[Congressional Record Volume 172, Number 43 (Monday, March 9, 2026)]
[Senate]
[Pages S933-S934]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 4382. Mr. PADILLA submitted an amendment intended to be proposed
by him to the bill H.R. 6644, a bill to increase the supply of housing
in America, and for other purposes; which was ordered to lie on the
table; as follows:
At the appropriate place, insert the following:
SEC. __. GRANT PROGRAM TO COORDINATE HEALTH CARE AND
HOMELESSNESS SERVICES.
(a) Definitions.--In this section:
(1) Behavioral health.--The term ``behavioral health''
includes mental health and substance use.
(2) Eligible entity.--The term ``eligible entity'' means an
entity described in subsection (b)(3)(D) that is eligible for
a competitive grant under subsection (b).
(3) Indian tribe.--The term ``Indian Tribe'' has the
meaning given the term in section 4 of the Indian Self-
Determination and Education Assistance Act (25 U.S.C. 5304).
(4) Person experiencing homelessness.--The term ``person
experiencing homelessness'' has the same meaning as the terms
``homeless'', ``homeless individual'', and ``homeless
person'', as defined in section 103 of the McKinney-Vento
Homeless Assistance Act (42 U.S.C. 11302).
(5) Public housing agency.--The term ``public housing
agency'' has the meaning given the term in section 3(b)(6) of
the United States Housing Act of 1937 (42 U.S.C.
1437a(b)(6)).
(6) Secretary.--The term ``Secretary'' means the Secretary
of Housing and Urban Development.
(7) Substance use disorder.--The term ``substance use
disorder'' means the disorder that occurs when the recurrent
use of alcohol or drugs, or both, causes clinically
significant impairment, including health problems,
disability, and failure to meet major responsibilities at
work, school, or home.
(8) Tribal organization.--The term ``Tribal
organization''--
(A) has the meaning given the term in section 4 of the
Indian Self-Determination and Education Assistance Act (25
U.S.C. 3504); and
(B) includes entities that serve Native Hawaiians, as
defined in section 338K(c) of the Public Health Service Act
(42 U.S.C. 254s(c)).
(9) Tribally designated housing entity.--The term
``tribally designated housing entity'' has the meaning given
the term in section 4 of the Native American Housing
Assistance and Self-Determination Act of 1996 (25 U.S.C.
4103).
(b) Establishment of Grant Program.--
(1) In general.--The Secretary, in coordination with the
Secretary of Health and Human Services and in consultation
with the working group established under paragraph (2), shall
establish a grant program to award competitive grants to
eligible entities in direct coordination with a continuum of
care to build or increase capacity to coordinate the delivery
of health care and homelessness services within the continuum
of care.
(2) Working group.--
(A) Establishment.--The Secretary, in coordination with the
Secretary of Health and Human Services, shall establish an
interagency working group to provide advice and coordinate
along relevant existing working groups to the Secretary in
carrying out the program established under paragraph (1).
(B) Composition.--The working group established under
subparagraph (A) shall include representatives from the
Department
[[Page S934]]
of Health and Human Services, the Department of Housing and
Urban Development, the United States Interagency Council on
Homelessness, the Department of Agriculture, and the Bureau
of Indian Affairs, to be appointed by the heads of such
agencies.
(C) Development of assistance tools.--Not later than 1 year
after the date of enactment of this Act, the working group
established under subparagraph (A) shall--
(i) develop training, tools, and other technical assistance
materials that simplify homelessness services for providers
of health care and simplify health care services for
providers of homelessness services by identifying the basic
elements the health and homelessness sectors need to
understand about the other; and
(ii) circulate the materials described in clause (i) to
interested entities, particularly eligible entities that
apply for grants awarded pursuant to this Act.
(3) Capacity-building grants.--
(A) In general.--The Secretary shall award 5-year grants to
eligible entities, which shall be used only to build or
increase capacities to coordinate health care and
homelessness services.
(B) Prohibition.--None of the proceeds from the grants
awarded pursuant to this Act may be used to pay for--
(i) health care, with the exception of efforts to increase
the availability of Naloxone and provide training for the
administration of Naloxone; or
(ii) rent.
(C) Amount.--The amount awarded to an eligible entity under
a grant under this paragraph shall not exceed $500,000.
(D) Eligibility.--To be eligible to receive a grant under
this paragraph, an entity shall--
(i) be designated by a continuum of care to ensure
coordination across the continuum of care geographic regions,
and which may be--
(I) a governmental entity at the county, city, regional, or
locality level;
(II) an Indian Tribe, a tribally designated housing entity,
a Tribal organization, or an urban Indian organization;
(III) a public housing agency administering housing choice
vouchers; or
(IV) a nonprofit organization;
(ii) be responsible for homelessness services;
(iii) provide such assurances as the Secretary shall
require that, in carrying out activities with amounts from
the grant, the entity will ensure that services are
culturally competent, meet the needs of the people being
served, and follow trauma-informed best practices to address
those needs using a harm reduction approach; and
(iv) demonstrate how the capacity of the entity to
coordinate health care and homelessness services to better
serve people experiencing homelessness and significant
behavioral health issues, including substance use disorder,
can be increased through--
(I) the designation of a governmental official as a
coordinator for making connections between health and
homelessness services and developing a strategy for using
those services in a holistic way to help people experiencing
homelessness and behavioral health conditions such as
substance use disorder, including those with co-occurring
conditions;
(II) improvements in infrastructure at the systems level;
(III) improvements in technology for voluntary remote
monitoring capabilities, including internet and video, which
can allow for more home- and community-based behavioral
health care services and ensure such improvements maintain
effective communication requirements for persons with
disabilities and program access for persons with limited
English proficiency;
(IV) improvements in connections to health care services
delivered by providers experienced in behavioral health care
and people experiencing homelessness;
(V) efforts to increase the availability, and training for
the administration, of opioid antagonists indicated for
emergency treatment of opioid overdose; and
(VI) any additional activities identified by the Secretary
that will advance the coordination of homelessness
assistance, housing, and behavioral health care services and
other health care services.
(E) Eligible activities.--An eligible entity receiving a
grant under this paragraph may use the grant to cover costs
related to--
(i) hiring system coordinators; and
(ii) administrative costs, including staffing costs,
technology costs, and other such costs identified by the
Secretary.
(F) Distribution of funds.--An eligible entity receiving a
grant under this paragraph may distribute all or a portion of
the grant amounts to private nonprofit organizations, other
government entities, State, local, or Tribal public health
departments, community health centers or organizations,
public housing agencies, tribally designated housing
entities, or other entities as determined by the Secretary to
carry out programs and activities in accordance with this
section.
(G) Oversight requirements.--
(i) Annual reports.--Not later than 6 years after the date
on which grant amounts are first received by an eligible
entity, the eligible entity shall submit to the Secretary a
report on the activities carried out under the grant, which
shall include, with respect to activities carried out with
grant amounts in the community served--
(I) measures of outcomes relating to whether people
experiencing homelessness and significant behavioral health
issues, including substance use disorder, who sought help
from an entity that received a grant--
(aa) were housed and did not experience intermittent
periods of homelessness;
(bb) were voluntarily enrolled in treatment and recovery
programs;
(cc) experienced improvements in their health;
(dd) obtained access to specific primary care providers;
and
(ee) have health care plans that meet their individual
needs, including access to mental health and substance use
disorder treatment and recovery services;
(II) how grant funds were used; and
(III) any other matters determined appropriate by the
Secretary.
(ii) Rule of construction.--Nothing in this paragraph may
be construed to condition the receipt of future housing and
other services by individuals assisted with activities and
services provided with grant amounts on the outcomes detailed
in the reports submitted under this subparagraph.
(4) Administration.--The Secretary shall carry out the
requirements under this section through the Office of Special
Needs Assistance Programs within the Office of Community
Planning and Development of the Department of Housing and
Urban Development.
(5) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section $20,000,000 for
each of fiscal years 2027 through 2032, of which not less
than 5 percent of such funds shall be awarded to Indian
Tribes, tribally designated housing entities, and Tribal
organizations.
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