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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10448 Introduced in House (IH)]

<DOC>

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.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Combating 
Loneliness Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Sense of Congress.
                   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.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) 36 percent of individuals in the United States report 
        serious loneliness.
            (2) 61 percent of young adults and over 50 percent of 
        mothers with young children in the United States report serious 
        loneliness.
            (3) 61 percent of disabled individuals in the United States 
        experience chronic loneliness, with an even higher prevalence 
        of 70 percent among young disabled people in the United States.
            (4) LGBTQI+ youth, particularly transgender and Black 
        individuals, experience higher levels of loneliness, 
        depression, and anxiety than their straight or cisgender 
        counterparts.
            (5) Black individuals, Indigenous individuals, and 
        individuals of color are disproportionately affected by social 
        loneliness and isolation, with 75 percent of Latinx and 
        Hispanic adults and 68 percent of Black and African American 
        adults categorized as lonely.
            (6) Due to fragmented social networks, loneliness is 
        especially pervasive with people experiencing homelessness, 
        with 1 in 5 reporting to have no friends.
            (7) Farmers and agricultural workers, predominantly based 
        in rural areas, face heightened risks to mental well-being due 
        to social and geographical isolation.
            (8) Older adults face heightened vulnerability to 
        loneliness and social isolation due to factors including living 
        alone, loss of familial and social ties, chronic illness, and 
        impaired hearing.
            (9) Elderly individuals are increasingly affected by 
        homelessness and loneliness as their social circles shrink, 
        lifespans increase, and economic challenges grow, making them 
        one of the fastest-growing segments of the homeless population.
            (10) Veterans often experience feelings of isolation due to 
        losing touch with their military community, physical or mental 
        health issues, and difficulties adjusting to civilian life.
            (11) 1 out of every 5 veterans reports that they often feel 
        lonely, leading to higher rates of mental and physical health, 
        as well as suicidal ideation.
            (12) Climate-related disasters are associated with negative 
        impacts on mental health nationwide.
            (13) People who use social media for more than 2 hours a 
        day are twice as likely to report increased feelings of social 
        isolation than those who were using it for less than 30 minutes 
        a day.
            (14) Students with low academic performance may turn to 
        social networking sites to cope with feelings of loneliness and 
        isolation, finding online interactions less stressful than 
        face-to-face relationships.
            (15) A shortage of 139,000 primary care physicians is 
        projected by 2033, with particularly concerning deficits 
        anticipated rural areas.
            (16) Burnout rates reported by health care workers 
        nationally are higher than in any other industry.
            (17) Nearly half of health workers reported often feeling 
        burned out in 2022, up from 32 percent in 2018.
            (18) Rural clinics report the highest rates of burnout.
            (19) Increased feeling of loneliness and social isolation 
        can lead to an increase in susceptibility to radicalization and 
        violence.
            (20) Increased feelings of loneliness lead to a reduced 
        sense of civic duty and lower voter turnout.
            (21) Positive relationships with peers, parents, and 
        teachers during childhood and adolescence correlate with 
        improved academic outcomes and predict higher rates of college 
        graduation and attainment of four-year degrees in early 
        adulthood.
            (22) Building design incorporating elements that promote 
        physical activity and social interaction enhances health and 
        reduces loneliness among older adults.
            (23) Housing with care is effective at reducing loneliness 
        and social isolation in later life, providing better outcomes 
        than living in the general community.

SEC. 3. SENSE OF CONGRESS.

    It is the sense of the Congress that it is the duty of the Federal 
Government to--
            (1) create a national health insurance program that 
        provides comprehensive and essential care to all individuals in 
        the United States, which is critical to building healthier 
        communities;
            (2) establish a national paid family and medical leave 
        program that allows every worker to take care of their own 
        health and their families' health, which creates healthy and 
        vibrant communities;
            (3) encourage participation in the arts and the humanities, 
        which provides communities with a foundation to engage in our 
        democracy and fosters an appreciation for our shared cultural 
        heritage;
            (4) establish universal early education that supports early 
        childhood development and sets children up for academic 
        success, which is an investment in our children, their 
        families, and future generations;
            (5) provide safe, affordable housing that provides working 
        families with stability, which is critical to building vibrant 
        communities;
            (6) provide affordable and quality child care that is a 
        lifeline for working families, which is critical to building a 
        stronger economy, workforce, and communities;
            (7) address the climate crisis by transitioning to 
        renewable energy, promoting environmental justice, and 
        conserving public and wild lands, which is essential to 
        building resilient communities and a sustainable future;
            (8) reduce gun violence through common-sense gun safety 
        reform, which will protect families from senseless gun 
        violence, which is critical to creating safer communities;
            (9) build a tax code that works for working families and 
        small businesses, and ensure the wealthy pay their fair share, 
        which is essential in order to invest in critical resources 
        such as housing and mental health care; and
            (10) encourage States, counties, and local municipalities 
        to develop policies that have a focus on connection and social 
        connectivity.

                   TITLE I--COMMUNITY-BASED PROGRAMS

SEC. 101. GRANTS FOR THIRD-SPACES.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), in consultation with 
the appropriate Federal officials, shall establish a program to award 
grants, on a competitive basis, to State or local governments to 
support eligible entities to create and scale community connection 
programs and local institutions that bring people together at community 
facilities.
    (b) Applications.--To be eligible to receive a grant under this 
section, a State or local government shall submit to the Secretary an 
application at such time, in such manner, and containing such 
information as the Secretary may require.
    (c) Use of Funds.--A grant awarded under this section--
            (1) may be used to pay the salary or wages of appropriate 
        staff of the community connection programs and local 
        institutions referred to in subsection (a); and
            (2) may not be used for the construction of any facility.
    (d) Priority.--In awarding grants under this section, the Secretary 
shall prioritize--
            (1) underserved communities; and
            (2) communities with high percentages of children or 
        elderly individuals.
    (e) Definitions.--In this section:
            (1) Appropriate federal officials.--The term ``appropriate 
        Federal officials'' means--
                    (A) the Administrator of the Administration for 
                Community Living;
                    (B) the Secretary of Education;
                    (C) the Secretary of Veterans Affairs;
                    (D) the Secretary of Labor; and
                    (E) the Director of the Institute of Museum and 
                Library Services.
            (2) Eligible entity.--The term ``eligible entity'' means a 
        governmental or nonprofit entity that is--
                    (A) a library;
                    (B) a senior center;
                    (C) a childcare center or after-school program;
                    (D) a recreation center;
                    (E) a teen center;
                    (F) a veteran service organization; or
                    (G) any other entity, as the relevant State or 
                local government determines appropriate.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $200,000,000 for each of fiscal 
years 2025 through 2029.

SEC. 102. GRANTS FOR SOCIAL INFRASTRUCTURE.

    (a) In General.--The Secretary of Housing and Urban Development (in 
this section referred to as the ``Secretary'') shall establish a 
competitive grant program to award grants to eligible entities to plan 
and build infrastructure that encourages social connection.
    (b) Eligible Entities.--To be eligible for a grant under this 
section, an entity shall be--
            (1) a State government;
            (2) a local government;
            (3) a metropolitan planning organization; or
            (4) a multijurisdictional group of entities described in 
        paragraphs (1) through (3).
    (c) Eligible Uses.--An eligible entity may use amounts awarded 
under this section to--
            (1) plan infrastructure projects that encourage social 
        connection, including--
                    (A) parks;
                    (B) playgrounds;
                    (C) recreation spaces; and
                    (D) access to natural areas;
            (2) build such projects; and
            (3) preserve such projects.
    (d) Applicant Preference.--The Secretary shall give preference to 
eligible entities that--
            (1) demonstrate environmentally conscious operations;
            (2) emphasize accessibility for disabled individuals; or
            (3) are located in or represent underserved communities.
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary to carry out this section $170,000,000 
for each of fiscal years 2025 through 2029.

SEC. 103. GRANTS FOR OUTREACH AND INTERVENTION TO ADDRESS LONELINESS.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall establish a 
program to make grants, on a competitive basis, to covered entities for 
the purposes described in subsection (c).
    (b) Applications.--To be eligible to receive a grant under this 
section, a covered entity shall submit to the Secretary an application 
at such time, in such manner, and containing such information as the 
Secretary may require.
    (c) Purposes Described.--The purposes described in this subsection 
are the following:
            (1) To conduct outreach, through established screening 
        tools or other methods, as the Secretary determines 
        appropriate, to at-risk individuals regarding the health 
        effects of loneliness and social isolation.
            (2) To develop and implement community-based interventions 
        for the purpose of mitigating loneliness or social isolation in 
        at-risk individuals, including evidence-based programs, as 
        determined by the Secretary, developed with multi-stakeholder 
        input.
            (3) To connect at-risk individuals with community social or 
        clinical support.
    (d) Definitions.--In this section:
            (1) At-risk individual.--The term ``at-risk individual'' 
        means an individual who--
                    (A) is--
                            (i) between the ages of 18 and 25 years 
                        old; or
                            (ii) 60 years of age or older;
                    (B) has a disability;
                    (C) has a pre-existing health condition; or
                    (D) has poor indicators of social determinants of 
                health, which may include--
                            (i) the conditions in which people are 
                        born, grow, work, live, worship, and age; and
                            (ii) a wide set of forces and systems that 
                        shape daily life, such as economic policies and 
                        systems.
            (2) Covered entity.--The term ``covered entity'' means--
                    (A) an area agency on aging;
                    (B) a center for independent living; and
                    (C) such other community-based organization, as the 
                Secretary determines appropriate.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out this section.

                        TITLE II--PUBLIC HEALTH

SEC. 201. SUPPORT GROUP DEMONSTRATION PROGRAM.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Assistant Secretary for Mental Health and Substance Use, 
(in this section referred to as the ``Secretary'') shall establish a 
demonstration program to award grants to States and localities to 
support eligible organizations in--
            (1) coordinating group therapy care for mental health and 
        substance use treatment;
            (2) administrative and operational costs related to such 
        treatment; and
            (3) outreach, participant recruitment, patient education, 
        and treatment plan development.
    (b) Priority.--In awarding grants under this section, the Secretary 
shall give priority to States and localities that will support eligible 
organizations in rural areas.
    (c) Technical Assistance.--The Secretary shall provide technical 
assistance to States and localities seeking or receiving a grant under 
this section.
    (d) Eligible Organization Defined.--In this section, the term 
``eligible organization'' means a partnership between--
            (1) at least 1--
                    (A) clinician with a private practice;
                    (B) health care center or association of community 
                health centers; or
                    (C) hospital; and
            (2) at least 1--
                    (A) elementary or secondary school;
                    (B) institution of higher education; or
                    (C) community organization, including a senior 
                center, youth center, or LGBTQ center.

SEC. 202. BUILDING COMMUNITIES OF RECOVERY PROGRAM REAUTHORIZATION.

    Section 547(f) of the Public Health Service Act (42 U.S.C. 290ee-
2(f)) is amended by striking ``$5,000,000 for each of fiscal years 2019 
through 2023'' and inserting ``$16,000,000 for each of fiscal years 
2025 through 2029''.

SEC. 203. MENTAL HEALTH PROVIDER STUDENT LOAN FORGIVENESS.

    Part F of title VII of the Public Health Service Act (42 U.S.C. 
295h) is amended--
            (1) by amending the part heading to read as follows: 
        ``substance use disorder treatment and mental health workforce 
        loan repayment programs'';
            (2) in section 781(e)(2), by striking ``338I, or 846'' and 
        inserting ``338I, 782, or 846''; and
            (3) by adding at the end the following:

``SEC. 782. LOAN REPAYMENT PROGRAM FOR MENTAL HEALTH WORKFORCE.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, (in this section 
referred to as the `Secretary') shall carry out a program under which--
            ``(1) the Secretary enters into agreements with individuals 
        to make payments in accordance with subsection (b) on the 
        principal of and interest on any eligible loan; and
            ``(2) the individuals each agree to the requirements of 
        service in mental health services employment, as described in 
        subsection (d).
    ``(b) Payments.--For each year of obligated service by an 
individual pursuant to an agreement under subsection (a), the Secretary 
shall make a payment to such individual as follows:
            ``(1) Service in a shortage area.--The Secretary shall 
        pay--
                    ``(A) for each year of obligated service by an 
                individual pursuant to an agreement under subsection 
                (a), \1/6\ of the principal of and interest on each 
                eligible loan of the individual which is outstanding on 
                the date the individual began service pursuant to the 
                agreement; and
                    ``(B) for completion of the sixth and final year of 
                such service, the remainder of such principal and 
                interest.
            ``(2) Maximum amount.--The total amount of payments under 
        this section to any individual shall not exceed $75,000.
    ``(c) Eligible Loans.--The loans eligible for repayment under this 
section are each of the following:
            ``(1) Any loan for education or training for a substance 
        use disorder treatment employment.
            ``(2) Any loan under part E of title VIII (relating to 
        nursing student loans).
            ``(3) Any Federal Direct Stafford Loan, Federal Direct PLUS 
        Loan, Federal Direct Unsubsidized Stafford Loan, or Federal 
        Direct Consolidation Loan (as such terms are used in section 
        455 of the Higher Education Act of 1965).
            ``(4) Any Federal Perkins Loan under part E of title I of 
        the Higher Education Act of 1965.
            ``(5) Any other Federal loan as determined appropriate by 
        the Secretary.
    ``(d) Requirements of Service.--Any individual receiving payments 
under this program as required by an agreement under subsection (a) 
shall agree to an annual commitment to full-time employment, with no 
more than 1 year passing between any 2 years of covered employment, in 
mental health services employment in the United States in a Mental 
Health Professional Shortage Area, as designated under section 332.
    ``(e) Ineligibility for Double Benefits.--No borrower may, for the 
same service, receive a reduction of loan obligations or a loan 
repayment under both--
            ``(1) this section; and
            ``(2) any federally supported loan forgiveness program, 
        including under section 338B, 338I, 781, or 846 of this Act, or 
        section 428J, 428L, 455(m), or 460 of the Higher Education Act 
        of 1965.
    ``(f) Breach.--
            ``(1) Liquidated damages formula.--The Secretary may 
        establish a liquidated damages formula to be used in the event 
        of a breach of an agreement entered into under subsection (a).
            ``(2) Limitation.--The failure by an individual to complete 
        the full period of service obligated pursuant to such an 
        agreement, taken alone, shall not constitute a breach of the 
        agreement, so long as the individual completed in good faith 
        the years of service for which payments were made to the 
        individual under this section.
    ``(g) Additional Criteria.--The Secretary--
            ``(1) may establish such criteria and rules to carry out 
        this section as the Secretary determines are needed and in 
        addition to the criteria and rules specified in this section; 
        and
            ``(2) shall give notice to the committees specified in 
        subsection (h) of any criteria and rules so established.
    ``(h) Report to Congress.--Not later than 5 years after the date of 
enactment of this section, and every other year thereafter, the 
Secretary shall prepare and submit to the Committee on Energy and 
Commerce of the House of Representatives and the Committee on Health, 
Education, Labor, and Pensions of the Senate a report on--
            ``(1) the number and location of borrowers who have 
        qualified for loan repayments under this section; and
            ``(2) the impact of this section on the availability of 
        substance use disorder treatment employees nationally and in 
        shortage areas and counties described in subsection (d).
    ``(i) Definition.--In this section:
            ``(1) Community-based organization.--The term `community-
        based organization' includes, except as otherwise provided by 
        the Secretary, a nonprofit community-based organization, a 
        consortium of nonprofit community-based organizations, a 
        national nonprofit organization acting as an intermediary for a 
        community-based organization, or a community-based organization 
        that has a fiscal sponsor that allows the organization to 
        function as an organization described in section 501(c)(3) of 
        the Internal Revenue Code of 1986 and exempt from taxation 
        under section 501(a) of such Code.
            ``(2) ISDEAA terms.--The terms `Indian tribe' and `tribal 
        organization' have the meanings given those terms in section 4 
        of the Indian Self-Determination and Education Assistance Act.
            ``(3) Mental health services employment.--The term `mental 
        health services employment' means full-time employment 
        (including a fellowship)--
                    ``(A) where the primary intent and function of the 
                position is the direct treatment or recovery support of 
                patients with or in recovery from a diagnosable mental, 
                behavioral, or emotional disorder, including master's 
                level social workers, psychologists, counselors, 
                marriage and family therapists, psychiatric mental 
                health practitioners, child and adolescent 
                psychiatrists, occupational therapists, psychology 
                doctoral interns, behavioral health paraprofessionals 
                and physicians, physician assistants, and nurses, who 
                are licensed or certified in accordance with applicable 
                State and Federal laws; and
                    ``(B) which is located at a mental health treatment 
                program, private physician practice, hospital or health 
                system-affiliated inpatient treatment center or 
                outpatient clinic (including an academic medical 
                center-affiliated treatment program), correctional 
                facility or program, youth detention center or program, 
                inpatient psychiatric facility, crisis stabilization 
                unit, community health center, community mental health 
                or other specialty community behavioral health center, 
                recovery center, school, community-based organization, 
                telehealth platform, migrant health center, health 
                program or facility operated by an Indian tribe or 
                tribal organization, Federal medical facility, or any 
                other facility as determined appropriate for purposes 
                of this section by the Secretary.
            ``(4) Municipality.--The term `municipality' means a city, 
        town, or other public body created by or pursuant to State law, 
        or an Indian tribe.''.

SEC. 204. HEALTH WORKFORCE RESILIENCY PROGRAM.

    (a) Funding for Mental Health and Substance Use Disorder Training 
for Health Care Professionals, Paraprofessionals, and Public Safety 
Officers.--Section 2703 of the American Rescue Plan Act of 2021 (Public 
Law 117-2; 135 Stat. 46) is amended--
            (1) in subsection (b), by striking ``appropriated by 
        subsection (a)'' and inserting ``appropriated by subsection (a) 
        or pursuant to subsection (c)''; and
            (2) by adding at the end the following:
    ``(c) Authorization for FY 2025 to 2029.--There is authorized to be 
appropriated for the purpose described in subsection (b) $100,000,000 
for the period of fiscal years 2025 through 2029.''.
    (b) Funding for Education and Awareness Campaign Encouraging 
Healthy Work Conditions and Use of Mental Health and Substance Use 
Disorder Services by Health Care Professionals.--Section 2704 of the 
American Rescue Plan Act of 2021 (Public Law 117-2; 135 Stat. 46) is 
amended--
            (1) in subsection (b), by striking ``appropriated by 
        subsection (a)'' and inserting ``appropriated by subsection (a) 
        or pursuant to subsection (c)''; and
            (2) by adding at the end the following:
    ``(c) Authorization for FY 2025 to 2029.--There is authorized to be 
appropriated for the purpose described in subsection (b) $100,000,000 
for the period of fiscal years 2025 through 2029.''.
    (c) Funding for Grants for Health Care Providers To Promote Mental 
Health Among Their Health Professional Workforce.--Section 2705 of the 
American Rescue Plan Act of 2021 (Public Law 117-2; 135 Stat. 46) is 
amended--
            (1) in subsection (b), by striking ``appropriated by 
        subsection (a)'' and inserting ``appropriated by subsection (a) 
        or pursuant to subsection (c)''; and
            (2) by adding at the end the following:
    ``(c) Authorization for FY 2025 to 2029.--There is authorized to be 
appropriated for the purpose described in subsection (b) $100,000,000 
for the period of fiscal years 2025 through 2029.''.

SEC. 205. TASK FORCE TO PREVENT HEALTH CARE WORKER BURNOUT.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Administrator of the Health Resources and Services 
Administration, (in this section referred to as the ``Secretary'') 
shall establish a task force to prevent health care worker burnout (in 
this section referred to as the ``Task Force'').
    (b) Members.--The Task Force shall have the following members, to 
be appointed by the Secretary (unless otherwise specified):
            (1) The Surgeon General, who shall serve as chair.
            (2) A representative from the Centers for Medicare & 
        Medicaid Services.
            (3) A representative from the Centers for Disease Control 
        and Prevention.
            (4) A representative from the Office of Rural Health Policy 
        of the Health Resources and Services Administration.
            (5) A representative from the Provider Relief Bureau of the 
        Health Resources and Services Administration.
            (6) A representative from the Office of Civil Rights, 
        Diversity, and Inclusion of the Health Resources and Services 
        Administration.
            (7) Such other members as the chair determines appropriate, 
        who shall be appointed by the chair.
    (c) Reports.--Not later than 2 years after the date of enactment of 
this Act, the Task Force shall submit to Congress a report that 
includes--
            (1) statistics and data on turnover in health care 
        employment and health care worker satisfaction (including with 
        regard to the mental health and substance use disorder 
        workforces);
            (2) recommendations on how to reduce burnout among health 
        care workers;
            (3) an assessment of burnout in Health Resources and 
        Services Administration workforce programs and how such 
        programs may be improved; and
            (4) a study of the administrative burden of health 
        insurance systems (including Medicare, Medicaid, CHIP programs, 
        and VA health).

                 TITLE III--MEASUREMENTS OF LONELINESS

SEC. 301. ADDITION OF LONELINESS TO THE OLDER AMERICANS ACT OF 1965.

    Section 102(14)(N) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)(N)) is amended by inserting ``or loneliness'' after ``social 
isolation'' each place it appears.

SEC. 302. HHS WORKING GROUP ON MEASUREMENTS OF LONELINESS AND 
              ISOLATION.

    The Secretary of Health and Human Services shall establish within 
the Department of Health and Human Services a working group to 
formulate recommendations for standardizing the methods by which 
agencies and components of the Department measure loneliness and 
isolation.

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

    (a) Study.--The Comptroller General of the United States shall 
conduct a study on the impact of social isolation and efforts by the 
Federal Government and State and local governments to address such 
social isolation.
    (b) Report.--Not later than 5 years after the date of enactment of 
this Act, the Comptroller General of the United shall submit to 
Congress a report detailing the results of the study under subsection 
(a).

                   TITLE IV--COMMUNITY HEALTH WORKERS

SEC. 401. COVERAGE OF COMMUNITY HEALTH WORKER SERVICES UNDER MEDICARE 
              AND INCREASED FMAP FOR COMMUNITY HEALTH WORKER SERVICES.

    (a) Coverage of Community Health Worker Services and Certified 
Community Behavioral Health Clinic Services Under Medicare.--
            (1) In general.--Section 1861 of the Social Security Act 
        (42 U.S.C. 1395x) is amended--
                    (A) in subsection (s)(2), by adding at the end the 
                following new subparagraphs:
            ``(KK) professional services furnished by a community 
        health worker (as defined in subsection (nnn)) on or after 
        October 1, 2026;
            ``(LL) certified community behavioral health clinic 
        services (as defined in section 1905(jj)) furnished on or after 
        October 1, 2026;''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(nnn) Community Health Worker.--The term `community health 
worker' means an individual who is a frontline health worker who is a 
trusted member of the community in which the worker serves or who has 
an unusually close understanding of the community served that enables 
the worker to build trusted relationships, serve as a liaison or link 
between health and social services and the community, facilitate access 
to services, improve the quality and cultural competence of service 
delivery, build individual and community capacity, and increase health 
knowledge and self-sufficiency through a wide range of community health 
worker core roles, including through--
            ``(1) providing cultural mediation among individuals, 
        communities, and health and social service systems;
            ``(2) providing culturally appropriate health education and 
        information;
            ``(3) providing care coordination, case management, and 
        system navigation;
            ``(4) providing coaching and social support;
            ``(5) advocating for individuals and communities;
            ``(6) building individual and community capacity;
            ``(7) providing direct service, including basic screening 
        tests, such as weight and blood pressure screening, basic 
        services such as diabetic foot checks, and meeting basic needs;
            ``(8) implementing individual and community assessments;
            ``(9) conducting outreach; and
            ``(10) participating in evaluation and research''.
            (2) Payment rule.--Section 1833 of the Social Security Act 
        (42 U.S.C. 1395l) is amended--
                    (A) in subsection (a)(1)--
                            (i) in subparagraph (GG), by striking 
                        ``and'' at the end; and
                            (ii) by inserting before the semicolon at 
                        the end the following: ``, and (II) with 
                        respect to professional services furnished by a 
                        community health worker (as defined in section 
                        1861(nnn)) and certified community behavioral 
                        health clinic services (as defined in section 
                        1905(jj)), the amounts paid shall be 100 
                        percent of the lesser of the actual charge for 
                        the services or the amount determined under a 
                        fee schedule established by the Secretary for 
                        such services''; and
                    (B) in subsection (b)--
                            (i) by striking ``, and (13)'' and 
                        inserting ``(13)''; and
                            (ii) by striking ``1861(n).'' and inserting 
                        ``1861(n), (14) such deductible shall not apply 
                        with respect to professional services furnished 
                        by a community health worker (as defined in 
                        section 1861(nnn)), and (15) such deductible 
                        shall not apply with respect to certified 
                        community behavioral health clinic services (as 
                        defined in section 1905(jj))''.
    (b) Coverage of Community Health Worker Services Under Medicaid.--
            (1) In general.--Section 1905(a) of the Social Security Act 
        (42 U.S.C. 1396d(a)) is amended--
                    (A) in paragraph (31), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (32) as paragraph 
                (33); and
                    (C) by inserting after paragraph (31) the following 
                new paragraph:
            ``(32) beginning on October 1, 2026, professional services 
        furnished by a community health worker (as defined in section 
        1861(nnn)); and''.
            (2) FMAP increase.--Section 1905 of the Social Security Act 
        (42 U.S.C. 1396d) is amended--
                    (A) in subsection (b), by striking ``and (ii)'' and 
                inserting ``(ii), and (kk)''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(kk) Increased FMAP for Community Health Worker Services.--For 
each fiscal quarter beginning on or after October 1, 2026, the Federal 
medical assistance percentage for a State shall be increased by 6 
percentage points with respect to amounts expended by the State for 
medical assistance for professional services furnished by a community 
health worker (as defined in section 1861(nnn)).''.

SEC. 402. COMMUNITY HEALTH WORKERS IN NHSC LOAN REPAYMENT PROGRAM.

    Section 338B of the Public Health Service Act (42 U.S.C. 254l-1) is 
amended--
            (1) in subsection (b)(1)(A), by striking ``or physician 
        assistant'' and inserting ``physician assistant, or community 
        health worker''; and
            (2) by adding at the end the following:
    ``(i) Community Health Worker Defined.--In this section, the term 
`community health worker' means an individual who--
            ``(1) promotes wellness by helping individuals adopt 
        healthy behaviors;
            ``(2) implements programs and advocates for individuals who 
        may have limited access to health resources and social 
        services; and
            ``(3) works closely with other health care and social 
        service providers.''.

                           TITLE V--EDUCATION

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

    Section 11003(b) of the Bipartisan Safer Communities Act (42 U.S.C. 
1396a note) is amended by inserting ``, and $50,000,000 for fiscal year 
2026,'' after ``fiscal year 2022''.

SEC. 502. SUPPORT FOR PROJECT AWARE.

    Part D of title V of the Public Health Service Act (42 U.S.C. 290dd 
et seq.) is amended by adding at the end the following:

``SEC. 554. PROJECT AWARE GRANTS.

    ``(a) In General.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Use, (in this section 
referred to as the `Secretary') shall establish the Project Advancing 
Wellness and Resiliency in Education (in this section referred to as 
`Project AWARE'), to award grants to develop a sustainable 
infrastructure for school-based mental health programs and services.
    ``(b) Use of Funds.--A grant awarded under Project AWARE may be 
used to provide peer mental health first aid training, including--
            ``(1) to train teachers, other relevant school personnel 
        (including education support professionals), students, and 
        parents and caregivers of students--
                    ``(A) to recognize symptoms of childhood and 
                adolescent mental health conditions;
                    ``(B) to refer teachers, school personnel, 
                students, and their family members to appropriate 
                mental health services if necessary; and
                    ``(C) to recognize signs of immediate mental 
                distress and, upon recognizing such signs apply mental 
                health first aid tactics; and
            ``(2) to provide education to such teachers, personnel, 
        students, parents, and caregivers regarding resources that are 
        available in the community for individuals with a mental 
        illness.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $130,000,000 for each of fiscal 
years 2026 through 2030.''.

SEC. 503. SUPPORT FOR THE 21ST CENTURY COMMUNITY LEARNING CENTERS 
              PROGRAM AND THE FULL-SERVICE COMMUNITY SCHOOLS PROGRAM.

    (a) Community Learning Center Services, Programs, and Activities.--
Section 4201(a)(2) of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7171(a)(2)) is amended by inserting ``mental health 
services, community service activities,'' after ``counseling 
programs,''.
    (b) Authorization of Appropriations for 21st Century Community 
Learning Centers Program.--Section 4206 of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7176) is amended to read as follows:

``SEC. 4206. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this part--
            ``(1) $1,329,673,000 for fiscal year 2025;
            ``(2) $1,429,673,000 for fiscal year 2026;
            ``(3) $1,529,673,000 for fiscal year 2027;
            ``(4) $1,629,673,000 for fiscal year 2028; and
            ``(5) $1,729,673,000 for fiscal year 2029.''.
    (c) Authorization of Appropriations for Full-Service Community 
Schools Program.--Section 4601 of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7251(a)) is amended--
            (1) in the matter preceding paragraph (1) of subsection 
        (a), by inserting ``(except for section 4625)'' after ``part'';
            (2) in the matter preceding clause (i) of subsection 
        (b)(2)(B), by inserting ``(except for section 4625)'' after 
        ``subpart 2''; and
            (3) by adding at the end the following:
    ``(c) Authorization of Appropriations for Full-Service Community 
Schools.--There are authorized to be appropriated to carry out section 
4625--
            ``(1) $500,000,000 for fiscal year 2025;
            ``(2) $600,000,000 for fiscal year 2026;
            ``(3) $700,000,000 for fiscal year 2027;
            ``(4) $850,000,000 for fiscal year 2028; and
            ``(5) $1,000,000,000 for fiscal year 2029.''.
    (d) Conforming Amendments.--Section 4623(a) of the Elementary and 
Secondary Education Act of 1965 (20 U.S.C. 7273(a)) is amended--
            (1) by redesignating paragraph (2) as paragraph (3); and
            (2) by striking paragraph (1) and inserting the following:
            ``(1) Promise neighborhoods.--The Secretary shall use not 
        less than 95 percent of the amounts made available under 
        section 4601(b)(2)(B) to award grants, on a competitive basis 
        and subject to subsection (e), to eligible entities for the 
        implementation of a comprehensive, effective continuum of 
        coordinated services that meets the purpose described in 
        section 4621(1) by carrying out activities in neighborhoods 
        with--
                    ``(A) high concentrations of low-income 
                individuals;
                    ``(B) multiple signs of distress, which may include 
                high rates of poverty, childhood obesity, academic 
                failure, and juvenile delinquency, adjudication, or 
                incarceration; and
                    ``(C) schools implementing comprehensive support 
                and improvement activities or targeted support and 
                improvement activities under section 1111(d).
            ``(2) Full-service community schools authorized.--The 
        Secretary shall use the amounts made available under section 
        4601(c) to carry out the full-service community school program 
        under section 4625.''.

                         TITLE VI--DEFINITIONS

SEC. 601. DEFINITIONS.

    In this Act:
            (1) Burnout.--The term ``burnout'' means exhaustion and 
        mental distance from one's job.
            (2) Loneliness.--The term ``loneliness'' means subjectively 
        feeling alone, or the discrepancy between one's desired level 
        of social connection and one's actual level of social 
        connection.
            (3) Social connection.--The term ``social connection'' 
        means the variety of ways one can connect with others socially, 
        through physical, behavioral, social-cognitive, and emotional 
        channels.
            (4) Social isolation.--The term ``social isolation'' means 
        objectively being alone, or having few relationships or 
        infrequent social contact.
            (5) Underserved communities.--The term ``underserved 
        communities'' includes communities with a high proportion of 
        individuals who--
                    (A) are socioeconomically disadvantaged;
                    (B) have limited English proficiency;
                    (C) are geographically isolated;
                    (D) are educationally disenfranchised;
                    (E) are individuals of color;
                    (F) are of ethnic or national origin minorities;
                    (G) are women or children;
                    (H) have disabilities; or
                    (I) are seniors.
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