I 

118TH CONGRESS 

2D SESSION H. R. 10448 

To combat loneliness and increase social connection, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 17, 2024 

Ms. BALINT (for herself and Mr. TONKO) introduced the following bill; which 

was referred to the Committee on Energy and Commerce, and in addition 

to the Committees on Financial Services, Education and the Workforce, 

and Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To combat loneliness and increase social connection, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Combating Loneliness Act’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Sense of Congress. 


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TITLE I—COMMUNITY-BASED PROGRAMS 

Sec. 101. Grants for third-spaces. 

Sec. 102. Grants for social infrastructure. 

Sec. 103. Grants for Outreach and Intervention to address loneliness. 

TITLE II—PUBLIC HEALTH 

Sec. 201. Support group demonstration program. 

Sec. 202. Building communities of recovery program reauthorization. 

Sec. 203. Mental health provider student loan forgiveness. 

Sec. 204. Health workforce resiliency program. 

Sec. 205. Task force to prevent health care worker burnout. 

TITLE III—MEASUREMENTS OF LONELINESS 

Sec. 301. Addition of loneliness to the Older Americans Act of 1965. 

Sec. 302. HHS working group on measurements of loneliness and isolation. 

Sec. 303. GAO study and report on impact of social isolation. 

TITLE IV—COMMUNITY HEALTH WORKERS 

Sec. 401. Coverage of Community Health Worker services under Medicare and 

Increased FMAP for Community Health Worker services. 

Sec. 402. Community Health Workers in NHSC loan repayment program. 

TITLE V—EDUCATION 

Sec. 501. School-based services under Medicaid and CHIP. 

Sec. 502. Support for Project AWARE. 

Sec. 503. Support for the 21st Century Community Learning Centers program 

and the Full-Service Community Schools Program. 

TITLE VI—DEFINITIONS 

Sec. 601. Definitions. 

1 SEC. 2. FINDINGS. 

2 The Congress finds the following: 

3 (1) 36 percent of individuals in the United 

4 States report serious loneliness. 

5 (2) 61 percent of young adults and over 50 per6 cent of mothers with young children in the United 

7 States report serious loneliness. 

8 (3) 61 percent of disabled individuals in the 

9 United States experience chronic loneliness, with an 


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1 even higher prevalence of 70 percent among young 

2 disabled people in the United States. 

3 (4) LGBTQI+ youth, particularly transgender 

4 and Black individuals, experience higher levels of 

5 loneliness, depression, and anxiety than their 

6 straight or cisgender counterparts. 

7 (5) Black individuals, Indigenous individuals, 

8 and individuals of color are disproportionately af9 fected by social loneliness and isolation, with 75 per10 cent of Latinx and Hispanic adults and 68 percent 

11 of Black and African American adults categorized as 

12 lonely. 

13 (6) Due to fragmented social networks, loneli14 ness is especially pervasive with people experiencing 

15 homelessness, with 1 in 5 reporting to have no 

16 friends. 

17 (7) Farmers and agricultural workers, predomi18 nantly based in rural areas, face heightened risks to 

19 mental well-being due to social and geographical iso20 lation. 

21 (8) Older adults face heightened vulnerability to 

22 loneliness and social isolation due to factors includ23 ing living alone, loss of familial and social ties, 

24 chronic illness, and impaired hearing. 


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1 (9) Elderly individuals are increasingly affected 

2 by homelessness and loneliness as their social circles 

3 shrink, lifespans increase, and economic challenges 

4 grow, making them one of the fastest-growing seg5 ments of the homeless population. 

6 (10) Veterans often experience feelings of isola7 tion due to losing touch with their military commu8 nity, physical or mental health issues, and difficul9 ties adjusting to civilian life. 

10 (11) 1 out of every 5 veterans reports that they 

11 often feel lonely, leading to higher rates of mental 

12 and physical health, as well as suicidal ideation. 

13 (12) Climate-related disasters are associated 

14 with negative impacts on mental health nationwide. 

15 (13) People who use social media for more than 

16 2 hours a day are twice as likely to report increased 

17 feelings of social isolation than those who were using 

18 it for less than 30 minutes a day. 

19 (14) Students with low academic performance 

20 may turn to social networking sites to cope with feel21 ings of loneliness and isolation, finding online inter22 actions less stressful than face-to-face relationships. 

23 (15) A shortage of 139,000 primary care physi24 cians is projected by 2033, with particularly con25 cerning deficits anticipated rural areas. 


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1 (16) Burnout rates reported by health care 

2 workers nationally are higher than in any other in3 dustry. 

4 (17) Nearly half of health workers reported 

5 often feeling burned out in 2022, up from 32 per6 cent in 2018. 

7 (18) Rural clinics report the highest rates of 

8 burnout. 

9 (19) Increased feeling of loneliness and social 

10 isolation can lead to an increase in susceptibility to 

11 radicalization and violence. 

12 (20) Increased feelings of loneliness lead to a 

13 reduced sense of civic duty and lower voter turnout. 

14 (21) Positive relationships with peers, parents, 

15 and teachers during childhood and adolescence cor16 relate with improved academic outcomes and predict 

17 higher rates of college graduation and attainment of 

18 four-year degrees in early adulthood. 

19 (22) Building design incorporating elements 

20 that promote physical activity and social interaction 

21 enhances health and reduces loneliness among older 

22 adults. 

23 (23) Housing with care is effective at reducing 

24 loneliness and social isolation in later life, providing 


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1 better outcomes than living in the general commu2 nity. 

3 SEC. 3. SENSE OF CONGRESS. 

4 It is the sense of the Congress that it is the duty 

5 of the Federal Government to— 

6 (1) create a national health insurance program 

7 that provides comprehensive and essential care to all 

8 individuals in the United States, which is critical to 

9 building healthier communities; 

10 (2) establish a national paid family and medical 

11 leave program that allows every worker to take care 

12 of their own health and their families’ health, which 

13 creates healthy and vibrant communities; 

14 (3) encourage participation in the arts and the 

15 humanities, which provides communities with a foun16 dation to engage in our democracy and fosters an 

17 appreciation for our shared cultural heritage; 

18 (4) establish universal early education that sup19 ports early childhood development and sets children 

20 up for academic success, which is an investment in 

21 our children, their families, and future generations; 

22 (5) provide safe, affordable housing that pro23 vides working families with stability, which is critical 

24 to building vibrant communities; 


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1 (6) provide affordable and quality child care 

2 that is a lifeline for working families, which is crit3 ical to building a stronger economy, workforce, and 

4 communities; 

5 (7) address the climate crisis by transitioning to 

6 renewable energy, promoting environmental justice, 

7 and conserving public and wild lands, which is essen8 tial to building resilient communities and a sustain9 able future; 

10 (8) reduce gun violence through common-sense 

11 gun safety reform, which will protect families from 

12 senseless gun violence, which is critical to creating 

13 safer communities; 

14 (9) build a tax code that works for working 

15 families and small businesses, and ensure the 

16 wealthy pay their fair share, which is essential in 

17 order to invest in critical resources such as housing 

18 and mental health care; and 

19 (10) encourage States, counties, and local mu20 nicipalities to develop policies that have a focus on 

21 connection and social connectivity. 


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1 TITLE I—COMMUNITY-BASED 

2 PROGRAMS 

3 SEC. 101. GRANTS FOR THIRD-SPACES. 

4 (a) IN GENERAL.—The Secretary of Health and 

5 Human Services (in this section referred to as the ‘‘Sec6 retary’’), in consultation with the appropriate Federal offi7 cials, shall establish a program to award grants, on a com8 petitive basis, to State or local governments to support eli9 gible entities to create and scale community connection 

10 programs and local institutions that bring people together 

11 at community facilities. 

12 (b) APPLICATIONS.—To be eligible to receive a grant 

13 under this section, a State or local government shall sub14 mit to the Secretary an application at such time, in such 

15 manner, and containing such information as the Secretary 

16 may require. 

17 (c) USE OF FUNDS.—A grant awarded under this 

18 section— 

19 (1) may be used to pay the salary or wages of 

20 appropriate staff of the community connection pro21 grams and local institutions referred to in subsection 

22 (a); and 

23 (2) may not be used for the construction of any 

24 facility. 


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1 (d) PRIORITY.—In awarding grants under this sec2 tion, the Secretary shall prioritize— 

3 (1) underserved communities; and 

4 (2) communities with high percentages of chil5 dren or elderly individuals. 

6 (e) DEFINITIONS.—In this section: 

7 (1) APPROPRIATE FEDERAL OFFICIALS.—The 

8 term ‘‘appropriate Federal officials’’ means— 

9 (A) the Administrator of the Administra10 tion for Community Living; 

11 (B) the Secretary of Education; 

12 (C) the Secretary of Veterans Affairs; 

13 (D) the Secretary of Labor; and 

14 (E) the Director of the Institute of Mu15 seum and Library Services. 

16 (2) ELIGIBLE ENTITY.—The term ‘‘eligible enti17 ty’’ means a governmental or nonprofit entity that 

18 is— 

19 (A) a library; 

20 (B) a senior center; 

21 (C) a childcare center or after-school pro22 gram; 

23 (D) a recreation center; 

24 (E) a teen center; 

25 (F) a veteran service organization; or 


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1 (G) any other entity, as the relevant State 

2 or local government determines appropriate. 

3 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

4 authorized to be appropriated to carry out this section 

5 $200,000,000 for each of fiscal years 2025 through 2029. 

6 SEC. 102. GRANTS FOR SOCIAL INFRASTRUCTURE. 

7 (a) IN GENERAL.—The Secretary of Housing and 

8 Urban Development (in this section referred to as the 

9 ‘‘Secretary’’) shall establish a competitive grant program 

10 to award grants to eligible entities to plan and build infra11 structure that encourages social connection. 

12 (b) ELIGIBLE ENTITIES.—To be eligible for a grant 

13 under this section, an entity shall be— 

14 (1) a State government; 

15 (2) a local government; 

16 (3) a metropolitan planning organization; or 

17 (4) a multijurisdictional group of entities de18 scribed in paragraphs (1) through (3). 

19 (c) ELIGIBLE USES.—An eligible entity may use 

20 amounts awarded under this section to— 

21 (1) plan infrastructure projects that encourage 

22 social connection, including— 

23 (A) parks; 

24 (B) playgrounds; 

25 (C) recreation spaces; and 


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1 (D) access to natural areas; 

2 (2) build such projects; and 

3 (3) preserve such projects. 

4 (d) APPLICANT PREFERENCE.—The Secretary shall 

5 give preference to eligible entities that— 

6 (1) demonstrate environmentally conscious op7 erations; 

8 (2) emphasize accessibility for disabled individ9 uals; or 

10 (3) are located in or represent underserved 

11 communities. 

12 (e) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to the Secretary to carry 

14 out this section $170,000,000 for each of fiscal years 2025 

15 through 2029. 

16 SEC. 103. GRANTS FOR OUTREACH AND INTERVENTION TO 

17 ADDRESS LONELINESS. 

18 (a) IN GENERAL.—The Secretary of Health and 

19 Human Services (in this section referred to as the ‘‘Sec20 retary’’) shall establish a program to make grants, on a 

21 competitive basis, to covered entities for the purposes de22 scribed in subsection (c). 

23 (b) APPLICATIONS.—To be eligible to receive a grant 

24 under this section, a covered entity shall submit to the 

25 Secretary an application at such time, in such manner, 


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1 and containing such information as the Secretary may re2 quire. 

3 (c) PURPOSES DESCRIBED.—The purposes described 

4 in this subsection are the following: 

5 (1) To conduct outreach, through established 

6 screening tools or other methods, as the Secretary 

7 determines appropriate, to at-risk individuals regard8 ing the health effects of loneliness and social isola9 tion. 

10 (2) To develop and implement community-based 

11 interventions for the purpose of mitigating loneliness 

12 or social isolation in at-risk individuals, including 

13 evidence-based programs, as determined by the Sec14 retary, developed with multi-stakeholder input. 

15 (3) To connect at-risk individuals with commu16 nity social or clinical support. 

17 (d) DEFINITIONS.—In this section: 

18 (1) AT-RISK INDIVIDUAL.—The term ‘‘at-risk 

19 individual’’ means an individual who— 

20 (A) is— 

21 (i) between the ages of 18 and 25 

22 years old; or 

23 (ii) 60 years of age or older; 

24 (B) has a disability; 

25 (C) has a pre-existing health condition; or 


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1 (D) has poor indicators of social deter2 minants of health, which may include— 

3 (i) the conditions in which people are 

4 born, grow, work, live, worship, and age; 

5 and 

6 (ii) a wide set of forces and systems 

7 that shape daily life, such as economic 

8 policies and systems. 

9 (2) COVERED ENTITY.—The term ‘‘covered en10 tity’’ means— 

11 (A) an area agency on aging; 

12 (B) a center for independent living; and 

13 (C) such other community-based organiza14 tion, as the Secretary determines appropriate. 

15 (e) AUTHORIZATION OF APPROPRIATIONS.—There is 

16 authorized to be appropriated such sums as may be nec17 essary to carry out this section. 

18 TITLE II—PUBLIC HEALTH 

19 SEC. 201. SUPPORT GROUP DEMONSTRATION PROGRAM. 

20 (a) IN GENERAL.—The Secretary of Health and 

21 Human Services, acting through the Assistant Secretary 

22 for Mental Health and Substance Use, (in this section re23 ferred to as the ‘‘Secretary’’) shall establish a demonstra24 tion program to award grants to States and localities to 

25 support eligible organizations in— 


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1 (1) coordinating group therapy care for mental 

2 health and substance use treatment; 

3 (2) administrative and operational costs related 

4 to such treatment; and 

5 (3) outreach, participant recruitment, patient 

6 education, and treatment plan development. 

7 (b) PRIORITY.—In awarding grants under this sec8 tion, the Secretary shall give priority to States and local9 ities that will support eligible organizations in rural areas. 

10 (c) TECHNICAL ASSISTANCE.—The Secretary shall 

11 provide technical assistance to States and localities seek12 ing or receiving a grant under this section. 

13 (d) ELIGIBLE ORGANIZATION DEFINED.—In this 

14 section, the term ‘‘eligible organization’’ means a partner15 ship between— 

16 (1) at least 1— 

17 (A) clinician with a private practice; 

18 (B) health care center or association of 

19 community health centers; or 

20 (C) hospital; and 

21 (2) at least 1— 

22 (A) elementary or secondary school; 

23 (B) institution of higher education; or 

24 (C) community organization, including a 

25 senior center, youth center, or LGBTQ center. 


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1 SEC. 202. BUILDING COMMUNITIES OF RECOVERY PRO2 GRAM REAUTHORIZATION. 

3 Section 547(f) of the Public Health Service Act (42 

4 U.S.C. 290ee–2(f)) is amended by striking ‘‘$5,000,000 

5 for each of fiscal years 2019 through 2023’’ and inserting 

6 ‘‘$16,000,000 for each of fiscal years 2025 through 

7 2029’’. 

8 SEC. 203. MENTAL HEALTH PROVIDER STUDENT LOAN FOR9 GIVENESS. 

10 Part F of title VII of the Public Health Service Act 

11 (42 U.S.C. 295h) is amended— 

12 (1) by amending the part heading to read as 

13 follows: ‘‘SUBSTANCE USE DISORDER TREAT14 MENT AND MENTAL HEALTH WORKFORCE

15 LOAN REPAYMENT PROGRAMS’’; 

16 (2) in section 781(e)(2), by striking ‘‘338I, or 

17 846’’ and inserting ‘‘338I, 782, or 846’’; and 

18 (3) by adding at the end the following: 

19 ‘‘SEC. 782. LOAN REPAYMENT PROGRAM FOR MENTAL 

20 HEALTH WORKFORCE. 

21 ‘‘(a) IN GENERAL.—The Secretary, acting through 

22 the Administrator of the Health Resources and Services 

23 Administration, (in this section referred to as the ‘Sec24 retary’) shall carry out a program under which— 

25 ‘‘(1) the Secretary enters into agreements with 

26 individuals to make payments in accordance with 


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1 subsection (b) on the principal of and interest on 

2 any eligible loan; and 

3 ‘‘(2) the individuals each agree to the require4 ments of service in mental health services employ5 ment, as described in subsection (d). 

6 ‘‘(b) PAYMENTS.—For each year of obligated service 

7 by an individual pursuant to an agreement under sub8 section (a), the Secretary shall make a payment to such 

9 individual as follows: 

10 ‘‘(1) SERVICE IN A SHORTAGE AREA.—The Sec11 retary shall pay— 

12 ‘‘(A) for each year of obligated service by 

13 an individual pursuant to an agreement under 

subsection (a), 1 14 ⁄6 of the principal of and inter15 est on each eligible loan of the individual which 

16 is outstanding on the date the individual began 

17 service pursuant to the agreement; and 

18 ‘‘(B) for completion of the sixth and final 

19 year of such service, the remainder of such 

20 principal and interest. 

21 ‘‘(2) MAXIMUM AMOUNT.—The total amount of 

22 payments under this section to any individual shall 

23 not exceed $75,000. 

24 ‘‘(c) ELIGIBLE LOANS.—The loans eligible for repay25 ment under this section are each of the following: 


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1 ‘‘(1) Any loan for education or training for a 

2 substance use disorder treatment employment. 

3 ‘‘(2) Any loan under part E of title VIII (relat4 ing to nursing student loans). 

5 ‘‘(3) Any Federal Direct Stafford Loan, Fed6 eral Direct PLUS Loan, Federal Direct Unsub7 sidized Stafford Loan, or Federal Direct Consolida8 tion Loan (as such terms are used in section 455 of 

9 the Higher Education Act of 1965). 

10 ‘‘(4) Any Federal Perkins Loan under part E 

11 of title I of the Higher Education Act of 1965. 

12 ‘‘(5) Any other Federal loan as determined ap13 propriate by the Secretary. 

14 ‘‘(d) REQUIREMENTS OF SERVICE.—Any individual 

15 receiving payments under this program as required by an 

16 agreement under subsection (a) shall agree to an annual 

17 commitment to full-time employment, with no more than 

18 1 year passing between any 2 years of covered employ19 ment, in mental health services employment in the United 

20 States in a Mental Health Professional Shortage Area, as 

21 designated under section 332. 

22 ‘‘(e) INELIGIBILITY FOR DOUBLE BENEFITS.—No 

23 borrower may, for the same service, receive a reduction 

24 of loan obligations or a loan repayment under both— 

25 ‘‘(1) this section; and 


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1 ‘‘(2) any federally supported loan forgiveness 

2 program, including under section 338B, 338I, 781, 

3 or 846 of this Act, or section 428J, 428L, 455(m), 

4 or 460 of the Higher Education Act of 1965. 

5 ‘‘(f) BREACH.— 

6 ‘‘(1) LIQUIDATED DAMAGES FORMULA.—The 

7 Secretary may establish a liquidated damages for8 mula to be used in the event of a breach of an 

9 agreement entered into under subsection (a). 

10 ‘‘(2) LIMITATION.—The failure by an individual 

11 to complete the full period of service obligated pur12 suant to such an agreement, taken alone, shall not 

13 constitute a breach of the agreement, so long as the 

14 individual completed in good faith the years of serv15 ice for which payments were made to the individual 

16 under this section. 

17 ‘‘(g) ADDITIONAL CRITERIA.—The Secretary— 

18 ‘‘(1) may establish such criteria and rules to 

19 carry out this section as the Secretary determines 

20 are needed and in addition to the criteria and rules 

21 specified in this section; and 

22 ‘‘(2) shall give notice to the committees speci23 fied in subsection (h) of any criteria and rules so es24 tablished. 


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1 ‘‘(h) REPORT TO CONGRESS.—Not later than 5 years 

2 after the date of enactment of this section, and every other 

3 year thereafter, the Secretary shall prepare and submit 

4 to the Committee on Energy and Commerce of the House 

5 of Representatives and the Committee on Health, Edu6 cation, Labor, and Pensions of the Senate a report on— 

7 ‘‘(1) the number and location of borrowers who 

8 have qualified for loan repayments under this sec9 tion; and 

10 ‘‘(2) the impact of this section on the avail11 ability of substance use disorder treatment employ12 ees nationally and in shortage areas and counties de13 scribed in subsection (d). 

14 ‘‘(i) DEFINITION.—In this section: 

15 ‘‘(1) COMMUNITY-BASED ORGANIZATION.—The 

16 term ‘community-based organization’ includes, ex17 cept as otherwise provided by the Secretary, a non18 profit community-based organization, a consortium 

19 of nonprofit community-based organizations, a na20 tional nonprofit organization acting as an inter21 mediary for a community-based organization, or a 

22 community-based organization that has a fiscal 

23 sponsor that allows the organization to function as 

24 an organization described in section 501(c)(3) of the 


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1 Internal Revenue Code of 1986 and exempt from 

2 taxation under section 501(a) of such Code. 

3 ‘‘(2) ISDEAA TERMS.—The terms ‘Indian 

4 tribe’ and ‘tribal organization’ have the meanings 

5 given those terms in section 4 of the Indian Self-De6 termination and Education Assistance Act. 

7 ‘‘(3) MENTAL HEALTH SERVICES EMPLOY8 MENT.—The term ‘mental health services employ9 ment’ means full-time employment (including a fel10 lowship)— 

11 ‘‘(A) where the primary intent and func12 tion of the position is the direct treatment or 

13 recovery support of patients with or in recovery 

14 from a diagnosable mental, behavioral, or emo15 tional disorder, including master’s level social 

16 workers, psychologists, counselors, marriage 

17 and family therapists, psychiatric mental health 

18 practitioners, child and adolescent psychiatrists, 

19 occupational therapists, psychology doctoral in20 terns, behavioral health paraprofessionals and 

21 physicians, physician assistants, and nurses, 

22 who are licensed or certified in accordance with 

23 applicable State and Federal laws; and 

24 ‘‘(B) which is located at a mental health 

25 treatment program, private physician practice, 


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1 hospital or health system-affiliated inpatient 

2 treatment center or outpatient clinic (including 

3 an academic medical center-affiliated treatment 

4 program), correctional facility or program, 

5 youth detention center or program, inpatient 

6 psychiatric facility, crisis stabilization unit, 

7 community health center, community mental 

8 health or other specialty community behavioral 

9 health center, recovery center, school, commu10 nity-based organization, telehealth platform, mi11 grant health center, health program or facility 

12 operated by an Indian tribe or tribal organiza13 tion, Federal medical facility, or any other facil14 ity as determined appropriate for purposes of 

15 this section by the Secretary. 

16 ‘‘(4) MUNICIPALITY.—The term ‘municipality’ 

17 means a city, town, or other public body created by 

18 or pursuant to State law, or an Indian tribe.’’. 

19 SEC. 204. HEALTH WORKFORCE RESILIENCY PROGRAM. 

20 (a) FUNDING FOR MENTAL HEALTH AND SUB21 STANCE USE DISORDER TRAINING FOR HEALTH CARE

22 PROFESSIONALS, PARAPROFESSIONALS, AND PUBLIC

23 SAFETY OFFICERS.—Section 2703 of the American Res24 cue Plan Act of 2021 (Public Law 117–2; 135 Stat. 46) 

25 is amended— 


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1 (1) in subsection (b), by striking ‘‘appropriated 

2 by subsection (a)’’ and inserting ‘‘appropriated by 

3 subsection (a) or pursuant to subsection (c)’’; and 

4 (2) by adding at the end the following: 

5 ‘‘(c) AUTHORIZATION FOR FY 2025 TO 2029.— 

6 There is authorized to be appropriated for the purpose de7 scribed in subsection (b) $100,000,000 for the period of 

8 fiscal years 2025 through 2029.’’. 

9 (b) FUNDING FOR EDUCATION AND AWARENESS

10 CAMPAIGN ENCOURAGING HEALTHY WORK CONDITIONS

11 AND USE OF MENTAL HEALTH AND SUBSTANCE USE

12 DISORDER SERVICES BY HEALTH CARE PROFES13 SIONALS.—Section 2704 of the American Rescue Plan Act 

14 of 2021 (Public Law 117–2; 135 Stat. 46) is amended— 

15 (1) in subsection (b), by striking ‘‘appropriated 

16 by subsection (a)’’ and inserting ‘‘appropriated by 

17 subsection (a) or pursuant to subsection (c)’’; and 

18 (2) by adding at the end the following: 

19 ‘‘(c) AUTHORIZATION FOR FY 2025 TO 2029.— 

20 There is authorized to be appropriated for the purpose de21 scribed in subsection (b) $100,000,000 for the period of 

22 fiscal years 2025 through 2029.’’. 

23 (c) FUNDING FOR GRANTS FOR HEALTH CARE PRO24 VIDERS TO PROMOTE MENTAL HEALTH AMONG THEIR

25 HEALTH PROFESSIONAL WORKFORCE.—Section 2705 of 


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1 the American Rescue Plan Act of 2021 (Public Law 117– 

2 2; 135 Stat. 46) is amended— 

3 (1) in subsection (b), by striking ‘‘appropriated 

4 by subsection (a)’’ and inserting ‘‘appropriated by 

5 subsection (a) or pursuant to subsection (c)’’; and 

6 (2) by adding at the end the following: 

7 ‘‘(c) AUTHORIZATION FOR FY 2025 TO 2029.— 

8 There is authorized to be appropriated for the purpose de9 scribed in subsection (b) $100,000,000 for the period of 

10 fiscal years 2025 through 2029.’’. 

11 SEC. 205. TASK FORCE TO PREVENT HEALTH CARE WORK12 ER BURNOUT. 

13 (a) IN GENERAL.—The Secretary of Health and 

14 Human Services, acting through the Administrator of the 

15 Health Resources and Services Administration, (in this 

16 section referred to as the ‘‘Secretary’’) shall establish a 

17 task force to prevent health care worker burnout (in this 

18 section referred to as the ‘‘Task Force’’). 

19 (b) MEMBERS.—The Task Force shall have the fol20 lowing members, to be appointed by the Secretary (unless 

21 otherwise specified): 

22 (1) The Surgeon General, who shall serve as 

23 chair. 

24 (2) A representative from the Centers for Medi25 care & Medicaid Services. 


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1 (3) A representative from the Centers for Dis2 ease Control and Prevention. 

3 (4) A representative from the Office of Rural 

4 Health Policy of the Health Resources and Services 

5 Administration. 

6 (5) A representative from the Provider Relief 

7 Bureau of the Health Resources and Services Ad8 ministration. 

9 (6) A representative from the Office of Civil 

10 Rights, Diversity, and Inclusion of the Health Re11 sources and Services Administration. 

12 (7) Such other members as the chair deter13 mines appropriate, who shall be appointed by the 

14 chair. 

15 (c) REPORTS.—Not later than 2 years after the date 

16 of enactment of this Act, the Task Force shall submit to 

17 Congress a report that includes— 

18 (1) statistics and data on turnover in health 

19 care employment and health care worker satisfaction 

20 (including with regard to the mental health and sub21 stance use disorder workforces); 

22 (2) recommendations on how to reduce burnout 

23 among health care workers; 

24 (3) an assessment of burnout in Health Re25 sources and Services Administration workforce proVerDate Sep 11 2014 21:05 Jan 22, 2025 Jkt 059200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H10448.IH H10448

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1 grams and how such programs may be improved; 

2 and 

3 (4) a study of the administrative burden of 

4 health insurance systems (including Medicare, Med5 icaid, CHIP programs, and VA health). 

6 TITLE III—MEASUREMENTS OF 

7 LONELINESS 

8 SEC. 301. ADDITION OF LONELINESS TO THE OLDER AMERI9 CANS ACT OF 1965. 

10 Section 102(14)(N) of the Older Americans Act of 

11 1965 (42 U.S.C. 3002(14)(N)) is amended by inserting 

12 ‘‘or loneliness’’ after ‘‘social isolation’’ each place it ap13 pears. 

14 SEC. 302. HHS WORKING GROUP ON MEASUREMENTS OF 

15 LONELINESS AND ISOLATION. 

16 The Secretary of Health and Human Services shall 

17 establish within the Department of Health and Human 

18 Services a working group to formulate recommendations 

19 for standardizing the methods by which agencies and com20 ponents of the Department measure loneliness and isola21 tion. 

22 SEC. 303. GAO STUDY AND REPORT ON IMPACT OF SOCIAL 

23 ISOLATION. 

24 (a) STUDY.—The Comptroller General of the United 

25 States shall conduct a study on the impact of social isolaVerDate Sep 11 2014 21:05 Jan 22, 2025 Jkt 059200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\H10448.IH H10448

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1 tion and efforts by the Federal Government and State and 

2 local governments to address such social isolation. 

3 (b) REPORT.—Not later than 5 years after the date 

4 of enactment of this Act, the Comptroller General of the 

5 United shall submit to Congress a report detailing the re6 sults of the study under subsection (a). 

7 TITLE IV—COMMUNITY HEALTH 

8 WORKERS 

9 SEC. 401. COVERAGE OF COMMUNITY HEALTH WORKER 

10 SERVICES UNDER MEDICARE AND IN11 CREASED FMAP FOR COMMUNITY HEALTH 

12 WORKER SERVICES. 

13 (a) COVERAGE OF COMMUNITY HEALTH WORKER

14 SERVICES AND CERTIFIED COMMUNITY BEHAVIORAL

15 HEALTH CLINIC SERVICES UNDER MEDICARE.— 

16 (1) IN GENERAL.—Section 1861 of the Social 

17 Security Act (42 U.S.C. 1395x) is amended— 

18 (A) in subsection (s)(2), by adding at the 

19 end the following new subparagraphs: 

20 ‘‘(KK) professional services furnished by a com21 munity health worker (as defined in subsection 

22 (nnn)) on or after October 1, 2026; 

23 ‘‘(LL) certified community behavioral health 

24 clinic services (as defined in section 1905(jj)) fur25 nished on or after October 1, 2026;’’; and 


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1 (B) by adding at the end the following new 

2 subsection: 

3 ‘‘(nnn) COMMUNITY HEALTH WORKER.—The term 

4 ‘community health worker’ means an individual who is a 

5 frontline health worker who is a trusted member of the 

6 community in which the worker serves or who has an un7 usually close understanding of the community served that 

8 enables the worker to build trusted relationships, serve as 

9 a liaison or link between health and social services and 

10 the community, facilitate access to services, improve the 

11 quality and cultural competence of service delivery, build 

12 individual and community capacity, and increase health 

13 knowledge and self-sufficiency through a wide range of 

14 community health worker core roles, including through— 

15 ‘‘(1) providing cultural mediation among indi16 viduals, communities, and health and social service 

17 systems; 

18 ‘‘(2) providing culturally appropriate health 

19 education and information; 

20 ‘‘(3) providing care coordination, case manage21 ment, and system navigation; 

22 ‘‘(4) providing coaching and social support; 

23 ‘‘(5) advocating for individuals and commu24 nities; 


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1 ‘‘(6) building individual and community capac2 ity; 

3 ‘‘(7) providing direct service, including basic 

4 screening tests, such as weight and blood pressure 

5 screening, basic services such as diabetic foot checks, 

6 and meeting basic needs; 

7 ‘‘(8) implementing individual and community 

8 assessments; 

9 ‘‘(9) conducting outreach; and 

10 ‘‘(10) participating in evaluation and research’’. 

11 (2) PAYMENT RULE.—Section 1833 of the So12 cial Security Act (42 U.S.C. 1395l) is amended— 

13 (A) in subsection (a)(1)— 

14 (i) in subparagraph (GG), by striking 

15 ‘‘and’’ at the end; and 

16 (ii) by inserting before the semicolon 

17 at the end the following: ‘‘, and (II) with 

18 respect to professional services furnished 

19 by a community health worker (as defined 

20 in section 1861(nnn)) and certified com21 munity behavioral health clinic services (as 

22 defined in section 1905(jj)), the amounts 

23 paid shall be 100 percent of the lesser of 

24 the actual charge for the services or the 

25 amount determined under a fee schedule 


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1 established by the Secretary for such serv2 ices’’; and 

3 (B) in subsection (b)— 

4 (i) by striking ‘‘, and (13)’’ and in5 serting ‘‘(13)’’; and 

6 (ii) by striking ‘‘1861(n).’’ and insert7 ing ‘‘1861(n), (14) such deductible shall 

8 not apply with respect to professional serv9 ices furnished by a community health 

10 worker (as defined in section 1861(nnn)), 

11 and (15) such deductible shall not apply 

12 with respect to certified community behav13 ioral health clinic services (as defined in 

14 section 1905(jj))’’. 

15 (b) COVERAGE OF COMMUNITY HEALTH WORKER

16 SERVICES UNDER MEDICAID.— 

17 (1) IN GENERAL.—Section 1905(a) of the So18 cial Security Act (42 U.S.C. 1396d(a)) is amend19 ed— 

20 (A) in paragraph (31), by striking ‘‘and’’ 

21 at the end; 

22 (B) by redesignating paragraph (32) as 

23 paragraph (33); and 

24 (C) by inserting after paragraph (31) the 

25 following new paragraph: 


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1 ‘‘(32) beginning on October 1, 2026, profes2 sional services furnished by a community health 

3 worker (as defined in section 1861(nnn)); and’’. 

4 (2) FMAP INCREASE.—Section 1905 of the So5 cial Security Act (42 U.S.C. 1396d) is amended— 

6 (A) in subsection (b), by striking ‘‘and 

7 (ii)’’ and inserting ‘‘(ii), and (kk)’’; and 

8 (B) by adding at the end the following new 

9 subsection: 

10 ‘‘(kk) INCREASED FMAP FOR COMMUNITY HEALTH

11 WORKER SERVICES.—For each fiscal quarter beginning 

12 on or after October 1, 2026, the Federal medical assist13 ance percentage for a State shall be increased by 6 per14 centage points with respect to amounts expended by the 

15 State for medical assistance for professional services fur16 nished by a community health worker (as defined in sec17 tion 1861(nnn)).’’. 

18 SEC. 402. COMMUNITY HEALTH WORKERS IN NHSC LOAN 

19 REPAYMENT PROGRAM. 

20 Section 338B of the Public Health Service Act (42 

21 U.S.C. 254l–1) is amended— 

22 (1) in subsection (b)(1)(A), by striking ‘‘or phy23 sician assistant’’ and inserting ‘‘physician assistant, 

24 or community health worker’’; and 

25 (2) by adding at the end the following: 


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1 ‘‘(i) COMMUNITY HEALTH WORKER DEFINED.—In 

2 this section, the term ‘community health worker’ means 

3 an individual who— 

4 ‘‘(1) promotes wellness by helping individuals 

5 adopt healthy behaviors; 

6 ‘‘(2) implements programs and advocates for in7 dividuals who may have limited access to health re8 sources and social services; and 

9 ‘‘(3) works closely with other health care and 

10 social service providers.’’. 

11 TITLE V—EDUCATION 

12 SEC. 501. SCHOOL-BASED SERVICES UNDER MEDICAID AND 

13 CHIP. 

14 Section 11003(b) of the Bipartisan Safer Commu15 nities Act (42 U.S.C. 1396a note) is amended by inserting 

16 ‘‘, and $50,000,000 for fiscal year 2026,’’ after ‘‘fiscal 

17 year 2022’’. 

18 SEC. 502. SUPPORT FOR PROJECT AWARE. 

19 Part D of title V of the Public Health Service Act 

20 (42 U.S.C. 290dd et seq.) is amended by adding at the 

21 end the following: 

22 ‘‘SEC. 554. PROJECT AWARE GRANTS. 

23 ‘‘(a) IN GENERAL.—The Secretary, acting through 

24 the Assistant Secretary for Mental Health and Substance 

25 Use, (in this section referred to as the ‘Secretary’) shall 


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1 establish the Project Advancing Wellness and Resiliency 

2 in Education (in this section referred to as ‘Project 

3 AWARE’), to award grants to develop a sustainable infra4 structure for school-based mental health programs and 

5 services. 

6 ‘‘(b) USE OF FUNDS.—A grant awarded under 

7 Project AWARE may be used to provide peer mental 

8 health first aid training, including— 

9 ‘‘(1) to train teachers, other relevant school 

10 personnel (including education support profes11 sionals), students, and parents and caregivers of stu12 dents— 

13 ‘‘(A) to recognize symptoms of childhood 

14 and adolescent mental health conditions; 

15 ‘‘(B) to refer teachers, school personnel, 

16 students, and their family members to appro17 priate mental health services if necessary; and 

18 ‘‘(C) to recognize signs of immediate men19 tal distress and, upon recognizing such signs 

20 apply mental health first aid tactics; and 

21 ‘‘(2) to provide education to such teachers, per22 sonnel, students, parents, and caregivers regarding 

23 resources that are available in the community for in24 dividuals with a mental illness. 


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1 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

2 is authorized to be appropriated to carry out this section 

3 $130,000,000 for each of fiscal years 2026 through 

4 2030.’’. 

5 SEC. 503. SUPPORT FOR THE 21ST CENTURY COMMUNITY 

6 LEARNING CENTERS PROGRAM AND THE 

7 FULL-SERVICE COMMUNITY SCHOOLS PRO8 GRAM. 

9 (a) COMMUNITY LEARNING CENTER SERVICES, PRO10 GRAMS, AND ACTIVITIES.—Section 4201(a)(2) of the Ele11 mentary and Secondary Education Act of 1965 (20 U.S.C. 

12 7171(a)(2)) is amended by inserting ‘‘mental health serv13 ices, community service activities,’’ after ‘‘counseling pro14 grams,’’. 

15 (b) AUTHORIZATION OF APPROPRIATIONS FOR 21ST

16 CENTURY COMMUNITY LEARNING CENTERS PROGRAM.— 

17 Section 4206 of the Elementary and Secondary Education 

18 Act of 1965 (20 U.S.C. 7176) is amended to read as fol19 lows: 

20 ‘‘SEC. 4206. AUTHORIZATION OF APPROPRIATIONS. 

21 ‘‘There are authorized to be appropriated to carry out 

22 this part— 

23 ‘‘(1) $1,329,673,000 for fiscal year 2025; 

24 ‘‘(2) $1,429,673,000 for fiscal year 2026; 

25 ‘‘(3) $1,529,673,000 for fiscal year 2027; 


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1 ‘‘(4) $1,629,673,000 for fiscal year 2028; and 

2 ‘‘(5) $1,729,673,000 for fiscal year 2029.’’. 

3 (c) AUTHORIZATION OF APPROPRIATIONS FOR FULL4 SERVICE COMMUNITY SCHOOLS PROGRAM.—Section 4601 

5 of the Elementary and Secondary Education Act of 1965 

6 (20 U.S.C. 7251(a)) is amended— 

7 (1) in the matter preceding paragraph (1) of 

8 subsection (a), by inserting ‘‘(except for section 

9 4625)’’ after ‘‘part’’; 

10 (2) in the matter preceding clause (i) of sub11 section (b)(2)(B), by inserting ‘‘(except for section 

12 4625)’’ after ‘‘subpart 2’’; and 

13 (3) by adding at the end the following: 

14 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS FOR

15 FULL-SERVICE COMMUNITY SCHOOLS.—There are au16 thorized to be appropriated to carry out section 4625— 

17 ‘‘(1) $500,000,000 for fiscal year 2025; 

18 ‘‘(2) $600,000,000 for fiscal year 2026; 

19 ‘‘(3) $700,000,000 for fiscal year 2027; 

20 ‘‘(4) $850,000,000 for fiscal year 2028; and 

21 ‘‘(5) $1,000,000,000 for fiscal year 2029.’’. 

22 (d) CONFORMING AMENDMENTS.—Section 4623(a) 

23 of the Elementary and Secondary Education Act of 1965 

24 (20 U.S.C. 7273(a)) is amended— 


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1 (1) by redesignating paragraph (2) as para2 graph (3); and 

3 (2) by striking paragraph (1) and inserting the 

4 following: 

5 ‘‘(1) PROMISE NEIGHBORHOODS.—The Sec6 retary shall use not less than 95 percent of the 

7 amounts made available under section 4601(b)(2)(B) 

8 to award grants, on a competitive basis and subject 

9 to subsection (e), to eligible entities for the imple10 mentation of a comprehensive, effective continuum 

11 of coordinated services that meets the purpose de12 scribed in section 4621(1) by carrying out activities 

13 in neighborhoods with— 

14 ‘‘(A) high concentrations of low-income in15 dividuals; 

16 ‘‘(B) multiple signs of distress, which may 

17 include high rates of poverty, childhood obesity, 

18 academic failure, and juvenile delinquency, ad19 judication, or incarceration; and 

20 ‘‘(C) schools implementing comprehensive 

21 support and improvement activities or targeted 

22 support and improvement activities under sec23 tion 1111(d). 

24 ‘‘(2) FULL-SERVICE COMMUNITY SCHOOLS AU25 THORIZED.—The Secretary shall use the amounts 


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1 made available under section 4601(c) to carry out 

2 the full-service community school program under 

3 section 4625.’’. 

4 TITLE VI—DEFINITIONS 

5 SEC. 601. DEFINITIONS. 

6 In this Act: 

7 (1) BURNOUT.—The term ‘‘burnout’’ means ex8 haustion and mental distance from one’s job. 

9 (2) LONELINESS.—The term ‘‘loneliness’’ 

10 means subjectively feeling alone, or the discrepancy 

11 between one’s desired level of social connection and 

12 one’s actual level of social connection. 

13 (3) SOCIAL CONNECTION.—The term ‘‘social 

14 connection’’ means the variety of ways one can con15 nect with others socially, through physical, behav16 ioral, social-cognitive, and emotional channels. 

17 (4) SOCIAL ISOLATION.—The term ‘‘social isola18 tion’’ means objectively being alone, or having few 

19 relationships or infrequent social contact. 

20 (5) UNDERSERVED COMMUNITIES.—The term 

21 ‘‘underserved communities’’ includes communities 

22 with a high proportion of individuals who— 

23 (A) are socioeconomically disadvantaged; 

24 (B) have limited English proficiency; 

25 (C) are geographically isolated; 


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1 (D) are educationally disenfranchised; 

2 (E) are individuals of color; 

3 (F) are of ethnic or national origin minori4 ties; 

5 (G) are women or children; 

6 (H) have disabilities; or 

7 (I) are seniors. 

Æ 


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