Sec. 309. Homelessness and behavioral health care coordination
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In this section: The term behavioral health includes mental health and substance use. The term eligible entity means an entity described in section 402(c)(4) that is eligible for a competitive grant under subsection (b). 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 ). 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.
The term Tribal organization — has the meaning given the term in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 3504 ); and includes entities that serve Native Hawaiians, as defined in section 338K(c) of the Public Health Service Act ( 42 U.S.C. 254s(c) ). The Secretary, in consultation with the working group established under subsection (c), shall establish a grant program to award competitive grants to eligible entities to build or increase the capacity of the eligible entity for the better coordination of health care and homelessness services for people— experiencing homelessness and significant behavioral health issues, including substance use disorder; and who are voluntarily seeking assistance.
The Secretary shall establish an interagency working group to provide advice to the Secretary in carrying out the program established under subsection (b). The working group established under paragraph
(1)shall include representatives from the Department of Housing and Urban Development, the United States Interagency Council on Homelessness, the Department of Health and Human Services, the Department of Agriculture, and Bureau of Indian Affairs, to be appointed by the heads of such agencies. Not later than 1 year after the date of enactment of this Act, the working group established under paragraph
(1)shall— 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 circulate the materials described in subparagraph
(A)to interested entities, particularly eligible entities that apply for grants awarded pursuant to this section. 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. None of the proceeds from the grants awarded pursuant to this subsection may be used to pay for— health care, with the exception of efforts to increase the availability of Naloxone and provide training for the administration of Naloxone; or rent. The amount awarded to an eligible entity under a grant under this subsection shall not exceed $500,000. To be eligible to receive a grant under this subsection, an entity shall— be— a governmental entity at the county, city, regional, or locality level; an Indian Tribe, a tribally designated housing entity, a Tribal organization, or an urban Indian organization; a public housing agency administering housing choice vouchers; or a continuum of care or nonprofit organization designated by the continuum of care; be responsible for homelessness services; 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 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— 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 cooccurring conditions; improvements in infrastructure at the systems level; 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; improvements in connections to health care services delivered by providers experienced in behavioral health care and people experiencing homelessness; efforts to increase the availability of Naloxone and provide training for the administration of Naloxone; and 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. An eligible entity receiving a grant under this subsection may use the grant to cover costs related to— hiring system coordinators; and administrative costs, including staffing costs, technology costs, and other such costs identified by the Secretary. An eligible entity receiving a grant under this subsection may distribute all or a portion of the grant amounts to private nonprofit organizations, other government entities, 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. Not later than 6 years after the date on which grant amounts are first received by an eligible entity under this subsection, 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— 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— were housed and did not experience intermittent periods of homelessness; were voluntarily enrolled in treatment and recovery programs; experienced improvements in their health; obtained access to specific primary care providers; and have health care plans that meet their individual needs, including access to mental health and substance use disorder treatment and recovery services; how grant funds were used; and any other matters determined appropriate by the Secretary. 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 paragraph. There is authorized to be appropriated to carry out this section $20,000,000 for each of fiscal years 2024 through 2029, 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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