I 

108TH CONGRESS 

2D SESSION H. R. 4866

To amend the Public Health Service Act to establish a grant program to 

provide supportive services in permanent supportive housing for chronically homeless individuals, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 20, 2004

Mr. BURR (for himself, Ms. ESHOO, Mr. SIMMONS, Mr. RAMSTAD, Mrs. 

MYRICK, Ms. ROS-LEHTINEN, Ms. PRYCE of Ohio, Ms. KAPTUR, Mr. 

ROGERS of Michigan, and Mr. PRICE of North Carolina) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL

To amend the Public Health Service Act to establish a grant 

program to provide supportive services in permanent supportive housing for chronically homeless individuals, 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. 

4 This Act may be cited as the ‘‘Services for Ending 

5 Long-Term Homelessness Act’’. 
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1 SEC. 2. DUTIES OF CENTER FOR MENTAL HEALTH SERV2 ICES. 

3 Section 520(b) of the Public Health Service Act (42 

4 U.S.C. 290bb–31(b)) is amended—

5 (1) in paragraph (14), by striking ‘‘and’’ at the 

6 end; 

7 (2) in paragraph (15), by striking the period 

8 and inserting ‘‘; and’’; and 

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

10 ‘‘(16) administer the program under part J in 

11 consultation with the Director of the Center for Sub12 stance Abuse Treatment; 

13 ‘‘(17) provide technical assistance, in consulta14 tion with the Director of the Center for Substance 

15 Abuse Treatment, to public and private entities that 

16 are providers of permanent supportive housing that 

17 includes individuals who are chronically homeless as 

18 defined in section 596(m); and 

19 ‘‘(18) implement a comprehensive approach to 

20 support the widespread dissemination of information 

21 about services in permanent supportive housing tar22 geted to individuals who have been homeless for long 

23 periods of time and have disabilities, including the 

24 use of existing clearinghouses, toolkits, and reg25 istries of promising practices.’’. 
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1 SEC. 3. DUTIES OF ADMINISTRATOR OF SUBSTANCE ABUSE 

2 AND MENTAL HEALTH SERVICES ADMINIS3 TRATION. 

4 Section 501(d) of the Public Health Service Act (42 

5 U.S.C. 290aa(d)) is amended—

6 (1) in paragraph (17), by striking ‘‘and’’ at the 

7 end; 

8 (2) in paragraph (18), by striking the period 

9 and inserting ‘‘; and’’; and 

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

11 ‘‘(19) design national strategies for providing 

12 services in supportive housing that will assist in end13 ing chronic homelessness; 

14 ‘‘(20) collaborate with Federal departments and 

15 programs that are part of the President’s Inter16 agency Council on Homelessness, particularly the 

17 Department of Housing and Urban Development, 

18 the Department of Labor, and the Department of 

19 Veterans Affairs, and with other agencies within the 

20 Department of Health and Human Services, particu21 larly the Health Resources and Services Administra22 tion, the Administration on Children and Families, 

23 and the Centers for Medicare and Medicaid Services, 

24 to implement programs that address chronic home25 lessness; 
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1 ‘‘(21) develop improved methods of serving indi2 viduals with mental illness, physical illness, disabil3 ities, substance abuse, or co-occurring disorders, to 

4 ensure that they remain stably housed; 

5 ‘‘(22) promote collaboration between Federal, 

6 State and local agencies that are responsible for 

7 criminal justice, mental health, substance abuse 

8 treatment, medical care, employment training, and 

9 other systems of care that serve individuals who are 

10 chronically homeless to ensure that services are de11 livered in a coordinated manner that promotes hous12 ing stability; and 

13 ‘‘(23) collaborate with the Department of Hous14 ing and Urban Development and the Health Re15 sources and Services Administration to develop a 

16 streamlined set of data collection, reporting, and 

17 performance measurements for programs that pro18 vide housing and services to homeless persons, and 

19 recommend to the Office of Management and Budg20 et a consistent set of performance standards for 

21 these programs consistent with the requirements of 

22 the Government Performance and Results Act.’’. 
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1 SEC. 4. GRANTS FOR SERVICES FOR CHRONICALLY HOME2 LESS INDIVIDUALS IN SUPPORTIVE HOUSING. 

3 Title V of the Public Health Service Act (42 U.S.C. 

4 290aa et seq.) is amended by adding at the end the fol5 lowing: 

6 ‘‘PART J—GRANTS FOR SERVICES TO END 

7 CHRONIC HOMELESSNESS 

8 ‘‘SEC. 596. GRANTS FOR SERVICES TO END CHRONIC HOME9 LESSNESS. 

10 ‘‘(a) IN GENERAL.—

11 ‘‘(1) GRANTS.—The Secretary shall make 

12 grants to entities described in paragraph (2) for the 

13 purpose of carrying out projects to provide the serv14 ices described in subsection (c) to chronically home15 less individuals in permanent supportive housing. 

16 ‘‘(2) ELIGIBLE ENTITIES.—For purposes of 

17 paragraph (1), an entity described in this paragraph 

18 is—

19 ‘‘(A) a State or political subdivision of a 

20 State, an Indian tribe or tribal organization, or 

21 a public or nonprofit private entity, including a 

22 community-based or faith-based provider of 

23 homelessness services, health care, housing, or 

24 other services important to individuals experi25 encing chronic homelessness; or 
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1 ‘‘(B) a consortium composed of entities de2 scribed in subparagraph (A), which consortium 

3 includes a public or nonprofit private entity 

4 that serves as the lead applicant and has re5 sponsibility for coordinating the activities of the 

6 consortium. 

7 ‘‘(b) PRIORITIES.—In making grants under sub8 section (a), the Secretary shall give priority to applicants 

9 demonstrating that the applicants—

10 ‘‘(1) target funds to individuals or families 

11 who—

12 ‘‘(A) have been homeless for longer periods 

13 of time or have experienced more episodes of 

14 homelessness than are required to meet the def15 inition of chronic homelessness under this sec16 tion; 

17 ‘‘(B) have high rates of utilization of emer18 gency public systems of care; or 

19 ‘‘(C) have a history of interactions with 

20 law enforcement and the criminal justice sys21 tem; 

22 ‘‘(2) have greater funding commitments from 

23 State or local government agencies responsible for 

24 overseeing mental health treatment, substance abuse 

25 treatment, medical care, and employment (including 
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1 commitments to provide Federal funds in accordance 

2 with subsection (e)(2)(B)(ii)); and 

3 ‘‘(3) will provide for an increase in the number 

4 of units of permanent supportive housing that would 

5 serve chronically homeless individuals in the commu6 nity as a result of an award of a grant under sub7 section (a). 

8 ‘‘(c) SERVICES.—The services referred to in sub9 section (a) are the following: 

10 ‘‘(1) Services provided by the grantee or by 

11 qualified subcontractors that promote recovery and 

12 self-sufficiency and address barriers to housing sta13 bility, including but not limited to the following: 

14 ‘‘(A) Mental health services, including 

15 treatment and recovery support services. 

16 ‘‘(B) Substance abuse treatment and re17 covery support services, including counseling, 

18 treatment planning, recovery coaching, and re19 lapse prevention. 

20 ‘‘(C) Integrated, coordinated treatment 

21 and recovery support services for co-occurring 

22 disorders. 

23 ‘‘(D) Health education. 

24 ‘‘(E) Referrals for medical and dental care. 
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1 ‘‘(F) Benefits advocacy, and money man2 agement. 

3 ‘‘(G) Life skills training. 

4 ‘‘(H) Parental skills training and family 

5 support. 

6 ‘‘(I) Self-help programs. 

7 ‘‘(J) Engagement and motivational inter8 ventions. 

9 ‘‘(K) Case management. 

10 ‘‘(L) Other supportive services that pro11 mote an end to chronic homelessness. 

12 ‘‘(2) Services, as described in paragraph (1), 

13 that are delivered to individuals and families who 

14 are chronically homeless and who are scheduled to 

15 become residents of permanent supportive housing 

16 within 90 days pending the location or development 

17 of an appropriate unit of housing. 

18 ‘‘(3) For individuals and families who are oth19 erwise eligible, and who have voluntarily chosen to 

20 seek other housing opportunities after a period of 

21 tenancy in supportive housing, services, as described 

22 in paragraph (1), that are delivered, for a period of 

23 90 days after exiting permanent supportive housing 

24 or until the individuals have transitioned to com25 prehensive services adequate to meet their current 
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1 needs, provided that the purpose of the services is to 

2 support the individuals in their choice to transition 

3 into housing that is responsive to their individual 

4 needs and preferences. 

5 ‘‘(d) CERTAIN REQUIREMENTS.—A condition for the 

6 receipt of a grant under subsection (a) is that the appli7 cant involved demonstrate the following: 

8 ‘‘(1) The applicant and all direct providers of 

9 services have the experience, infrastructure, and ex10 pertise needed to ensure the quality and effective11 ness of services, which may be demonstrated by any 

12 of the following: 

13 ‘‘(A) Compliance with all local, city, coun14 ty, or State requirements for licensing, accredi15 tation, or certification (if any) which are appli16 cable to the proposed project. 

17 ‘‘(B) A minimum of two years experience 

18 providing comparable services that do not re19 quire licensing, accreditation, or certification. 

20 ‘‘(C) Certification as a Medicaid service 

21 provider, including health care for the homeless 

22 programs and community health centers. 

23 ‘‘(D) An executed agreement with a rel24 evant State or local government agency that 

25 will provide oversight over the mental health, 
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1 substance abuse, or other services that will be 

2 delivered by the project. 

3 ‘‘(2) There is a mechanism for determining 

4 whether residents are chronically homeless. Such a 

5 mechanism may rely on local data systems or 

6 records of shelter admission. If there are no sources 

7 of data regarding the duration or number of home8 less episodes, or if such data are unreliable for the 

9 purposes of this subsection, an applicant must dem10 onstrate that the project will implement appropriate 

11 procedures, taking into consideration the capacity of 

12 local homeless service providers to document epi13 sodes of homelessness and the challenges of engag14 ing persons who have been chronically homeless, to 

15 verify that an individual or family meets the defini16 tion for being chronically homeless under this sec17 tion. 

18 ‘‘(3) The applicant participates in a local, re19 gional, or statewide homeless management informa20 tion system. 

21 ‘‘(e) MATCHING FUNDS.—

22 ‘‘(1) IN GENERAL.—A condition for the receipt 

23 of a grant under subsection (a) is that, with respect 

24 to the cost of the project to be carried out by an ap-
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1 plicant pursuant to such subsection, the applicant 

2 agree as follows: 

3 ‘‘(A) In the case of the initial grant pursu4 ant to subsection (i)(1)(A), the applicant will, 

5 in accordance with paragraphs (2) and (3), 

6 make available contributions toward such costs 

7 in an amount that is not less than $1 for each 

8 $3 of Federal funds provided in the grant. 

9 ‘‘(B) In the case of a renewal grant pursu10 ant to subsection (i)(1)(B), the applicant will, 

11 in accordance with paragraphs (2) and (3), 

12 make available contributions toward such costs 

13 in an amount that is not less than $1 for each 

14 $1 of Federal funds provided in the grant. 

15 ‘‘(2) SOURCE OF CONTRIBUTION.—For pur16 poses of paragraph (1), contributions made by an 

17 applicant are in accordance with this paragraph if 

18 made as follows: 

19 ‘‘(A) The contribution is made from funds 

20 of the applicant or from donations from public 

21 or private entities. 

22 ‘‘(B) Of the contribution—

23 ‘‘(i) not less than 80 percent is from 

24 non-Federal funds; and 
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1 ‘‘(ii) not more than 20 percent is from 

2 Federal funds provided under programs 

3 that—

4 ‘‘(I) are not expressly directed at 

5 services for homeless individuals, but 

6 whose purposes are broad enough to 

7 include the provision of a service or 

8 services described in subsection (c) as 

9 authorized expenditures under such 

10 program; and 

11 ‘‘(II) do not prohibit Federal 

12 funds under the program from being 

13 used to provide a contribution that is 

14 required as a condition for obtaining 

15 Federal funds. 

16 ‘‘(3) DETERMINATION OF AMOUNT CONTRIB17 UTED.—Contributions required in paragraph (1) 

18 may be in cash or in kind, fairly evaluated, including 

19 plant, equipment, or services. Amounts provided by 

20 the Federal Government, or services assisted or sub21 sidized to any significant extent by the Federal Gov22 ernment, may not be included in determining the 

23 amount of non-Federal contributions required in 

24 paragraph (2)(B)(i). 
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1 ‘‘(f) ADMINISTRATIVE EXPENSES.—A condition for 

2 the receipt of a grant under subsection (a) is that the ap3 plicant involved agree that not more than 6 percent of the 

4 grant will be expended for administrative expenses with 

5 respect to the grant. 

6 ‘‘(g) CERTAIN USES OF FUNDS.—Notwithstanding 

7 other provisions of this section, a grantee under subsection 

8 (a) may expend not more than 20 percent of the grant 

9 to provide the services described in subsection (c) to home10 less individuals who are not chronically homeless. 

11 ‘‘(h) APPLICATION FOR GRANT.—A grant may be 

12 made under subsection (a) only if an application for the 

13 grant is submitted to the Secretary and the application 

14 is in such form, is made in such manner, and contains 

15 such agreements, assurances, and information as the Sec16 retary determines to be necessary to carry out this section. 

17 ‘‘(i) DURATION OF INITIAL AND RENEWAL GRANTS; 

18 ADDITIONAL PROVISIONS REGARDING RENEWAL

19 GRANTS.—

20 ‘‘(1) IN GENERAL.—Subject to paragraphs (2) 

21 and (3), the period during which payments are made 

22 to a grantee under subsection (a) shall be in accord23 ance with the following: 
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1 ‘‘(A) In the case of the initial grant, the 

2 period of payments shall be not less than three 

3 years and not more than five years. 

4 ‘‘(B) In the case of a subsequent grant (re5 ferred to in this subsection as a ‘renewal 

6 grant’), the period of payments shall be not 

7 more than five years. 

8 ‘‘(2) ANNUAL APPROVAL; AVAILABILITY OF AP9 PROPRIATIONS; NUMBER OF GRANTS.—The provision 

10 of payments under an initial or renewal grant is sub11 ject to annual approval by the Secretary of the pay12 ments and to the availability of appropriations for 

13 the fiscal year involved to make the payments. This 

14 subsection may not be construed as establishing a 

15 limitation on the number of grants under subsection 

16 (a) that may be made to an entity. 

17 ‘‘(3) ADDITIONAL PROVISIONS REGARDING RE18 NEWAL GRANTS.—

19 ‘‘(A) PRIORITY IN MAKING GRANTS.—In 

20 making grants under subsection (a), the Sec21 retary shall give priority to renewal grants. 

22 ‘‘(B) COMPLIANCE WITH MINIMUM STAND23 ARDS.—A renewal grant may be made by the 

24 Secretary only if the Secretary determines that 

25 the applicant involved has, in the project car-
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1 ried out with the grant, maintained compliance 

2 with minimum standards for quality and suc3 cessful outcomes for housing retention, as de4 termined by the Secretary. 

5 ‘‘(C) EVALUATION OF APPLICANTS.—In 

6 evaluating an applicant for a renewal grant, the 

7 Secretary shall consider such applicant in rela8 tion to other applicants for renewal grants, and 

9 not in relation to applicants for initial grants. 

10 ‘‘(j) DATA COLLECTION; EVALUATIONS.—

11 ‘‘(1) IN GENERAL.—The Secretary may, as a 

12 condition of the receipt of grants under subsection 

13 (a), require grantees to provide data to the Sec14 retary regarding the projects carried out pursuant to 

15 such subsection, and may require evaluations of the 

16 projects. The purpose of such requirements shall be 

17 to assist the Secretary in—

18 ‘‘(A) determining whether grantees are 

19 meeting the standards referred to in subsection 

20 (i)(3)(B); and 

21 ‘‘(B) determining the extent to which indi22 viduals served by projects under subsection (a) 

23 are avoiding homelessness and achieving hous24 ing stability. 
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1 ‘‘(2) CONSISTENCY WITH OTHER HOMELESS AS2 SISTANCE PROGRAMS.—In establishing requirements 

3 under paragraph (1), the Secretary shall develop and 

4 implement an approach that is practical, stream5 lined, and designed for consistency with the require6 ments of the homeless assistance programs adminis7 tered by the Secretary of Housing and Urban Devel8 opment. 

9 ‘‘(3) USE OF GRANT.—A grantee under sub10 section (a) may expend the grant to comply with re11 quirements established by the Secretary under para12 graph (1). For purposes of subsection (f), such ex13 penditures of the grant shall not be included in de14 termining the portion of the grant that has been ex15 pended for administrative expenses. 

16 ‘‘(4) AVAILABILITY OF GRANT FOR DIRECT

17 SERVICES.—In order to maximize the proportion of 

18 grant funds that are available directly for the provi19 sion of services described in subsection (c), the Sec20 retary shall ensure that requirements under para21 graph (1) minimize the cost and burdens imposed on 

22 grantees by using a coordinated and streamlined 

23 methodology. Such methodology may rely on appro24 priate sampling techniques. 
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1 ‘‘(k) TRAINING AND TECHNICAL ASSISTANCE.—The 

2 Secretary, directly or through awards of grants or con3 tracts to public or nonprofit private entities, shall provide 

4 training and technical assistance regarding the planning, 

5 development, and provision of services in projects under 

6 subsection (a). 

7 ‘‘(l) BIENNIAL REPORTS TO CONGRESS.—Not later 

8 than two years after the date of the enactment of the Serv9 ices for Ending Long-Term Homelessness Act, and bienni10 ally thereafter, the Secretary shall submit to the Congress 

11 a report on projects under subsection (a) that includes a 

12 summary of information received by the Secretary under 

13 subsection (j), and that describes the impact of the pro14 gram under subsection (a) as part of a comprehensive 

15 strategy for ending long term homelessness and improving 

16 outcomes for individuals with mental illness and substance 

17 abuse problems. 

18 ‘‘(m) DEFINITIONS.—For purposes of this section: 

19 ‘‘(1) The term ‘chronically homeless’ means an 

20 individual or family who—

21 ‘‘(A) is currently homeless; 

22 ‘‘(B) has been homeless continuously for at 

23 least one year or has been homeless on at least 

24 four separate occasions in the last three years; 

25 and 
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1 ‘‘(C) has an adult head of household with 

2 a disabling condition, defined as a diagnosable 

3 substance use disorder, serious mental illness, 

4 developmental disability, or chronic physical ill5 ness or disability, including the co-occurrence of 

6 two or more of these conditions. 

7 ‘‘(2) The term ‘disabling condition’ means a 

8 condition that limits an individual’s ability to work 

9 or perform one or more activities of daily living. 

10 ‘‘(3) The term ‘homeless’ means sleeping in a 

11 place not meant for human habitation or in an emer12 gency homeless shelter. 

13 ‘‘(4)(A) The term ‘permanent supportive hous14 ing’ means permanent, affordable housing with flexi15 ble support services that are available and designed 

16 to help the tenants stay housed and build the nec17 essary skills to live as independently as possible. 

18 Such term does not include housing that is time-lim19 ited. Supportive housing offers residents assistance 

20 in reaching their full potential, which may include 

21 opportunities to secure other housing that meets 

22 their needs and preferences, based on individual 

23 choice instead of the requirements of time-limited 

24 transitional programs. Under this section, perma25 nent affordable housing includes but is not limited 
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1 to permanent housing funded or assisted through 

2 title IV of the McKinney-Vento Homeless Assistance 

3 Act and section (8) of the United States Housing 

4 Act of 1937. 

5 ‘‘(B) For purposes of subparagraph (A), the 

6 term ‘affordable’ means within the financial means 

7 of individuals who are extremely low income, as de8 fined by the Secretary of Housing and Urban Devel9 opment. 

10 ‘‘(n) FUNDING.—

11 ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—

12 For the purpose of carrying out this section, there 

13 are authorized to be appropriated such sums as may 

14 be necessary for each of the fiscal years 2005 

15 through 2009. 

16 ‘‘(2) ALLOCATION FOR TRAINING AND TECH17 NICAL ASSISTANCE.—Of the amount appropriated 

18 under paragraph (1) for a fiscal year, the Secretary 

19 may reserve not more than 3 percent for carrying 

20 out subsection (k).’’.

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