Sec. 2. Findings
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Congress finds the following: The United States has a homelessness crisis, with more than 582,000 people experiencing homelessness on a single night according to the Department of Housing and Urban Development’s 2022 Annual Homeless Assessment Report to Congress. While the lack of affordable housing is the primary driver of homelessness, behavioral health conditions, including substance use disorder, can exacerbate homelessness and can also be a consequence of homelessness. Research shows that people experiencing homelessness have higher rates of substance use disorder than people with housing stability.
Some people who experience homelessness use substances to cope with the trauma and deprivations of their circumstances, but substance use disorder frequently makes it more difficult for people experiencing homelessness to secure permanent housing. Many individuals with substance use disorder who experience homelessness have co-occurring illnesses. The combined effect of physical illness, mental illness, and lack of housing results in higher mortality rates for individuals experiencing homelessness.
Safely and securely housing individuals who are experiencing both homelessness and behavioral health issues, including substance use disorder, often requires supportive services and close coordination between housing and social service providers, in addition to low-barrier, affordable housing. Subsidized housing is critical, but not enough—access to additional voluntary person-centered supportive services is needed. It is imperative that when people experiencing homelessness choose to seek help that housing as well as health care and person-centered supportive services be coordinated, particularly given their acute needs and the significant costs incurred by communities for law enforcement, correctional, and emergency department care for failing to do so.
While participation in health care and person-centered supportive services should not be a requirement for people experiencing homelessness to receive housing, access to such services can be beneficial in securing and successfully maintaining stable housing. Integration of health and homelessness services to achieve optimal outcomes for people experiencing homelessness, significant behavioral health conditions such as substance use disorder, and other health conditions can be challenging for State and local governments, continuums of care, and community-based organizations that administer both health and homelessness services and providers of homelessness services.
Capacity-building is needed to create systems-level linkages between the 2 sets of services to allow for smoother pathways and simpler navigation. Black, Hispanic, and Indigenous people are disproportionately underserved by person-centered supportive services. In order to address critical services deficits and affirmatively serve protected classes of people with significant behavioral health conditions, including substance use disorder, who are experiencing homelessness, the grant program established under this Act can be used to build the capacities of providers of homelessness services that have demonstrated cultural competencies in service provision and a record of serving Black, Hispanic, and Indigenous people and other underserved populations experiencing homelessness that also suffer from substance use disorder.