[Congressional Record Volume 150, Number 126 (Thursday, October 7, 2004)]
[Senate]
[Pages S10739-S10742]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself and Mr. Reed):
  S. 2937. 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 for other purposes; 
to the Committee on Health, Education, Labor, and Pensions.
  Mr. DeWINE. Mr. President, today I rise with my colleague, Senator 
Jack Reed, to introduce the Services for Ending Long-Term Homelessness 
Act. I would like to thank Senator Reed for his support in introducing 
this bill. I appreciate his dedication and commitment to this issue.
  The chronically homeless are about 10 percent of the entire homeless 
population, but consume a majority of the services. There are 
approximately 200,000 to 250,000 people who experience chronic 
homelessness. Those numbers include the heads of families, as well.
  Tragically, for these individuals, the periods of homelessness are 
measured in years--not weeks and months. They tend to have disabling 
health and behavioral health problems: 40 percent have substance abuse 
disorders, 25 percent have a physical disability, and 20 percent have 
serious mental illness. These factors often contribute to a person 
becoming homeless, in the first place, and are certainly an impediment 
to overcoming it.
  The President has set a goal of ending chronic homelessness in 10 
years. The President's New Freedom Commission on Mental Health, chaired 
by the Ohio Department of Mental Health Director, Mike Hogan, 
recommended that a comprehensive program be created to facilitate 
access to permanent supportive housing for individuals and families who 
are chronically homeless. This recommendation is so important because 
affordable housing, alone, is not enough for this hard to reach group. 
And, temporary shelter-housing does not provide the stability and 
services needed to provide long-term positive outcomes. Only supportive 
housing, where the chronically homeless can receive shelter and 
services, such as mental health and substance abuse treatment, has been 
effective in decreasing their chances of returning to the streets and 
increasing their chances for leading productive lives.
  Not only is it right to help this group of hard to reach individuals, 
but it is also fiscally responsible. This group is one of the most 
expensive groups to serve. As I mentioned previously, they represent 10 
percent of the overall homeless population, however they consume a 
majority of the services for the homeless. They consume the most 
emergency housing and health care services, which are also the most 
costly to provide. By encouraging supportive housing, we are providing 
the services necessary for these individuals and families to really get 
back on their feet. We can either continue to provide expensive 
emergency services to these needy people or we can give them the right 
kind of help--the type of help they need for their long-term well-being 
and long-term well-being of our communities.
  Unfortunately, current programs for funding services in permanent 
supportive housing, other than those administered by the Department of 
Housing and Urban Development (HUD), were not designed to be 
coordinated with housing programs. These programs were also not 
designed to meet the challenging needs of this specific subgroup of the 
homeless. That is why the bill we are introducing today would provide 
the authorization to fund services to the chronically homeless in 
supportive housing by providing grants which can be used with existing 
programs through HUD and State and local communities.
  This bill also would encourage those who provide services to the 
chronically homeless, such as SAMHSA within the Department of Health 
and Human Services, to work with and coordinate their efforts with 
those who provide the physical housing, such as HUD. Under the current 
administration, these two departments have started to truly coordinate 
their efforts and this bill would encourage and support that continued 
collaboration.
  This is a good bill, and it could make a real difference in the lives 
of so many individuals in need. I ask my colleagues to join us in 
support.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2937

       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, there are approximately 200,000 to 250,000 
     people who experience 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) 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.
       (3) Congress and the President have set a goal of ending 
     chronic homelessness in 10 years.
       (4) Permanent supportive housing is a proven and cost 
     effective solution to chronic homelessness. A recent study by 
     the University of Pennsylvania found that each unit of 
     supportive housing for homeless people with mental illness in 
     New York City resulted in public savings of $16,281 per year 
     in systems of care such as mental health, human services, 
     health care, veterans' affairs, and corrections.
       (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 and 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 IN SUPPORTIVE HOUSING.

       Title V of the Public Health Service Act (42 U.S.C. 290aa 
     et seq.) is amended by adding at the end the following:

[[Page S10740]]

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

     ``SEC. 596. 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 (c) 
     to chronically homeless individuals 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 experiencing chronic 
     homelessness; 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 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 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 meet the definition of chronic homelessness under this 
     section;
       ``(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 abuse treatment, medical care, and 
     employment (including commitments to provide Federal funds in 
     accordance with subsection (d)(2)(B)(ii)); and
       ``(3) will provide for an increase in the number of units 
     of permanent supportive housing that would serve chronically 
     homeless individuals in the community as a result of an award 
     of a grant under subsection (a).
       ``(c) 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 but not 
     limited to the following:
       ``(A) Mental health services, including treatment and 
     recovery support services.
       ``(B) Substance abuse 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 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.
       ``(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.
       ``(d) 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 agree as follows:
       ``(A) In the case of the initial grant pursuant to 
     subsection (i)(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 
     (i)(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 (c) 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).
       ``(e) Administrative Expenses.--A condition for the receipt 
     of a grant under subsection (a) is that the applicant 
     involved agree that not more than 6 percent of the grant will 
     be expended for administrative expenses with respect to the 
     grant.
       ``(f) 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 (c) to homeless 
     individuals who are not chronically homeless.
       ``(g) 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.
       ``(h) 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 two 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 abuse, or other services that will be 
     delivered by the project.
       ``(2) There is a mechanism for determining whether 
     residents are 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 persons who have been chronically 
     homeless, to verify that an individual or family meets the 
     definition for being chronically homeless under this section.
       ``(3) The applicant participates in a local, regional, or 
     statewide homeless management information system.
       ``(i) 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 not less than three years and not more than 
     five years.
       ``(B) In the case of a subsequent grant (referred to in 
     this subsection as a `renewal grant'), the period of payments 
     shall be not more than five 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) Priority in making grants.--In making grants under 
     subsection (a), the Secretary shall give priority to renewal 
     grants.
       ``(B) 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.

[[Page S10741]]

       ``(C) Amount.--The maximum amount of a renewal grant under 
     this subsection shall not exceed an amount equal to--
       ``(i) 75 percent of the amount of Federal funds provided in 
     the final year of the initial grant period; or
       ``(ii) 50 percent of the total costs of sustaining the 
     program funded under the grant at the level provided for in 
     the year preceding the year for which the renewal grant is 
     being awarded;
     as determined by the Secretary.
       ``(j) 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 report data regarding the performance outcomes of the 
     projects carried out pursuant to such subsection. Consistent 
     with the requirement of the preceding sentence, each 
     applicant shall measure and report specific performance 
     outcomes related to the long-term goals of increasing 
     stability within the community for individuals who have been 
     chronically homeless, and decreasing recurrence of periods of 
     homelessness.
       ``(2) Performance outcomes.--The performance outcomes 
     identified by a grantee under paragraph (1) shall include, 
     with respect to individuals who have been chronically 
     homeless, improvements in--
       ``(A) housing stability;
       ``(B) employment and education;
       ``(C) problems related to substance abuse;
       ``(D) participation in mental health services; 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 towards 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 who have been 
     chronically homeless.
       ``(k) 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).
       ``(l) Biennial Reports to Congress.--Not later than two 
     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 Congress a report on 
     projects under subsection (a) that includes a summary of 
     information received by the Secretary under subsection (j), 
     and that describes the impact of the program under subsection 
     (a) as part of a comprehensive strategy for ending long term 
     homelessness and improving outcomes for individuals with 
     mental illness and substance abuse problems.
       ``(m) Definitions.--For purposes of this section:
       ``(1) The term `chronically homeless' means an individual 
     or family who--
       ``(A) is currently homeless;
       ``(B) has been homeless continuously for at least one year 
     or has been homeless on at least four separate occasions in 
     the last three years; and
       ``(C) has an adult head of household with a disabling 
     condition, defined as a diagnosable substance use disorder, 
     serious mental illness, developmental disability, or chronic 
     physical illness or disability, including the co-occurrence 
     of two or more of these conditions.
       ``(2) The term `disabling condition' means a condition that 
     limits an individual's ability to work or perform one or more 
     activities of daily living.
       ``(3) The term `homeless' means sleeping in a place not 
     meant for human habitation or in an emergency homeless 
     shelter.
       ``(4)(A) 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 but is not limited to permanent housing funded or 
     assisted through title IV of the McKinney-Vento Homeless 
     Assistance Act and section (8) of the United States Housing 
     Act of 1937.
       ``(B) 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.
       ``(n) 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 2005 through 2009.
       ``(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 (k).''.

  Mr. REED. Mr. President, I am proud to join my colleague from Ohio, 
the Chairman of the Substance Abuse and Mental Health Subcommittee of 
the Senate HELP Committee, to introduce a bill that we believe will 
bring us closer to helping people who experience chronic homelessness 
get off the streets, out of shelters and into permanent housing. The 
Services for Ending Long-Term Homelessness Act (SELHA) will help local 
communities provide health care, mental health and substance abuse 
services in conjunction with safe, decent and affordable housing. This 
bill is another essential component in the continuum of housing and 
supportive service programs geared towards people who have become 
homeless in our society.
  Nationwide, as many as 3.5 million people experience homelessness 
every year. Between 200,000 and 250,000 of them--including at least 
12,000 children--experience chronic homelessness. They live on the 
streets and in emergency shelters for years on end or cycle between 
homelessness, jails, emergency rooms, and other institutions. Many also 
confront mental illness, substance addiction or other serious chronic 
health conditions. Moreover, because they don't get appropriate and 
regular care, these people exact a substantial toll on our public 
health systems.
  The legislation the Senior Senator from Ohio and I are proposing 
today would authorize funding for grants to state and local entities to 
offer services to individuals and families in supportive housing to 
help bring them out of the downward spiral of homelessness and onto the 
road to recovery and self-sufficiency. Permanent supportive housing 
combines safe, decent and affordable housing with needed services such 
as mental health, substance abuse, employment, health care, and other 
services.
  Research indicates that supportive housing represents a cost-
effective investment toward the goal of ending long-term homelessness. 
In one California supportive housing program, residents experienced a 
57 percent decline in emergency room visits, a 58 percent decline in 
the number of inpatient hospital days, and a near elimination of their 
need for residential mental-health facilities. A study in New York City 
found that each unit of supportive housing saved $16,282 per person per 
year in public expenditures for emergency care, court and jail costs, 
and other public services. After deducting the public benefits, the 
average supportive housing unit in New York City cost only $995 per 
year. In other words, it costs little more to house and offer 
supportive services to people than it does to leave them homeless.
  These remarkable findings have led the bipartisan Millennial Housing 
Commission, the President's New Freedom Mental Health Commission, the 
U.S. Conference of Mayors and the National League of Cities to endorse 
the goal of creating 150,000 units of permanent supportive housing.
  As the Ranking Member of the Senate Subcommittee on Housing of the 
Senate Banking Committee, I am deeply interested in tackling the 
challenge of homelessness on several fronts. I have been working on a 
bill to reauthorize the McKinney-Vento Homeless Assistance Act. My 
legislation would realign the incentives behind HUD's homelessness 
assistance programs, while more funding would flow to communities that 
actually demonstrate a commitment to accomplishing the goals of 
preventing and ending homelessness. It would also simplify and 
consolidate the three competitive HUD homeless assistance programs into 
one program and provide new flexibility in using McKinney-Vento funds.

[[Page S10742]]

  The Services for Ending Long-Term Homelessness Act perfectly 
compliments these efforts by making sure that communities offering 
permanent housing are also able to provide health, education and other 
supportive services that are so critical to the ultimate success of 
these efforts.
  I believe we have the ingenuity and dedication to ensure that 
everyone has a safe decent and affordable place to call home. We need 
to support innovative solutions, and this bill does just that. It gives 
communities some of the resources they need to develop more supportive 
housing and move towards ending chronic homelessness, and I am proud to 
join my colleague from Ohio in spearheading this initiative.
                                 ______