[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1523 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1523

To amend the Public Health Service Act to establish a grant program to 
    provide supportive services in permanent supportive housing for 
 chronically homeless individuals and families, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 28, 2009

  Mr. Burr (for himself and Mr. Reed) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to establish a grant program to 
    provide supportive services in permanent supportive housing for 
 chronically homeless individuals and families, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Services for Ending Long-Term 
Homelessness Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Nationally, on any given night, there are approximately 
        124,000 people who are experiencing chronic homelessness, 
        including some families with children. Chronically homeless 
        people often live in shelters or on the streets for years at a 
        time, experience repeated episodes of homelessness without 
        achieving housing stability, or cycle between homelessness, 
        jails, mental health facilities, and hospitals.
            (2) In 2003, the President's New Freedom Commission on 
        Mental Health recommended the development and implementation of 
        a comprehensive plan designed to facilitate access to 150,000 
        units of permanent supportive housing for consumers and 
        families who are chronically homeless. The Commission found 
        that affordable housing alone is insufficient for many people 
        with severe mental illness, and that flexible, mobile, 
        individualized support services are also necessary to support 
        and sustain consumers in their housing. Since the Commission 
        made the recommendations, approximately 60,000 units of 
        permanent supportive housing have been developed and currently 
        another 30,000 are under development. However, funding for the 
        services continues to be an ongoing problem even with respect 
        to existing service providers.
            (3) By implementing permanent supportive housing, 
        communities are making progress toward ending chronic 
        homelessness.
            (4) Permanent supportive housing is a proven and cost-
        effective solution to chronic homelessness. A 2007 study, of 
        progress in Portland, Oregon in ending chronic homelessness, 
        found that the city and county saved $15,000 per person 
        involved per year by housing chronically homeless individuals. 
        Also, a 2009 study in Seattle illustrated that one program 
        saved $29,388 per person involved per year by implementing 
        permanent supportive housing.
            (5) Current programs for funding services in permanent 
        supportive housing, other than those administered by the 
        Department of Housing and Urban Development, were not designed 
        to be closely coordinated with housing resources, nor were they 
        designed to meet the multiple needs of people who are 
        chronically homeless.

SEC. 3. DUTIES OF ADMINISTRATOR OF SUBSTANCE ABUSE AND MENTAL HEALTH 
              SERVICES ADMINISTRATION.

    Section 501(d) of the Public Health Service Act (42 U.S.C. 
290aa(d)) is amended--
            (1) in paragraph (17), by striking ``and'' at the end;
            (2) in paragraph (18), by striking the period and inserting 
        ``; and''; and
            (3) by adding at the end the following:
            ``(19) collaborate with Federal departments and programs 
        that are part of the President's Interagency Council on 
        Homelessness, particularly the Department of Housing and Urban 
        Development, the Department of Labor, and the Department of 
        Veterans Affairs, and with other agencies within the Department 
        of Health and Human Services, particularly the Health Resources 
        and Services Administration, the Administration on Children and 
        Families, and the Centers for Medicare & Medicaid Services, to 
        design national strategies for providing services in supportive 
        housing that will assist in ending chronic homelessness and to 
        implement programs that address chronic homelessness.''.

SEC. 4. GRANTS FOR SERVICES FOR CHRONICALLY HOMELESS INDIVIDUALS AND 
              FAMILIES IN SUPPORTIVE HOUSING.

    (a) In General.--Title V of the Public Health Service Act (42 
U.S.C. 290aa et seq.), as amended by subsection (b), is amended by 
adding at the end the following:

       ``PART K--GRANTS FOR SERVICES TO END CHRONIC HOMELESSNESS

``SEC. 597. GRANTS FOR SERVICES TO END CHRONIC HOMELESSNESS.

    ``(a) In General.--
            ``(1) Grants.--The Secretary shall make grants to entities 
        described in paragraph (2) for the purpose of carrying out 
        projects to provide the services described in subsection (d) to 
        chronically homeless individuals and families in permanent 
        supportive housing.
            ``(2) Eligible entities.--For purposes of paragraph (1), an 
        entity described in this paragraph is--
                    ``(A) a State or political subdivision of a State, 
                an Indian tribe or tribal organization, or a public or 
                nonprofit private entity, including a community-based 
                provider of homelessness services, health care, 
                housing, or other services important to individuals and 
                families who are chronically homeless; or
                    ``(B) a consortium composed of entities described 
                in subparagraph (A), which consortium includes a public 
                or nonprofit private entity that serves as the lead 
                applicant and has responsibility for fiscal management, 
                project management, and coordinating the activities of 
                the consortium.
    ``(b) Priorities.--In making grants under subsection (a), the 
Secretary shall give priority to applicants demonstrating that the 
applicants--
            ``(1) target the services described in subsection (d) and 
        related funds to individuals or families who--
                    ``(A) have been homeless for longer periods of time 
                or have experienced more episodes of homelessness than 
                are required to be individuals or families who are 
                chronically homeless;
                    ``(B) have high rates of utilization of emergency 
                public systems of care; or
                    ``(C) have a history of interactions with law 
                enforcement and the criminal justice system;
            ``(2) have greater funding commitments from State or local 
        government agencies responsible for overseeing mental health 
        treatment, substance use disorder treatment, medical care, and 
        employment (including commitments to provide Federal funds in 
        accordance with subsection (e)(2)(B)(ii));
            ``(3) will provide for an increase in the number of units 
        of permanent supportive housing that would serve chronically 
        homeless individuals and families in the community as a result 
        of an award of a grant under subsection (a); and
            ``(4) have demonstrated experience providing services to 
        address the mental health and substance use disorder problems 
        of chronically homeless individuals and families living in 
        permanent supportive housing settings.
    ``(c) Geographic Distribution.--The Secretary shall ensure that 
consideration is given to geographic distribution (such as urban and 
rural areas) in the awarding of grants under subsection (a).
    ``(d) Services.--The services referred to in subsection (a) are the 
following:
            ``(1) Services provided by the grantee or by qualified 
        subcontractors that promote recovery and self-sufficiency and 
        address barriers to housing stability, including the following:
                    ``(A) Mental health services, including treatment 
                and recovery support services.
                    ``(B) Substance use disorder treatment and recovery 
                support services, including counseling, treatment 
                planning, recovery coaching, and relapse prevention.
                    ``(C) Integrated, coordinated treatment and 
                recovery support services for co-occurring disorders.
                    ``(D) Health education, including referrals for 
                medical and dental care.
                    ``(E) Services designed to help individuals and 
                families make progress toward self-sufficiency and 
                recovery, including benefits advocacy, money 
                management, life-skills training, self-help programs, 
                and engagement and motivational interventions.
                    ``(F) Parental skills and family support.
                    ``(G) Case management.
                    ``(H) Other supportive services that promote an end 
                to chronic homelessness.
                    ``(I) Coordination or partnership with other 
                agencies, programs, or mainstream benefits to maximize 
                the availability of services and resources to meet the 
                needs of chronically homeless individuals and families 
                living in supportive housing using cost-effective 
                approaches that avoid duplication.
                    ``(J) Data collection and measuring performance 
                outcomes as specified in subsection (k).
            ``(2) Services, as described in paragraph (1), that are 
        delivered to individuals and families who are chronically 
        homeless and who are scheduled to become residents of permanent 
        supportive housing within 90 days pending the location or 
        development of an appropriate unit of housing.
            ``(3) For individuals and families who are otherwise 
        eligible, and who have voluntarily chosen to seek other housing 
        opportunities after a period of tenancy in supportive housing, 
        services, as described in paragraph (1), that are delivered, 
        for a period of 90 days after exiting permanent supportive 
        housing or until the individuals have transitioned to 
        comprehensive services adequate to meet their current needs, 
        provided that the purpose of the services is to support the 
        individuals in their choice to transition into housing that is 
        responsive to their individual needs and preferences.
    ``(e) Matching Funds.--
            ``(1) In general.--A condition for the receipt of a grant 
        under subsection (a) is that, with respect to the cost of the 
        project to be carried out by an applicant pursuant to such 
        subsection, the applicant agrees as follows:
                    ``(A) In the case of the initial grant pursuant to 
                subsection (j)(1)(A), the applicant will, in accordance 
                with paragraphs (2) and (3), make available 
                contributions toward such costs in an amount that is 
                not less than $1 for each $3 of Federal funds provided 
                in the grant.
                    ``(B) In the case of a renewal grant pursuant to 
                subsection (j)(1)(B), the applicant will, in accordance 
                with paragraphs (2) and (3), make available 
                contributions toward such costs in an amount that is 
                not less than $1 for each $1 of Federal funds provided 
                in the grant.
            ``(2) Source of contribution.--For purposes of paragraph 
        (1), contributions made by an applicant are in accordance with 
        this paragraph if made as follows:
                    ``(A) The contribution is made from funds of the 
                applicant or from donations from public or private 
                entities.
                    ``(B) Of the contribution--
                            ``(i) not less than 80 percent is from non-
                        Federal funds; and
                            ``(ii) not more than 20 percent is from 
                        Federal funds provided under programs that--
                                    ``(I) are not expressly directed at 
                                services for homeless individuals, but 
                                whose purposes are broad enough to 
                                include the provision of a service or 
                                services described in subsection (d) as 
                                authorized expenditures under such 
                                program; and
                                    ``(II) do not prohibit Federal 
                                funds under the program from being used 
                                to provide a contribution that is 
                                required as a condition for obtaining 
                                Federal funds.
            ``(3) Determination of amount contributed.--Contributions 
        required in paragraph (1) may be in cash or in kind, fairly 
        evaluated, including plant, equipment, or services. Amounts 
        provided by the Federal Government, or services assisted or 
        subsidized to any significant extent by the Federal Government, 
        may not be included in determining the amount of non-Federal 
        contributions required in paragraph (2)(B)(i).
    ``(f) Administrative Expenses.--A condition for the receipt of a 
grant under subsection (a) is that the applicant involved agree that 
not more than 10 percent of the grant will be expended for 
administrative expenses with respect to the grant. Expenses for data 
collection and measuring performance outcomes as specified in 
subsection (k) shall not be considered as administrative expenses 
subject to the limitation in this subsection.
    ``(g) Certain Uses of Funds.--Notwithstanding other provisions of 
this section, a grantee under subsection (a) may expend not more than 
20 percent of the grant to provide the services described in subsection 
(d) to homeless individuals or families who are not chronically 
homeless individuals or families.
    ``(h) Application for Grant.--A grant may be made under subsection 
(a) only if an application for the grant is submitted to the Secretary 
and the application is in such form, is made in such manner, and 
contains such agreements, assurances, and information as the Secretary 
determines to be necessary to carry out this section.
    ``(i) Certain Requirements.--A condition for the receipt of a grant 
under subsection (a) is that the applicant involved demonstrate the 
following:
            ``(1) The applicant and all direct providers of services 
        have the experience, infrastructure, and expertise needed to 
        ensure the quality and effectiveness of services, which may be 
        demonstrated by any of the following:
                    ``(A) Compliance with all local, city, county, or 
                State requirements for licensing, accreditation, or 
                certification (if any) which are applicable to the 
                proposed project.
                    ``(B) A minimum of 2 years experience providing 
                comparable services that do not require licensing, 
                accreditation, or certification.
                    ``(C) Certification as a Medicaid service provider, 
                including health care for the homeless programs and 
                community health centers.
                    ``(D) An executed agreement with a relevant State 
                or local government agency that will provide oversight 
                over the mental health, substance use disorder, or 
                other services that will be delivered by the project.
            ``(2) There is a mechanism for determining whether 
        residents of permanent supportive housing are chronically 
        homeless individuals or families. Such a mechanism may rely on 
        local data systems or records of shelter admission. If there 
        are no sources of data regarding the duration or number of 
        homeless episodes, or if such data are unreliable for the 
        purposes of this subsection, an applicant must demonstrate that 
        the project will implement appropriate procedures, taking into 
        consideration the capacity of local homeless service providers 
        to document episodes of homelessness and the challenges of 
        engaging individuals and families who have been chronically 
        homeless, to verify that an individual or family is chronically 
        homeless.
            ``(3) The applicant participates in a local, regional, or 
        statewide homeless management information system.
    ``(j) Duration of Initial and Renewal Grants; Additional Provisions 
Regarding Renewal Grants.--
            ``(1) In general.--Subject to paragraphs (2) and (3), the 
        period during which payments are made to a grantee under 
        subsection (a) shall be in accordance with the following:
                    ``(A) In the case of the initial grant, the period 
                of payments shall be 5 years.
                    ``(B) In the case of a subsequent grant (referred 
                to in this subsection as a `renewal grant'), the period 
                of payments shall not be more than 5 years.
            ``(2) Annual approval; availability of appropriations; 
        number of grants.--The provision of payments under an initial 
        or renewal grant is subject to annual approval by the Secretary 
        of the payments and to the availability of appropriations for 
        the fiscal year involved to make the payments. This subsection 
        may not be construed as establishing a limitation on the number 
        of grants under subsection (a) that may be made to an entity.
            ``(3) Additional provisions regarding renewal grants.--
                    ``(A) Compliance with minimum standards.--A renewal 
                grant may be made by the Secretary only if the 
                Secretary determines that the applicant involved has, 
                in the project carried out with the grant, maintained 
                compliance with minimum standards for quality and 
                successful outcomes for housing retention, as 
                determined by the Secretary.
                    ``(B) Amount.--The maximum amount of a renewal 
                grant under this subsection for an applicant shall not 
                exceed an amount equal to 75 percent of the amount of 
                Federal funds provided to the applicant in the final 
                year of the initial grant period.
    ``(k) Strategic Performance Outcomes and Reports.--
            ``(1) In general.--The Secretary shall, as a condition of 
        the receipt of grants under subsection (a), require grantees to 
        provide data regarding the performance outcomes of the projects 
        carried out under the grants. Consistent with the requirements 
        and procedures established by the Secretary, each grantee shall 
        measure and report specific performance outcomes related to the 
        long-term goals of increasing stability within the community 
        for individuals and families who have been chronically 
        homeless, and decreasing the recurrence of periods of 
        homelessness.
            ``(2) Performance outcomes.--The performance outcomes 
        described under paragraph (1) shall include, with respect to 
        individuals and families who have been chronically homeless--
                    ``(A) improvements in housing stability;
                    ``(B) improvements in employment and education;
                    ``(C) reductions in problems related to substance 
                use disorders;
                    ``(D) reductions in problems related to mental 
                health disorders; and
                    ``(E) other areas as the Secretary determines 
                appropriate.
            ``(3) Coordination and consistency with other homeless 
        assistance programs.--
                    ``(A) Procedures.--In establishing strategic 
                performance outcomes and reporting requirements under 
                paragraph (1), the Secretary shall develop and 
                implement procedures that minimize the costs and 
                burdens to grantees and program participants, and that 
                are practical, streamlined, and designed for 
                consistency with the requirements of the homeless 
                assistance programs administered by the Secretary of 
                Housing and Urban Development.
                    ``(B) Applicant coordination.--Applicants under 
                this section shall coordinate with community 
                stakeholders, including participants in the local 
                homeless management information system, concerning the 
                development of systems to measure performance outcomes 
                and with the Secretary for assistance with data 
                collection and measurements activities.
            ``(4) Report.--A grantee shall submit an annual report to 
        the Secretary that--
                    ``(A) identifies the grantee's progress toward 
                achieving its strategic performance outcomes; and
                    ``(B) describes other activities conducted by the 
                grantee to increase the participation, housing 
                stability, and other improvements in outcomes for 
                individuals and families who have been chronically 
                homeless.
    ``(l) Training and Technical Assistance.--The Secretary, directly 
or through awards of grants or contracts to public or nonprofit private 
entities, shall provide training and technical assistance regarding the 
planning, development, and provision of services in projects under 
subsection (a).
    ``(m) Biennial Reports to Congress.--Not later than 2 years after 
the date of the enactment of the Services for Ending Long-Term 
Homelessness Act, and biennially thereafter, the Secretary shall submit 
to the appropriate committees of Congress a report on projects under 
subsection (a) that--
            ``(1) includes a summary of information received by the 
        Secretary under subsection (k);
            ``(2) describes how the services provided under each such 
        project are coordinated with State and local social service 
        programs and homelessness assistance programs, and services 
        provided by the Department of Veterans Affairs and other 
        relevant Federal agencies; and
            ``(3) includes an evaluation of the manner in which funds 
        are used under such projects, and the effectiveness of such 
        projects in ending long-term homelessness and improving 
        outcomes for individuals with mental illness or substance use 
        disorder problems.
    ``(n) Definitions.--For purposes of this section:
            ``(1) Chronically homeless.--
                    ``(A) In general.--The term `chronically homeless', 
                used with respect to an individual or family, means an 
                individual or family who--
                            ``(i) is homeless;
                            ``(ii) has been homeless continuously for 
                        at least 1 year or has been homeless on at 
                        least 4 separate occasions in the last 3 years; 
                        and
                            ``(iii) has an adult head of household (or 
                        a minor head of household if no adult is 
                        present in the household) with a diagnosable 
                        substance use disorder, a serious mental 
                        illness, a developmental disability (as defined 
                        in section 102 of the Developmental 
                        Disabilities Assistance and Bill of Rights Act 
                        of 2000 (42 U.S.C. 15002)), post traumatic 
                        stress disorder, a cognitive impairment 
                        resulting from a brain injury, or a chronic 
                        physical illness or disability or the co-
                        occurrence of 2 or more chronic physical 
                        illnesses or disabilities.
                    ``(B) Rule of construction.--An individual shall be 
                considered to be chronically homeless if such 
                individual--
                            ``(i) resides in an institutional care 
                        facility, including a jail, substance use 
                        disorder or mental health treatment facility, 
                        hospital, or other similar facility;
                            ``(ii) has resided in a facility described 
                        in clause (i) for fewer than 90 days; and
                            ``(iii) met all of the requirements 
                        described in subparagraph (A) prior to entering 
                        that facility.
            ``(2) Homeless.--The term `homeless' means living or 
        residing in a place not meant for human habitation, in a safe 
        haven, or in an emergency homeless shelter.
            ``(3) Permanent supportive housing.--
                    ``(A) In general.--The term `permanent supportive 
                housing' means permanent, affordable housing with 
                flexible support services that are available and 
                designed to help the tenants stay housed and build the 
                necessary skills to live as independently as possible. 
                Such term does not include housing that is time-
                limited. Supportive housing offers residents assistance 
                in reaching their full potential, which may include 
                opportunities to secure other housing that meets their 
                needs and preferences, based on individual choice 
                instead of the requirements of time-limited 
                transitional programs. Under this section, permanent 
                affordable housing includes permanent housing funded or 
                assisted through title IV of the McKinney-Vento 
                Homeless Assistance Act (42 U.S.C. 11361 et seq.) and 
                section 8 of the United States Housing Act of 1937 (42 
                U.S.C. 1437f).
                    ``(B) Affordable.--For purposes of subparagraph 
                (A), the term `affordable' means within the financial 
                means of individuals who are extremely low income, as 
                defined by the Secretary of Housing and Urban 
                Development.
            ``(4) Substance use disorder services.--The term `substance 
        use disorder', used with respect to services, has the meaning 
        given the term `substance abuse services' in section 
        330(h)(5)(C).
    ``(o) Funding.--
            ``(1) Authorization of appropriations.--For the purpose of 
        carrying out this section, there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 2010 through 2014.
            ``(2) Allocation for training and technical assistance.--Of 
        the amount appropriated under paragraph (1) for a fiscal year, 
        the Secretary may reserve not more than 3 percent for carrying 
        out subsection (l).''.
    (b) Technical Amendments to Public Health Service Act.--Title V of 
the Public Health Service Act (42 U.S.C. 290aa et seq.) is amended by--
            (1) redesignating part G, as added by section 144 of the 
        Community Renewal Tax Relief Act of 2000, as part J; and
            (2) redesignating sections 581 through 584, as added by 
        section 144 of such Act, as sections 596 through 596C, 
        respectively.
    (c) Citation Amendment.--Effective on the effective date described 
in section 1503 of the Homeless Emergency Assistance and Rapid 
Transition to Housing Act of 2009 (42 U.S.C. 11302 note), section 
597(n)(3)(A) of the Public Health Service Act, as added by subsection 
(a), is amended by striking ``(42 U.S.C. 11361 et seq.)'' and inserting 
``(42 U.S.C. 11360 et seq.)''.
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