4DDD8DAB63EA882C98DF"><enum>(C)</enum><text>has a pre-existing health condition; or</text></subparagraph><subparagraph id="H2ED42AE24E204E0D9BBA26A39811C4CF"><enum>(D)</enum><text display-inline="yes-display-inline">has poor indicators of social determinants of health, which may include—</text><clause id="H6FAB52A86C0740C68C71C05B0B8C5D4E"><enum>(i)</enum><text>the conditions in which people are born, grow, work, live, worship, and age; and</text></clause><clause id="H3550D0D3A4104CFA817961BF38CE2822"><enum>(ii)</enum><text>a wide set of forces and systems that shape daily life, such as economic policies and systems.</text></clause></subparagraph></paragraph><paragraph id="HED58A3594CD640798F6B3864BD3D5EE8"><enum>(2)</enum><header>Covered entity</header><text>The term <term>covered entity</term> means—</text><subparagraph id="H1ACDD6B5B6CF406E921A37C3C1F7CB3B"><enum>(A)</enum><text display-inline="yes-display-inline">an area agency on aging;</text></subparagraph><subparagraph id="H49F416AA4B0C4C95A1D215E53D420696"><enum>(B)</enum><text display-inline="yes-display-inline">a center for independent living; and</text></subparagraph><subparagraph id="HB5FBB8517C8E4D069F2149471FC8A108"><enum>(C)</enum><text>such other community-based organization, as the Secretary determines appropriate.</text></subparagraph></paragraph></subsection><subsection id="H4591320384EE4C75BBBEDF68337FC786"><enum>(e)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated such sums as may be necessary to carry out this section.</text></subsection></section><enum>II</enum><header>Public health</header><section id="H0075FBE48B0040109D73C2D0CE4A3827"><enum>201.</enum><header>Support group demonstration program</header><subsection id="HEFF244896FF64B4E97CC0384A2102AE9"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, (in this section referred to as the <quote>Secretary</quote>) shall establish a demonstration program to award grants to States and localities to support eligible organizations in—</text><paragraph id="H968456BFFDE04BC18840BA9549D2DD8F"><enum>(1)</enum><text>coordinating group therapy care for mental health and substance use treatment;</text></paragraph><paragraph id="H9CDC2244746148BEBEDB43606A8832E5"><enum>(2)</enum><text>administrative and operational costs related to such treatment; and</text></paragraph><paragraph id="HAF7DE1827DF64EA786900E0036D26848"><enum>(3)</enum><text>outreach, participant recruitment, patient education, and treatment plan development.</text></paragraph></subsection><subsection id="HEE671E8ADD384C549695D13FE221FA3F"><enum>(b)</enum><header>Priority</header><text>In awarding grants under this section, the Secretary shall give priority to States and localities that will support eligible organizations in rural areas.</text></subsection><subsection id="H0919E60CB39743148F69177B70102422"><enum>(c)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide technical assistance to States and localities seeking or receiving a grant under this section.</text></subsection><subsection id="HDEF797D940EC46EDB942B2721C3DBDC7"><enum>(d)</enum><header>Eligible organization defined</header><text display-inline="yes-display-inline">In this section, the term <term>eligible organization</term> means a partnership between—</text><paragraph id="H3498BF985D8D4BE5A6FF64E56DFE5B97"><enum>(1)</enum><text>at least 1—</text><subparagraph id="H4D6B86502BA443D2B3274D83BCF974CE"><enum>(A)</enum><text display-inline="yes-display-inline">clinician with a private practice;</text></subparagraph><subparagraph id="HEBDADE45216B4FA9A210A1596B7A4442"><enum>(B)</enum><text display-inline="yes-display-inline">health care center or association of community health centers; or</text></subparagraph><subparagraph id="H478BF53275D6435AA2918197E4402905"><enum>(C)</enum><text>hospital; and</text></subparagraph></paragraph><paragraph id="H50CFC8DFE951486BB650E3E022B0B5FE"><enum>(2)</enum><text>at least 1—</text><subparagraph id="H50D0465483CB4F36933214C1BB0A0E3C"><enum>(A)</enum><text>elementary or secondary school;</text></subparagraph><subparagraph id="HD0BB6A9662A047F08C3BE49AB8289D9B"><enum>(B)</enum><text>institution of higher education; or</text></subparagraph><subparagraph id="H43702F338DDB4647BFDE0DB4277843E2"><enum>(C)</enum><text>community organization, including a senior center, youth center, or LGBTQ center.</text></subparagraph></paragraph></subsection></section><section id="H0D6DA4D009604CC8AB7A2636D5F95DEE"><enum>202.</enum><header>Building communities of recovery program reauthorization</header><text display-inline="no-display-inline">Section 547(f) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290ee-2">42 U.S.C. 290ee–2(f)</external-xref>) is amended by striking <quote>$5,000,000 for each of fiscal years 2019 through 2023</quote> and inserting <quote>$16,000,000 for each of fiscal years 2025 through 2029</quote>. </text></section><section id="HFCF5640BF41E447A951C07A40262DE73"><enum>203.</enum><header>Mental health provider student loan forgiveness</header><text display-inline="no-display-inline">Part F of title VII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/295h">42 U.S.C. 295h</external-xref>) is amended—</text><paragraph id="HBA4812FD9247491296CBC2CD59E3DB4D"><enum>(1)</enum><text>by amending the part heading to read as follows: <quote><header-in-text level="part" style="OLC">Substance use disorder treatment and mental health workforce loan repayment programs</header-in-text></quote>;</text></paragraph><paragraph id="H38DE63C375884A628F8BE0B7E6B45623"><enum>(2)</enum><text>in section 781(e)(2), by striking <quote>338I, or 846</quote> and inserting <quote>338I, 782, or 846</quote>; and </text></paragraph><paragraph id="H6B8A5D33283A4CE5B28EAF5920E956DC"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" id="H9519F64038BA466C843BF8C62E6C31D5" display-inline="no-display-inline"><section id="H8817A651FE6B485283524A8E439D786C"><enum>782.</enum><header>Loan repayment program for mental health workforce</header><subsection id="H018A865299A24C109F5FD853DC858282"><enum>(a)</enum><header>In General</header><text>The Secretary, acting through the Administrator of the Health Resources and Services Administration, (in this section referred to as the <quote>Secretary</quote>) shall carry out a program under which—</text><paragraph id="HA8B1EED2B81C434FAC6C3BFB2A9FAFC3"><enum>(1)</enum><text>the Secretary enters into agreements with individuals to make payments in accordance with subsection (b) on the principal of and interest on any eligible loan; and</text></paragraph><paragraph id="H227B3933A93C4B02B8A67C418E3AFC98"><enum>(2)</enum><text>the individuals each agree to the requirements of service in mental health services employment, as described in subsection (d).</text></paragraph></subsection><subsection id="HBB91330992434C64A117E732B03CCA65"><enum>(b)</enum><header>Payments</header><text>For each year of obligated service by an individual pursuant to an agreement under subsection (a), the Secretary shall make a payment to such individual as follows:</text><paragraph id="HE36A75E831B74E6B9A521BC53DE1D1BB"><enum>(1)</enum><header>Service in a shortage area</header><text>The Secretary shall pay—</text><subparagraph id="HA3A6803BC26C4C38A86F6D500EC811C9"><enum>(A)</enum><text>for each year of obligated service by an individual pursuant to an agreement under subsection (a), <fraction>1/6</fraction> of the principal of and interest on each eligible loan of the individual which is outstanding on the date the individual began service pursuant to the agreement; and</text></subparagraph><subparagraph id="HCB8854E3DDF547248C97D87F0D1013A0"><enum>(B)</enum><text>for completion of the sixth and final year of such service, the remainder of such principal and interest.</text></subparagraph></paragraph><paragraph id="HD94DBB8EE78F4C40BDB0BF56C70655E4"><enum>(2)</enum><header>Maximum amount</header><text>The total amount of payments under this section to any individual shall not exceed $75,000.</text></paragraph></subsection><subsection id="H5DBB57B382144ADE86A186894525BC42"><enum>(c)</enum><header>Eligible Loans</header><text>The loans eligible for repayment under this section are each of the following:</text><paragraph id="HAD3497ABDE7C4B9C9183CFD65D8DB495"><enum>(1)</enum><text>Any loan for education or training for a substance use disorder treatment employment.</text></paragraph><paragraph id="HAA87086801A24DF99758EDABB375525A"><enum>(2)</enum><text>Any loan under part E of title VIII (relating to nursing student loans).</text></paragraph><paragraph id="HD50D8AB7EF1E48378629479742FBE81B"><enum>(3)</enum><text>Any Federal Direct Stafford Loan, Federal Direct PLUS Loan, Federal Direct Unsubsidized Stafford Loan, or Federal Direct Consolidation Loan (as such terms are used in section 455 of the Higher Education Act of 1965).</text></paragraph><paragraph id="H4DA5F5C1D856466FAA792C95D3CE3B5B"><enum>(4)</enum><text>Any Federal Perkins Loan under part E of title I of the Higher Education Act of 1965.</text></paragraph><paragraph id="H95F6DC8138334FBBAA5ED9D2F7160CE6"><enum>(5)</enum><text>Any other Federal loan as determined appropriate by the Secretary.</text></paragraph></subsection><subsection id="HED9FCDE85D074F1AA40870A4194A663A"><enum>(d)</enum><header>Requirements of Service</header><text display-inline="yes-display-inline">Any individual receiving payments under this program as required by an agreement under subsection (a) shall agree to an annual commitment to full-time employment, with no more than 1 year passing between any 2 years of covered employment, in mental health services employment in the United States in a Mental Health Professional Shortage Area, as designated under section 332.</text></subsection><subsection id="HF4F9B7D56F684844A22FC3CF7668EC78"><enum>(e)</enum><header>Ineligibility for Double Benefits</header><text>No borrower may, for the same service, receive a reduction of loan obligations or a loan repayment under both—</text><paragraph id="H065666CAC0CF4E1E9797952290CF3F67"><enum>(1)</enum><text>this section; and</text></paragraph><paragraph id="H47031DD0B2D64EBCA062CE7DF2D32DD0"><enum>(2)</enum><text>any federally supported loan forgiveness program, including under section 338B, 338I, 781, or 846 of this Act, or section 428J, 428L, 455(m), or 460 of the Higher Education Act of 1965.</text></paragraph></subsection><subsection id="HE7C088CF56BB42259D0EC84A5C4BB601"><enum>(f)</enum><header>Breach</header><paragraph id="H80375CD2CFEC40E5946954A1A0026FFA"><enum>(1)</enum><header>Liquidated damages formula</header><text>The Secretary may establish a liquidated damages formula to be used in the event of a breach of an agreement entered into under subsection (a).</text></paragraph><paragraph id="HAF84C808E9D5425DB9AFABD8AC933976"><enum>(2)</enum><header>Limitation</header><text>The failure by an individual to complete the full period of service obligated pursuant to such an agreement, taken alone, shall not constitute a breach of the agreement, so long as the individual completed in good faith the years of service for which payments were made to the individual under this section.</text></paragraph></subsection><subsection id="H1BC850A5D5B54F32837660D1652D03CB"><enum>(g)</enum><header>Additional Criteria</header><text>The Secretary—</text><paragraph id="HF7DC8063F22E4692A42157892A40BC69"><enum>(1)</enum><text>may establish such criteria and rules to carry out this section as the Secretary determines are needed and in addition to the criteria and rules specified in this section; and</text></paragraph><paragraph id="H076FF65D3E1547449688597DBD020F00"><enum>(2)</enum><text>shall give notice to the committees specified in subsection (h) of any criteria and rules so established.</text></paragraph></subsection><subsection id="H8223E062F0CE4E27BA0743233832BFBE"><enum>(h)</enum><header>Report to Congress</header><text>Not later than 5 years after the date of enactment of this section, and every other year thereafter, the Secretary shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on—</text><paragraph id="H66AFB9DED61E4A5ABDF1A9BF76C172EE"><enum>(1)</enum><text>the number and location of borrowers who have qualified for loan repayments under this section; and</text></paragraph><paragraph id="H8FB92D5E409E48C9863C71F9822D9CEB"><enum>(2)</enum><text>the impact of this section on the availability of substance use disorder treatment employees nationally and in shortage areas and counties described in subsection (d).</text></paragraph></subsection><subsection id="HCDDC012684AA453D84C78DC899DDB9FA"><enum>(i)</enum><header>Definition</header><text>In this section:</text><paragraph id="HC8EF367AE7684F54AAAB32F7E74D9323" display-inline="no-display-inline"><enum>(1)</enum><header>Community-based organization</header><text>The term <term>community-based organization</term> includes, except as otherwise provided by the Secretary, a nonprofit community-based organization, a consortium of nonprofit community-based organizations, a national nonprofit organization acting as an intermediary for a community-based organization, or a community-based organization that has a fiscal sponsor that allows the organization to function as an organization described in <external-xref legal-doc="usc" parsable-cite="usc/26/501">section 501(c)(3)</external-xref> of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code.</text></paragraph><paragraph id="H7D14FCFD278B4ADFBAFB4659A72ED0FA"><enum>(2)</enum><header>ISDEAA terms</header><text>The terms <term>Indian tribe</term> and <term>tribal organization</term> have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act.</text></paragraph><paragraph id="HDE45549CB87B47EABA85F1173D088133"><enum>(3)</enum><header>Mental health services employment</header><text>The term <term>mental health services employment</term> means full-time employment (including a fellowship)—</text><subparagraph id="H90A1323B8BEE467D8A779CCEB06F8811"><enum>(A)</enum><text display-inline="yes-display-inline">where the primary intent and function of the position is the direct treatment or recovery support of patients with or in recovery from a diagnosable mental, behavioral, or emotional disorder, including master’s level social workers, psychologists, counselors, marriage and family therapists, psychiatric mental health practitioners, child and adolescent psychiatrists, occupational therapists, psychology doctoral interns, behavioral health paraprofessionals and physicians, physician assistants, and nurses, who are licensed or certified in accordance with applicable State and Federal laws; and</text></subparagraph><subparagraph id="H964B18149E284E17B881C9321D07FF32"><enum>(B)</enum><text display-inline="yes-display-inline">which is located at a mental health treatment program, private physician practice, hospital or health system-affiliated inpatient treatment center or outpatient clinic (including an academic medical center-affiliated treatment program), correctional facility or program, youth detention center or program, inpatient psychiatric facility, crisis stabilization unit, community health center, community mental health or other specialty community behavioral health center, recovery center, school, community-based organization, telehealth platform, migrant health center, health program or facility operated by an Indian tribe or tribal organization, Federal medical facility, or any other facility as determined appropriate for purposes of this section by the Secretary.</text></subparagraph></paragraph><paragraph id="H48174572B6A445F89CE5E48C3E901A9A"><enum>(4)</enum><header>Municipality</header><text>The term <term>municipality</term> means a city, town, or other public body created by or pursuant to State law, or an Indian tribe.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="HC335F77D0731480D8D264276ECD9A5E0"><enum>204.</enum><header>Health workforce resiliency program</header><subsection id="H5BCC4F10194B463D87E92168A2813ECD" commented="no"><enum>(a)</enum><header>Funding for mental health and substance use disorder training for health care professionals, paraprofessionals, and public safety officers</header><text display-inline="yes-display-inline">Section 2703 of the American Rescue Plan Act of 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>; 135 Stat. 46) is amended—</text><paragraph id="H523F04D609244DB2BEFEB9CC9A8FCA95"><enum>(1)</enum><text>in subsection (b), by striking <quote>appropriated by subsection (a)</quote> and inserting <quote>appropriated by subsection (a) or pursuant to subsection (c)</quote>; and </text></paragraph><paragraph id="HB5003CAE2C8F4AE682D49BB317F07207"><enum>(2)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" id="HE8253C71C4874DA9A3DE53625BA98AC6" display-inline="no-display-inline"><subsection id="H44B595CB697C4F86A908BF006A969F72" commented="no"><enum>(c)</enum><header>Authorization for FY 2025 to 2029</header><text display-inline="yes-display-inline">There is authorized to be appropriated for the purpose described in subsection (b) $100,000,000 for the period of fiscal years 2025 through 2029.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="H2E6256084DC74826BFBB40DE0546DE76" commented="no"><enum>(b)</enum><header>Funding for education and awareness campaign encouraging healthy work conditions and use of mental health and substance use disorder services by health care professionals</header><text display-inline="yes-display-inline">Section 2704 of the American Rescue Plan Act of 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>; 135 Stat. 46) is amended—</text><paragraph id="HE9BAD86A245D4F14B04FC53E8DBB948F"><enum>(1)</enum><text>in subsection (b), by striking <quote>appropriated by subsection (a)</quote> and inserting <quote>appropriated by subsection (a) or pursuant to subsection (c)</quote>; and</text></paragraph><paragraph id="H8305F8F4A5794F2BA6FDCADF29174045"><enum>(2)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H61627CD2A08F4A239569EC6F21F51EB4"><subsection id="HB7253BDB86B2449295D925A511680CC0" commented="no"><enum>(c)</enum><header>Authorization for FY 2025 to 2029</header><text display-inline="yes-display-inline">There is authorized to be appropriated for the purpose described in subsection (b) $100,000,000 for the period of fiscal years 2025 through 2029.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="H82367A8BF0AB48CF8932A1B516D269FA" commented="no"><enum>(c)</enum><header>Funding for grants for health care providers To promote mental health among their health professional workforce</header><text display-inline="yes-display-inline">Section 2705 of the American Rescue Plan Act of 2021 (<external-xref legal-doc="public-law" parsable-cite="pl/117/2">Public Law 117–2</external-xref>; 135 Stat. 46) is amended—</text><paragraph id="H74CC1BA6E3A04FF6B29E7D2F99181D7A"><enum>(1)</enum><text>in subsection (b), by striking <quote>appropriated by subsection (a)</quote> and inserting <quote>appropriated by subsection (a) or pursuant to subsection (c)</quote>; and</text></paragraph><paragraph id="H0769064BE8884E04A12BF33C8B36ED9A"><enum>(2)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H260DE87FAB334DA7B9708EEBE6D43DA4"><subsection id="HEAA8FA4CFF6649B39450A60D96F8FB9E" commented="no"><enum>(c)</enum><header>Authorization for FY 2025 to 2029</header><text display-inline="yes-display-inline">There is authorized to be appropriated for the purpose described in subsection (b) $100,000,000 for the period of fiscal years 2025 through 2029.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section><section id="HE2CE2B9E4E094B14AEAEF3B19349562C"><enum>205.</enum><header>Task force to prevent health care worker burnout</header><subsection id="H3C18EFB7D7F7475D8C3701546D97290E"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, (in this section referred to as the <quote>Secretary</quote>) shall establish a task force to prevent health care worker burnout (in this section referred to as the <quote>Task Force</quote>).</text></subsection><subsection id="H0DA94788FD2C4604AC68BDEDA741F046"><enum>(b)</enum><header>Members</header><text display-inline="yes-display-inline">The Task Force shall have the following members, to be appointed by the Secretary (unless otherwise specified):</text><paragraph id="H119F5A4C9F964921829AD2C1169BC6C3"><enum>(1)</enum><text>The Surgeon General, who shall serve as chair.</text></paragraph><paragraph id="H7FC567BDB5B4494D9D2FF9C21D268068"><enum>(2)</enum><text display-inline="yes-display-inline">A representative from the Centers for Medicare & Medicaid Services.</text></paragraph><paragraph id="HC0B50A93EF1D4F75B3FDBBFDE304876C"><enum>(3)</enum><text>A representative from the Centers for Disease Control and Prevention.</text></paragraph><paragraph id="HAF2DE32389954A92B67A60806427CE6B"><enum>(4)</enum><text>A representative from the Office of Rural Health Policy of the Health Resources and Services Administration.</text></paragraph><paragraph id="H472BA10201454C37A417CADD74D2497C"><enum>(5)</enum><text>A representative from the Provider Relief Bureau of the Health Resources and Services Administration.</text></paragraph><paragraph id="H4D12DE175D644174A179D845E42BD3FD"><enum>(6)</enum><text display-inline="yes-display-inline">A representative from the Office of Civil Rights, Diversity, and Inclusion of the Health Resources and Services Administration.</text></paragraph><paragraph id="H9FDE997D174F4EA0AC9FA07F47EF1EC4"><enum>(7)</enum><text>Such other members as the chair determines appropriate, who shall be appointed by the chair.</text></paragraph></subsection><subsection id="H630C799DE22C4C999421EDAA28F2C74C"><enum>(c)</enum><header>Reports</header><text>Not later than 2 years after the date of enactment of this Act, the Task Force shall submit to Congress a report that includes—</text><paragraph id="HD442D6C3D15F458C967C5DEB6A2013FC"><enum>(1)</enum><text>statistics and data on turnover in health care employment and health care worker satisfaction (including with regard to the mental health and substance use disorder workforces);</text></paragraph><paragraph id="H1CE429DC75CF48F58C45A996C54D06C7"><enum>(2)</enum><text>recommendations on how to reduce burnout among health care workers;</text></paragraph><paragraph id="H3BD2C0609EC24864BB95631117D7DCB5"><enum>(3)</enum><text>an assessment of burnout in Health Resources and Services Administration workforce programs and how such programs may be improved; and</text></paragraph><paragraph id="HC3F671A3EC504E8F9A65EF35DF184447"><enum>(4)</enum><text>a study of the administrative burden of health insurance systems (including Medicare, Medicaid, CHIP programs, and VA health).</text></paragraph></subsection></section><enum>III</enum><header>Measurements of loneliness</header><section id="HFEA3A7F7F78A466884AC3F91AC0D8C4A" section-type="subsequent-section" display-inline="no-display-inline"><enum>301.</enum><header>Addition of loneliness to the Older Americans Act of 1965</header><text display-inline="no-display-inline">Section 102(14)(N) of the Older Americans Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/42/3002">42 U.S.C. 3002(14)(N)</external-xref>) is amended by inserting <quote>or loneliness</quote> after <quote>social isolation</quote> each place it appears.</text></section><section id="H8BC330B2DD3C4BC7A819B6412C09BC6D"><enum>302.</enum><header>HHS working group on measurements of loneliness and isolation</header><text display-inline="no-display-inline">The Secretary of Health and Human Services shall establish within the Department of Health and Human Services a working group to formulate recommendations for standardizing the methods by which agencies and components of the Department measure loneliness and isolation.</text></section><section id="H8CEE05DD012742AD81D70D8D49E8DD02"><enum>303.</enum><header>GAO study and report on impact of social isolation</header><subsection id="H3107E85A474A4EBA84E8BE4EC6FF1AEA"><enum>(a)</enum><header>Study</header><text display-inline="yes-display-inline">The Comptroller General of the United States shall conduct a study on the impact of social isolation and efforts by the Federal Government and State and local governments to address such social isolation.</text></subsection><subsection id="H445949931DA24B15A3AF67D76B6C9CDD"><enum>(b)</enum><header>Report</header><text>Not later than 5 years after the date of enactment of this Act, the Comptroller General of the United shall submit to Congress a report detailing the results of the study under subsection (a).</text></subsection></section><enum>IV</enum><header>Community health workers</header><section id="H11B125EF3C2B46D99A8E0E0D1B430C09" section-type="subsequent-section"><enum>401.</enum><header>Coverage of Community Health Worker services under Medicare and Increased FMAP for Community Health Worker services</header><subsection id="H1ECFB8D822AE4FEDA1BE189B48CD3BB6"><enum>(a)</enum><header>Coverage of community health worker services and certified community behavioral health clinic services under Medicare</header><paragraph id="HFFE5A07D635244FEBDCC36359EE5E183"><enum>(1)</enum><header>In general</header><text>Section 1861 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x</external-xref>) is amended—</text><subparagraph id="H6C8049F758F64BA7B98E6B36CFC90E6F"><enum>(A)</enum><text>in subsection (s)(2), by adding at the end the following new subparagraphs:</text><quoted-block style="OLC" id="H30DB758D8B8E4C14B05BC53158C1B28F" display-inline="no-display-inline"><subparagraph id="H8E9D27184C354C86A878304B23EE90DB" indent="up1"><enum>(KK)</enum><text display-inline="yes-display-inline">professional services furnished by a community health worker (as defined in subsection (nnn)) on or after October 1, 2026;</text></subparagraph><subparagraph id="H8E2E7F6CB36D462B8A39E86A5DF5A604" indent="up1"><enum>(LL)</enum><text>certified community behavioral health clinic services (as defined in section 1905(jj)) furnished on or after October 1, 2026;</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph><subparagraph id="HA633EAF2B9C34DDDBFE43F3AD08BBFC5"><enum>(B)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" id="HCED97E08FC214D3CA91FAAB637C12DE4" display-inline="no-display-inline"><subsection id="H24C0654D836043C98C963A249523C321"><enum>(nnn)</enum><header>Community health worker</header><text display-inline="yes-display-inline">The term <term>community health worker</term> means an individual who is a frontline health worker who is a trusted member of the community in which the worker serves or who has an unusually close understanding of the community served that enables the worker to build trusted relationships, serve as a liaison or link between health and social services and the community, facilitate access to services, improve the quality and cultural competence of service delivery, build individual and community capacity, and increase health knowledge and self-sufficiency through a wide range of community health worker core roles, including through—</text><paragraph id="H263A4AD2ED2E423AB2D40C8EB584C06F"><enum>(1)</enum><text>providing cultural mediation among individuals, communities, and health and social service systems;</text></paragraph><paragraph id="H1B2AF07593C6448DA34C53A4CAE73005"><enum>(2)</enum><text>providing culturally appropriate health education and information;</text></paragraph><paragraph id="H86B75C1F14F24362AB0C9BA64E4F6F2B"><enum>(3)</enum><text>providing care coordination, case management, and system navigation;</text></paragraph><paragraph id="H6CF269A357114655B593BF764CA06C78"><enum>(4)</enum><text>providing coaching and social support;</text></paragraph><paragraph id="H68C7EF3A85224ADD9DD739B88458E590"><enum>(5)</enum><text>advocating for individuals and communities;</text></paragraph><paragraph id="H0903576FFAE34B11BA2914739D504DD1"><enum>(6)</enum><text>building individual and community capacity;</text></paragraph><paragraph id="HCD2D67F1A2C14C1CA989100151A9E4B5"><enum>(7)</enum><text>providing direct service, including basic screening tests, such as weight and blood pressure screening, basic services such as diabetic foot checks, and meeting basic needs;</text></paragraph><paragraph id="H87CBD4A687914F17966E4CA5F8670272"><enum>(8)</enum><text>implementing individual and community assessments;</text></paragraph><paragraph id="H016DDF6684384D4EB01F7531FC4BD8E6"><enum>(9)</enum><text>conducting outreach; and</text></paragraph><paragraph id="H2F3EFC364FB246979AC263924150FF00"><enum>(10)</enum><text>participating in evaluation and research</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H46EECB01C650481F8F991EAC33A1F661" commented="no"><enum>(2)</enum><header>Payment rule</header><text>Section 1833 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395l">42 U.S.C. 1395l</external-xref>) is amended—</text><subparagraph id="H8403377CCD06442888C350F1BD68152D" commented="no"><enum>(A)</enum><text>in subsection (a)(1)—</text><clause id="H35990680CF9144BBA42514E67B1FE99A" commented="no"><enum>(i)</enum><text>in subparagraph (GG), by striking <quote>and</quote> at the end; and</text></clause><clause id="HB3742138F58B42FF88EF468290CBAA2D" commented="no"><enum>(ii)</enum><text>by inserting before the semicolon at the end the following: <quote>, and (II) with respect to professional services furnished by a community health worker (as defined in section 1861(nnn)) and certified community behavioral health clinic services (as defined in section 1905(jj)), the amounts paid shall be 100 percent of the lesser of the actual charge for the services or the amount determined under a fee schedule established by the Secretary for such services</quote>; and</text></clause></subparagraph><subparagraph id="H19B6CA1302484E0795733ABB1AC3D2B4"><enum>(B)</enum><text>in subsection (b)—</text><clause id="H3FF388C8CD324CDAA94C5AC91905B021"><enum>(i)</enum><text>by striking <quote>, and (13)</quote> and inserting <quote>(13)</quote>; and</text></clause><clause id="H14B31B24516D4F199B15942B23FE95C6"><enum>(ii)</enum><text>by striking <quote>1861(n).</quote> and inserting <quote>1861(n), (14) such deductible shall not apply with respect to professional services furnished by a community health worker (as defined in section 1861(nnn)), and (15) such deductible shall not apply with respect to certified community behavioral health clinic services (as defined in section 1905(jj))</quote>.</text></clause></subparagraph></paragraph></subsection><subsection id="H9D2389E7C67D44CD97769D974009DCEE"><enum>(b)</enum><header>Coverage of community health worker services under Medicaid</header><paragraph id="HDDE7969B390946F5840B4669648FA23B"><enum>(1)</enum><header>In general</header><text>Section 1905(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(a)</external-xref>) is amended—</text><subparagraph id="H6BE6E6C05CF14C9A94D2869E9B159832"><enum>(A)</enum><text>in paragraph (31), by striking <quote>and</quote> at the end;</text></subparagraph><subparagraph id="H346416DAA5CA423085D54243295F8FA3"><enum>(B)</enum><text>by redesignating paragraph (32) as paragraph (33); and</text></subparagraph><subparagraph id="H8C3CCBFB41B7491FA4B2291BE1C92135"><enum>(C)</enum><text>by inserting after paragraph (31) the following new paragraph:</text><quoted-block style="OLC" id="H4FA5E9FB96F54D3286CDF1E945760557" display-inline="no-display-inline"><paragraph id="H4002FB1FC36F45B9A6D5CB1A9622428A"><enum>(32)</enum><text display-inline="yes-display-inline">beginning on October 1, 2026, professional services furnished by a community health worker (as defined in section 1861(nnn)); and</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="HF43EDBDC591C46C2A54BB5685416E284"><enum>(2)</enum><header>FMAP increase</header><text>Section 1905 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d</external-xref>) is amended—</text><subparagraph id="HF4151658F10D4993A9FB8418DB47B5E9"><enum>(A)</enum><text>in subsection (b), by striking <quote>and (ii)</quote> and inserting <quote>(ii), and (kk)</quote>; and</text></subparagraph><subparagraph id="H23CBC9DE0CE643CAABB4C0E3BAB0DD2A"><enum>(B)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" id="H5A0324DF4B6646A5910F55D4ABF72F7A" display-inline="no-display-inline"><subsection id="H60EA80B3CCBF4FA49DC158BFE71089FB"><enum>(kk)</enum><header>Increased FMAP for community health worker services</header><text display-inline="yes-display-inline">For each fiscal quarter beginning on or after October 1, 2026, the Federal medical assistance percentage for a State shall be increased by 6 percentage points with respect to amounts expended by the State for medical assistance for professional services furnished by a community health worker (as defined in section 1861(nnn)).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection></section><section id="HE5F1A911E21842BD9AB513EEFC2ED94D"><enum>402.</enum><header>Community Health Workers in NHSC loan repayment program</header><text display-inline="no-display-inline">Section 338B of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/254l-1">42 U.S.C. 254l–1</external-xref>) is amended—</text><paragraph id="H8CFB87857D8D472EBE2545C4DD301E22"><enum>(1)</enum><text>in subsection (b)(1)(A), by striking <quote>or physician assistant</quote> and inserting <quote>physician assistant, or community health worker</quote>; and</text></paragraph><paragraph id="H2C2EFF40CD354B1AAD43D8325E572417"><enum>(2)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" id="HD89B4C2C232C4A03922518936B9E3FE3" display-inline="no-display-inline"><subsection id="H79D71866B5E844269870F3C60BEDF928"><enum>(i)</enum><header>Community health worker defined</header><text>In this section, the term <term>community health worker</term> means an individual who—</text><paragraph id="H343514616DBB42B6990A0A463E756018"><enum>(1)</enum><text>promotes wellness by helping individuals adopt healthy behaviors;</text></paragraph><paragraph id="H0A6E902FCF8242A892DF42D05AD3259D"><enum>(2)</enum><text>implements programs and advocates for individuals who may have limited access to health resources and social services; and</text></paragraph><paragraph id="H2939BCB59EAD4513B315372877C307E8"><enum>(3)</enum><text>works closely with other health care and social service providers.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><enum>V</enum><header>Education</header><section id="H754EB98C3E4D4F1A8F68CCDB014E5475" commented="no"><enum>501.</enum><header>School-based services under Medicaid and CHIP</header><text display-inline="no-display-inline">Section 11003(b) of the Bipartisan Safer Communities Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a</external-xref> note) is amended by inserting <quote>, and $50,000,000 for fiscal year 2026,</quote> after <quote>fiscal year 2022</quote>. </text></section><section id="HB3CC2ECB078D4F6F83FC5B50EEF20704" commented="no"><enum>502.</enum><header>Support for Project AWARE</header><text display-inline="no-display-inline">Part D of title V of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/290dd">42 U.S.C. 290dd et seq.</external-xref>) is amended by adding at the end the following:</text><quoted-block style="OLC" id="H6F855702ECD645D7B759C174E12789A6" display-inline="no-display-inline"><section id="HA28BE08964F84FCAB7C1C67B291D16F7" commented="no"><enum>554.</enum><header>Project AWARE grants</header><subsection id="H66B9BB26F6274098AC45EE12F5998154" commented="no"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, (in this section referred to as the <quote>Secretary</quote>) shall establish the Project Advancing Wellness and Resiliency in Education (in this section referred to as <quote>Project AWARE</quote>), to award grants to develop a sustainable infrastructure for school-based mental health programs and services.</text></subsection><subsection id="HDB76F95F67B04F579F6757608BD9C793" commented="no"><enum>(b)</enum><header>Use of funds</header><text display-inline="yes-display-inline">A grant awarded under Project AWARE may be used to provide peer mental health first aid training, including—</text><paragraph id="H417A9CF660D345CA83ECAC2FCF7D422D" commented="no"><enum>(1)</enum><text display-inline="yes-display-inline">to train teachers, other relevant school personnel (including education support professionals), students, and parents and caregivers of students—</text><subparagraph id="H3B4DCE69E82B4B98AFC34ADCF986499F" commented="no"><enum>(A)</enum><text>to recognize symptoms of childhood and adolescent mental health conditions;</text></subparagraph><subparagraph id="HEA456E2CF504464F9D6551AF9F5C50B7" commented="no"><enum>(B)</enum><text>to refer teachers, school personnel, students, and their family members to appropriate mental health services if necessary; and</text></subparagraph><subparagraph id="H61BF9540CE6B46BDB566168C0CB04FE9" commented="no"><enum>(C)</enum><text>to recognize signs of immediate mental distress and, upon recognizing such signs apply mental health first aid tactics; and</text></subparagraph></paragraph><paragraph id="H0741B984FB344535A265D15B84B6CBF6" commented="no"><enum>(2)</enum><text>to provide education to such teachers, personnel, students, parents, and caregivers regarding resources that are available in the community for individuals with a mental illness.</text></paragraph></subsection><subsection id="H00374B1573E04593B8FE5CBC2C12E546" commented="no"><enum>(c)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $130,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="H371ABB9BC79F4518B52BCD7650F4B61B"><enum>503.</enum><header>Support for the 21st Century Community Learning Centers program and the Full-Service Community Schools Program</header><subsection id="H37A0014911FA4D59ACA4EF3C798294D9"><enum>(a)</enum><header>Community learning center services, programs, and activities</header><text display-inline="yes-display-inline">Section 4201(a)(2) of the Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7171">20 U.S.C. 7171(a)(2)</external-xref>) is amended by inserting <quote>mental health services, community service activities,</quote> after <quote>counseling programs,</quote>.</text></subsection><subsection id="H0CD8D5B03C2F41FF9B88BD9BF5791DEC"><enum>(b)</enum><header>Authorization of appropriations for 21st Century Community Learning Centers program</header><text display-inline="yes-display-inline">Section 4206 of the Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7176">20 U.S.C. 7176</external-xref>) is amended to read as follows:</text><quoted-block style="OLC" id="HC9CE16CF48EF47DD9CC3AA2FD7C5DD2C" display-inline="no-display-inline"><section id="H6CB21261D7BF48BBB6323A93ED0556BD"><enum>4206.</enum><header>Authorization of appropriations</header><text display-inline="no-display-inline">There are authorized to be appropriated to carry out this part—</text><paragraph id="H1FF2CB66701E4615916BB92D6B1B404C"><enum>(1)</enum><text display-inline="yes-display-inline">$1,329,673,000 for fiscal year 2025;</text></paragraph><paragraph id="HD8BAB8B536A44B6D93136BB841213B22"><enum>(2)</enum><text display-inline="yes-display-inline">$1,429,673,000 for fiscal year 2026;</text></paragraph><paragraph id="H88508F9AE6F943AE96CAA5BE83B9AFCA"><enum>(3)</enum><text display-inline="yes-display-inline">$1,529,673,000 for fiscal year 2027;</text></paragraph><paragraph id="HD8371461D3B9403E9184A263AEE86F5E"><enum>(4)</enum><text display-inline="yes-display-inline">$1,629,673,000 for fiscal year 2028; and</text></paragraph><paragraph id="H7C6005212E2644A6AB62777200D7E4AA"><enum>(5)</enum><text display-inline="yes-display-inline">$1,729,673,000 for fiscal year 2029.</text></paragraph></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="H9F168CECFFFC411EA23BD605202F23AA"><enum>(c)</enum><header>Authorization of appropriations for full-Service community schools program</header><text display-inline="yes-display-inline">Section 4601 of the Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7251">20 U.S.C. 7251(a)</external-xref>) is amended—</text><paragraph id="HBE671F6630694B8491BA8F938CEBF839"><enum>(1)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1) of subsection (a), by inserting <quote>(except for section 4625)</quote> after <quote>part</quote>;</text></paragraph><paragraph id="HE3303CFFF094477688C0A2375D1825D7"><enum>(2)</enum><text display-inline="yes-display-inline">in the matter preceding clause (i) of subsection (b)(2)(B), by inserting <quote>(except for section 4625)</quote> after <quote>subpart 2</quote>; and</text></paragraph><paragraph id="HB37DC8869F5B430BB8B140A869C64D20"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" id="HC0BD700F83664F08BCB37C5194A856F8" display-inline="no-display-inline"><subsection id="HE30F5D4359234D079DFC3957609FF8B4"><enum>(c)</enum><header>Authorization of appropriations for full-Service community schools</header><text display-inline="yes-display-inline">There are authorized to be appropriated to carry out section 4625—</text><paragraph id="HC4D6111C1A4C4A5AA88F431D0B717D0D"><enum>(1)</enum><text display-inline="yes-display-inline">$500,000,000 for fiscal year 2025;</text></paragraph><paragraph id="HD05B43EA7AF44C7EBDE170176CF47692"><enum>(2)</enum><text display-inline="yes-display-inline">$600,000,000 for fiscal year 2026;</text></paragraph><paragraph id="H1F93D8DBE8E4497994AFE7310EDAAA47"><enum>(3)</enum><text display-inline="yes-display-inline">$700,000,000 for fiscal year 2027;</text></paragraph><paragraph id="H92978DBB66994D838587A9A080D9C406"><enum>(4)</enum><text display-inline="yes-display-inline">$850,000,000 for fiscal year 2028; and</text></paragraph><paragraph id="H3010703CAF72404498B79B12FAB473AF"><enum>(5)</enum><text display-inline="yes-display-inline">$1,000,000,000 for fiscal year 2029.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="HA181959D80054AEDA4637762351051DE"><enum>(d)</enum><header>Conforming amendments</header><text>Section 4623(a) of the Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7273">20 U.S.C. 7273(a)</external-xref>) is amended—</text><paragraph id="H30EA607BBFAC4ECC9ACFA62ED3041CCD"><enum>(1)</enum><text>by redesignating paragraph (2) as paragraph (3); and</text></paragraph><paragraph id="HA7A71117AF014CC9B7A0E8571CCD161F"><enum>(2)</enum><text>by striking paragraph (1) and inserting the following:</text><quoted-block id="HE9172491FC0B4D17BFDA1B80BF50305A" style="OLC"><paragraph id="H209292E25ADD4056B296B255A084E224"><enum>(1)</enum><header>Promise neighborhoods</header><text>The Secretary shall use not less than 95 percent of the amounts made available under section 4601(b)(2)(B) to award grants, on a competitive basis and subject to subsection (e), to eligible entities for the implementation of a comprehensive, effective continuum of coordinated services that meets the purpose described in section 4621(1) by carrying out activities in neighborhoods with—</text><subparagraph id="H2AB0051B7C0649EF80F870F0BF7AB595"><enum>(A)</enum><text>high concentrations of low-income individuals;</text></subparagraph><subparagraph id="HC0648066A0AD4D009926807D3F618D37"><enum>(B)</enum><text>multiple signs of distress, which may include high rates of poverty, childhood obesity, academic failure, and juvenile delinquency, adjudication, or incarceration; and</text></subparagraph><subparagraph id="H9C0DF03D82A046CF94572867E0B113B8"><enum>(C)</enum><text>schools implementing comprehensive support and improvement activities or targeted support and improvement activities under section 1111(d).</text></subparagraph></paragraph><paragraph id="HED1B36C84D7F4A8090F99E901E96869F"><enum>(2)</enum><header>Full-service community schools authorized</header><text>The Secretary shall use the amounts made available under section 4601(c) to carry out the full-service community school program under section 4625.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section><enum>VI</enum><header>Definitions</header><section id="HC7936015E13E450886B2603039E2FB5F"><enum>601.</enum><header>Definitions</header><text display-inline="no-display-inline">In this Act:</text><paragraph id="H5D513E374E494DA38BD1A0E434058594" display-inline="no-display-inline"><enum>(1)</enum><header>Burnout</header><text>The term <term>burnout</term> means exhaustion and mental distance from one’s job.</text></paragraph><paragraph id="HADE8F78251B7410FAF7C446D2BF934AB"><enum>(2)</enum><header>Loneliness</header><text>The term <term>loneliness</term> means subjectively feeling alone, or the discrepancy between one’s desired level of social connection and one’s actual level of social connection.</text></paragraph><paragraph id="HBD5D08AFA9E34D18964F89AE3B1504B1"><enum>(3)</enum><header>Social connection</header><text>The term <term>social connection</term> means the variety of ways one can connect with others socially, through physical, behavioral, social-cognitive, and emotional channels.</text></paragraph><paragraph id="HB3B446C5089345ED8CC64472AB476B86"><enum>(4)</enum><header>Social isolation</header><text>The term <term>social isolation</term> means objectively being alone, or having few relationships or infrequent social contact.</text></paragraph><paragraph id="H7231B01BF03C4BA3BDACEE8DAD3B58A0" commented="no"><enum>(5)</enum><header>Underserved communities</header><text>The term <term>underserved communities</term> includes communities with a high proportion of individuals who—</text><subparagraph id="H3E3CC9AEE0194979854CE8B2412A334F" display-inline="no-display-inline"><enum>(A)</enum><text>are socioeconomically disadvantaged;</text></subparagraph><subparagraph id="H96B20BF59E1A407E990BE030116EE069"><enum>(B)</enum><text>have limited English proficiency;</text></subparagraph><subparagraph id="H2F14E51A5077437794C70B29FBE8D621"><enum>(C)</enum><text>are geographically isolated;</text></subparagraph><subparagraph id="H89D9D2F060CB474F8F67007DB33AB56F"><enum>(D)</enum><text>are educationally disenfranchised;</text></subparagraph><subparagraph id="H8881750E2F634AABA8E710E1860CE8FD"><enum>(E)</enum><text>are individuals of color;</text></subparagraph><subparagraph id="H6C72A8C8F9FB4875A7AB583579E32BFD"><enum>(F)</enum><text>are of ethnic or national origin minorities;</text></subparagraph><subparagraph id="H6A90D45231CD4E19AA65EF2770EE9E19"><enum>(G)</enum><text>are women or children;</text></subparagraph><subparagraph id="H10C9C438B5E04272B691C4EE9F666FDC"><enum>(H)</enum><text>have disabilities; or</text></subparagraph><subparagraph id="H0DED31F0C27E4C048C03C66CDBD92CEA"><enum>(I)</enum><text>are seniors. </text></subparagraph></paragraph></section>