[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.
                                 ______