Federal

Homelessness and Behavioral Health Care Coordination Act of 2023

Source: Congress.gov · 2,594 words in original text

What This Bill Does

This bill creates a grant program run by the Department of Housing and Urban Development to help state and local governments, homeless service providers, and health organizations work together better. The grants will help these groups coordinate services for people experiencing homelessness who also have behavioral health problems like substance use disorders. ##

Who It Affects

- People experiencing homelessness with behavioral health issues or substance use disorders - State and local government agencies - Continuums of Care (organizations that coordinate homeless services across regions) - Community-based organizations providing health and homelessness services - Indian tribes and tribal organizations - Public housing agencies - Nonprofit organizations working with homeless populations - Black, Hispanic, and Indigenous communities experiencing homelessness ##

Key Provisions

- The Department of Housing and Urban Development must create a grant program awarding competitive grants to eligible organizations to build their ability to coordinate health care and homelessness services for people voluntarily seeking assistance (Sec. 3(a)) - Grants are 5-year awards with a maximum of $500,000 per organization, with at least 5 percent of total funds going to Indian tribes and tribal organizations (Sec. 3(c)(3) and (d)) - Grant money cannot pay for health care services except for naloxone (a medication that reverses opioid overdoses) and training to use it, and cannot pay for rent (Sec. 3(c)(2)) - Organizations must designate a government official as a coordinator to connect health and homelessness services and use a harm reduction approach (providing services without requiring people to stop using drugs as a condition) (Sec. 3(c)(4)(D)(i)) - Grant recipients must submit reports within 6 years showing whether people served were housed, enrolled in treatment programs, experienced health improvements, and gained access to health care plans (Sec. 3(c)(7)(A)) - An interagency working group including representatives from the Department of Housing and Urban Development, Department of Health and Human Services, Department of Agriculture, and Bureau of Indian Affairs must develop training materials and technical assistance within 12 months of the bill becoming law (Sec. 3(b)(2)) ##

What Changes

A new federal grant program will begin awarding money to help coordinate homeless and health services. Organizations can use grants to hire coordinators, improve technology systems, increase naloxone availability, and improve connections between health and homeless service providers. At least 5 percent of funding will go to Indian tribes and tribal organizations. ##

Important Definitions

- "Behavioral health" means mental health and substance use (Sec. 3(8)(A)) - "Substance use disorder" means when repeated use of alcohol or drugs causes serious problems with health, daily functioning, work, school, or home responsibilities (Sec. 3(8)(D)) - "Person experiencing homelessness" has the same meaning as defined in the McKinney-Vento Act, a federal law about homelessness (Sec. 3(8)(C)) - "Indian Tribe" and "Tribal organization" include tribally designated housing entities and organizations serving Native Hawaiians (Sec. 3(8)(B)) ##

Effective Date

Not specified in bill text

I 118TH CONGRESS 1ST SESSION H. R. 773 To help persons in the United States experiencing homelessness and signifi- cant behavioral health issues, including substance use disorders, by au- thorizing a grant program within the Department of Housing and Urban Development to assist State and local governments, Continuums of Care, community-based organizations that administer both health and home- lessness services, and providers of services to people experiencing home- lessness, better coordinate health care and homelessness services, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 2, 2023 Ms. DEAN of Pennsylvania (for herself and Ms. GARCIA of Texas) introduced the following bill; which was referred to the Committee on Financial Services A BILL To help persons in the United States experiencing homeless- ness and significant behavioral health issues, including substance use disorders, by authorizing a grant program within the Department of Housing and Urban Develop- ment to assist State and local governments, Continuums of Care, community-based organizations that administer both health and homelessness services, and providers of services to people experiencing homelessness, better co- ordinate health care and homelessness services, and for other purposes. VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 773 IH Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Homelessness and Be- 4 havioral Health Care Coordination Act of 2023’’. 5 SEC. 2. FINDINGS. 6 Congress finds the following: 7 (1) The United States has a homelessness cri- 8 sis, with more than 582,000 people experiencing 9 homelessness on a single night according to the De- 10 partment of Housing and Urban Development’s 11 2022 Annual Homeless Assessment Report to Con- 12 gress. 13 (2) While the lack of affordable housing is the 14 primary driver of homelessness, behavioral health 15 conditions, including substance use disorders, can 16 exacerbate homelessness and can also be a con- 17 sequence of homelessness. 18 (3) Research shows that people experiencing 19 homelessness have higher rates of substance use dis- 20 order than people with housing stability. Some peo- 21 ple who experience homelessness use substances to 22 cope with the trauma and deprivations of their cir- 23 cumstances, but substance use disorders frequently 24 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 773 IH make it more difficult for people experiencing home- 1 lessness to secure permanent housing. 2 (4) Many individuals with substance use dis- 3 order who experience homelessness have co-occurring 4 illnesses. The combined effect of physical illness, 5 mental illness, and lack of housing results in higher 6 mortality rates for individuals experiencing home- 7 lessness. 8 (5) Safely and securely housing individuals who 9 are experiencing both homelessness and behavioral 10 health issues, including substance use disorders, 11 often requires supportive services and close coordina- 12 tion between housing and social service providers, in 13 addition to low-barrier, affordable housing. Sub- 14 sidized housing is critical, but not enough—access to 15 additional voluntary person-centered supportive serv- 16 ices is needed. 17 (6) It is imperative that when people experi- 18 encing homelessness choose to seek help that hous- 19 ing as well as health care and person-centered sup- 20 portive services be coordinated, particularly given 21 their acute needs and the significant costs incurred 22 by communities for law enforcement, correctional, 23 and emergency department care for failing to do so. 24 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 773 IH (7) While participation in health care and per- 1 son-centered supportive services should not be a re- 2 quirement for people experiencing homelessness to 3 receive housing, access to such services can be bene- 4 ficial in securing and successfully maintaining stable 5 housing. 6 (8) Integration of health and homelessness serv- 7 ices to achieve optimal outcomes for people experi- 8 encing homelessness, significant behavioral health 9 conditions such as substance use disorder, and other 10 health conditions can be challenging for State and 11 local governments, continuums of care, and commu- 12 nity-based organizations that administer both health 13 and homelessness services and providers of homeless- 14 ness services. 15 (9) Capacity building is needed to create sys- 16 tems-level linkages between the two sets of services 17 to allow for smoother pathways and simpler naviga- 18 tion. 19 (10) Black, Hispanic, and Indigenous people 20 are disproportionately underserved by person-cen- 21 tered supportive services. In order to address critical 22 services deficits and affirmatively serve protected 23 classes of people with significant behavioral health 24 conditions, including substance use disorders, who 25 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 773 IH are experiencing homelessness, the grant program 1 established under this Act can be used to build the 2 capacities of homelessness services providers that 3 have demonstrated cultural competencies in service 4 provision and a record of serving Black, Hispanic, 5 and Indigenous people and other underserved popu- 6 lations experiencing homelessness that also suffer 7 from substance use disorders. 8 SEC. 3. ESTABLISHMENT OF GRANT PROGRAM. 9 (a) IN GENERAL.—The Secretary of Housing and 10 Urban Development (in this Act referred to as the ‘‘Sec- 11 retary’’), in consultation with the working group estab- 12 lished pursuant to subsection (b), shall establish a grant 13 program to award competitive grants to eligible entities 14 to build or increase their capacities for the better coordi- 15 nation of health care and homelessness services for people 16 who are experiencing homelessness and significant behav- 17 ioral health issues, including substance use disorders, and 18 are voluntarily seeking assistance. 19 (b) WORKING GROUP.— 20 (1) ESTABLISHMENT.—The Secretary shall es- 21 tablish an interagency working group to provide ad- 22 vice to the Secretary in carrying out the program 23 under subsection (a). The working group shall in- 24 clude representatives from the Department of Hous- 25 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 773 IH ing and Urban Development, the United States 1 Interagency Council on Homelessness, Department 2 of Health and Human Services, Department of Agri- 3 culture, and Bureau of Indian Affairs, to be ap- 4 pointed by the heads of such agencies. 5 (2) DEVELOPMENT OF ASSISTANCE TOOLS.— 6 The working group shall, not later than 12 months 7 after the date of the enactment of this Act, develop 8 training, tools, and other technical assistance mate- 9 rials that simplify homelessness services for pro- 10 viders of health care and simplify health care serv- 11 ices for providers of homelessness services by identi- 12 fying the basic elements the health and homelessness 13 sectors need to understand about the other, and 14 shall circulate such materials to interested entities, 15 particularly those who apply for grants awarded pur- 16 suant to this Act. 17 (c) CAPACITY-BUILDING GRANTS.— 18 (1) IN GENERAL.—The Secretary shall award 19 5-year grants to eligible entities, which shall be used 20 only to build or increase their capacities to coordi- 21 nate health care and homelessness services. 22 (2) PROHIBITION.—None of the proceeds from 23 the grants awarded pursuant to this Act may be 24 used to pay for health care, with the exception of ef- 25 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 773 IH forts to increase the availability of Naloxone and 1 provide training for its administration, or rent. 2 (3) AMOUNT.—The amount awarded to an enti- 3 ty under a grant under this subsection shall not ex- 4 ceed $500,000. 5 (4) ELIGIBILITY.—To be eligible to receive a 6 grant under this subsection an entity shall— 7 (A) be— 8 (i) a governmental entity (at the coun- 9 ty, city, regional, or locality level); 10 (ii) an Indian tribe, a Tribally des- 11 ignated housing entity, a Tribal organiza- 12 tion, or an urban Indian organization; 13 (iii) a public housing agency admin- 14 istering housing choice vouchers; or 15 (iv) a continuum of care or nonprofit 16 organization designated by the continuum 17 of care; 18 (B) be responsible for homelessness serv- 19 ices; 20 (C) provide such assurances as the Sec- 21 retary shall require that, in carrying out activi- 22 ties with amounts from the grant, the entity 23 will ensure that services are culturally com- 24 petent, meet the needs of the people being 25 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 773 IH served, and follow trauma-informed best prac- 1 tices to address those needs using a harm re- 2 duction approach; and 3 (D) demonstrate how its capacity to co- 4 ordinate health care and homelessness services 5 to better serve people experiencing homelessness 6 and significant behavioral health issues, includ- 7 ing substance use disorders, can be increased 8 through— 9 (i) the designation of a governmental 10 official as a coordinator for making con- 11 nections between health and homelessness 12 services and developing a strategy for 13 using those services in a holistic way to 14 help people experiencing homelessness and 15 behavioral health conditions such as sub- 16 stance use disorders, including those with 17 co-occurring conditions; 18 (ii) improvements in infrastructure at 19 the systems level; 20 (iii) improvements in technology for 21 voluntary remote monitoring capabilities, 22 including internet and video, which can 23 allow for more home- and community- 24 based behavioral health care services and 25 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 773 IH ensure such improvements maintain effec- 1 tive communication requirements for per- 2 sons with disabilities and program access 3 for persons with limited English pro- 4 ficiency; 5 (iv) improvements in connections to 6 health care services delivered by providers 7 experienced in behavioral health care and 8 people experiencing homelessness; 9 (v) efforts to increase the availability 10 of Naloxone and provide training for its 11 administration; and 12 (vi) any additional activities identified 13 by the Secretary that will advance the co- 14 ordination of homelessness assistance, 15 housing, and behavioral health care serv- 16 ices and other health care services. 17 (5) ELIGIBLE ACTIVITIES.—An eligible grantee 18 receiving a grant under this subsection may use the 19 grant to cover costs related to— 20 (A) hiring system coordinators; and 21 (B) administrative costs, including staffing 22 costs, technology costs, and other such costs 23 identified by the Secretary. 24 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •HR 773 IH (6) DISTRIBUTION OF FUNDS.—An eligible 1 grantee receiving a grant under this subsection may 2 distribute all or a portion of the grant amounts to 3 private nonprofit organizations, other government 4 entities, public housing agencies, tribally designated 5 housing entities, or other entities as determined by 6 the Secretary to carry out programs and activities in 7 accordance with this section. 8 (7) OVERSIGHT REQUIREMENTS.— 9 (A) ANNUAL REPORTS.—Not later than 6 10 years after the date on which grant amounts 11 are first received by an eligible entity, such en- 12 tity shall submit to the Secretary a report on 13 the activities carried out under the grant. Such 14 report shall include, with respect to activities 15 carried out with grant amounts in the commu- 16 nity served— 17 (i) measures of outcomes relating to 18 whether people experiencing homelessness 19 and significant behavioral health issues, in- 20 cluding substance use disorders, who 21 sought help from an entity that received a 22 grant— 23 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •HR 773 IH (I) were housed and did not ex- 1 perience intermittent periods of home- 2 lessness; 3 (II) were voluntarily enrolled in 4 treatment and recovery programs; 5 (III) experienced improvements 6 in their health; 7 (IV) obtained access to specific 8 primary care providers; and 9 (V) have health care plans that 10 meet their individual needs, including 11 access to mental health and substance 12 use disorder treatment and recovery 13 services; 14 (ii) how grant funds were used; and 15 (iii) any other matters determined ap- 16 propriate by the Secretary. 17 (B) RULE OF CONSTRUCTION.—Nothing in 18 this subsection may be construed to condition 19 the receipt of future housing and other services 20 by individuals assisted with activities and serv- 21 ices provided with grant amounts on the out- 22 comes detailed in the reports submitted under 23 this subsection. 24 (8) DEFINITIONS.—In this section: 25 VerDate Sep 11 2014 03:43 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H773.IH H773 pbinns on DSKJLVW7X2PROD with $$_JOB 12 •HR 773 IH (A) BEHAVIORAL HEALTH.—The term 1 ‘‘behavioral health’’ includes mental health and 2 substance use. 3 (B) INDIAN TRIBE; TRIBAL ORGANIZA- 4 TION.—The terms ‘‘Indian Tribe’’ and ‘‘Tribal 5 organization’’ have the meanings given such 6 terms in section 4 of the Indian Self-Deter- 7 mination and Education Assistance Act (25 8 U.S.C. 5304) and shall include tribally des- 9 ignated housing entities (as such term is de- 10 fined in section 4 of the Native American Hous- 11 ing Assistance and Self-Determination Act of 12 1996 (25 U.S.C. 4103)) and entities that serve 13 Native Hawaiians (as such term is defined in 14 section 338K(c) of the Public Health Service 15 Act (4 [Text truncated for display. Full text available on Congress.gov.]

Important: This plain English summary was generated by AI and is provided for informational purposes only. It is not legal advice. Always consult the official bill text on Congress.gov or a qualified attorney for legal matters.