[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3272 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 3272
To amend the Public Health Service Act to establish a grant program to
place in permanent supportive housing, and provide supportive services,
to individuals who have physical or mental health conditions or
substance use disorders and are chronically homeless or at risk of
becoming chronically homeless, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 13, 2019
Mr. Hastings (for himself, Ms. Lee of California, Ms. Jackson Lee, Mr.
McGovern, Mr. Cohen, Ms. Norton, and Mr. Gomez) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to establish a grant program to
place in permanent supportive housing, and provide supportive services,
to individuals who have physical or mental health conditions or
substance use disorders and are chronically homeless or at risk of
becoming chronically homeless, 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) Point-in-time data collected by the Department of
Housing and Urban Development in 2018 found that, nationally,
on any given night, there are approximately 96,913 people who
are experiencing chronic homelessness. 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 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.
(3) The United States Interagency Council on Homelessness
(USICH), originally authorized by title II of the McKinney-
Vento Homeless Assistance Act (42 U.S.C. 11311 et seq.) and
reauthorized by the Homeless Emergency Assistance and Rapid
Transition to Housing (HEARTH) Act of 2009 (division B of
Public Law 111-22), is responsible for coordinating the Federal
response to homelessness in cooperation with the Secretaries
and senior leaders of the 19 Federal member agencies. Since the
USICH's implementation of ``Opening Doors: Federal Strategic
Plan to Prevent and End Homelessness'', chronic homelessness in
the United States has been reduced by 18 percent.
(4) Research indicates that permanent supportive housing is
a cost-effective solution to chronic homelessness that leads to
improved residential stability and reduction in psychiatric
symptoms. Studies have also shown that supportive housing is
associated with significant reductions in costs for emergency
room visits, hospitalizations, shelters, sobering centers,
jails, and other public services used by people experiencing
homelessness.
(5) By implementing permanent supportive housing,
communities are making progress toward ending chronic
homelessness.
SEC. 3. DUTIES OF ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE
USE.
Section 501(d) of the Public Health Service Act (42 U.S.C.
290aa(d)) is amended--
(1) in paragraph (24), by striking ``and'' at the end;
(2) in paragraph (25), by striking the period and inserting
``; and''; and
(3) by adding at the end the following:
``(26) collaborate with Federal departments and programs
that are part of the United States 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 for 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 further amended
by adding at the end the following:
``PART L--GRANTS FOR SERVICES TO END CHRONIC HOMELESSNESS
``SEC. 598. GRANTS FOR SERVICES TO END CHRONIC HOMELESSNESS.
``(a) In General.--
``(1) Grants.--The Secretary shall make grants to entities
described in paragraph (2) for projects--
``(A) to place in permanent supportive housing--
``(i) individuals who have physical or
mental health conditions or substance use
disorders and are chronically homeless or at
risk of becoming chronically homeless; and
``(ii) their families; and
``(B) to provide the supportive services described
in subsection (d) to such individuals and their
families.
``(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.--
``(1) In selecting grantees.--In making grants under
subsection (a), the Secretary shall give priority to applicants
demonstrating that the applicants--
``(A) prioritize the services described in
subsection (d) and related funds to individuals or
families who--
``(i) 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;
``(ii) have high rates of utilization of
emergency public systems of care; or
``(iii) have a history of interactions with
law enforcement and the criminal justice
system;
``(B) 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));
``(C) 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
``(D) 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.
``(2) In providing supportive services.--A condition for
the receipt of a grant under subsection (a) is that the
applicant agrees that, in using the grant to place individuals
and their families in permanent supportive housing, and to
provide supportive services described in subsection (d), the
applicant will give priority to individuals and families
described in subsection (a)(1) who, at the time of their
placement in permanent supportive housing, are chronically
homeless.
``(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, peer support, 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) Services designed to help individuals obtain
employment.
``(G) Parental skills and family support.
``(H) Case management.
``(I) Other supportive services that promote an end
to chronic homelessness.
``(J) 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.
``(K) 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 $4 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 $2 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 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 agrees 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 supportive services as described in
subsection (a)(1)(B).
``(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, at the time of
being placed in such housing, chronically homeless or at risk
of becoming chronically homeless. 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 or at risk of becoming 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, totaling 12 months
in one year 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. 11360 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).
``(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 fiscal
years 2020 through 2025.
``(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 the second part G (42 U.S.C. 290kk et
seq.), as added by section 144 of the Community Renewal Tax
Relief Act of 2000, as part J;
(2) redesignating sections 581, 582, 583, and 584 (42
U.S.C. 290kk, 290kk-1, 290kk-2, 290kk-3), as added by such
section 144, as sections 596, 596A, 596B, and 596C,
respectively; and
(3) redesignating the second section 550 (42 U.S.C. 290ee-
10), as added by section 8214 of the SUPPORT for Patients and
Communities Act, as section 553 and moving such section 553, as
so redesignated, so it follows section 552.
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