[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3272 Introduced in House (IH)]

<DOC>






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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