Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Coordinating Sub-
stance Use and Homelessness Care Act of 2022’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) The United States has a homelessness cri-
sis, with more than 580,000 people experiencing 
homelessness on a single night according to the De-
partment of Housing and Urban Development’s 
2020 Annual Homeless Assessment Report to Con-
gress. 
(2) While the lack of affordable housing is the 
primary driver of homelessness, behavioral health 
conditions, including substance use disorders, can 
exacerbate homelessness and can also be a con-
sequence of homelessness. 
(3) Research shows that people experiencing 
homelessness have higher rates of substance use dis-
order than people with housing stability. Some peo-
ple who experience homelessness use substances to 
cope with the trauma and deprivations of their cir-
cumstances, but substance use disorders frequently 
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make it more difficult for people experiencing home-
lessness to secure permanent housing. 
(4) Many individuals with substance use dis-
order who experience homelessness have co-occurring 
illnesses. The combined effect of physical illness, 
mental illness, and lack of housing results in higher 
mortality rates for individuals experiencing home-
lessness. 
(5) Safely and securely housing individuals who 
are experiencing both homelessness and behavioral 
health issues, including substance use disorders, 
often requires supportive services and close coordina-
tion between housing and social service providers, in 
addition to low-barrier, affordable housing. Sub-
sidized housing is critical, but not enough—access to 
additional voluntary person-centered supportive serv-
ices is needed. 
(6) Nevertheless, it is imperative that when 
people experiencing homelessness, including those 
with a behavioral health condition such as substance 
use disorder, choose to seek help that housing as 
well as health care and person-centered supportive 
services be coordinated, particularly given their 
acute needs and the significant costs incurred by 
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communities for law enforcement, correctional, and 
emergency department care for failing to do so. 
(7) Providing access to health care and vol-
untary person-centered supportive services can be 
beneficial in securing and successfully maintaining 
stable housing. 
(8) Integration of health and homelessness serv-
ices to achieve optimal outcomes for people experi-
encing homelessness, significant behavioral health 
conditions such as substance use disorder, and other 
health conditions can be challenging for State and 
local governments, continuums of care, and commu-
nity-based organizations that administer both health 
and homelessness services and providers of homeless-
ness services. 
(9) Capacity-building is needed to create sys-
tems-level linkages between the two sets of services 
to allow for smoother pathways and simpler naviga-
tion. 
(10) Black, Hispanic, and Indigenous people 
are disproportionately underserved by person-cen-
tered supportive services. In order to address critical 
services deficits and affirmatively serve protected 
classes of people with significant behavioral health 
conditions, including substance use disorders, who 
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are experiencing homelessness, the grant program 
established under this Act can be used to build the 
capacities of homelessness services providers that 
have demonstrated cultural competencies in service 
provision and a record of serving Black, Hispanic, 
and Indigenous people and other underserved popu-
lations experiencing homelessness that also suffer 
from substance use disorders. 
SEC. 3. ESTABLISHMENT OF GRANT PROGRAM. 
(a) IN GENERAL.—The Secretary of Housing and 
Urban Development (in this Act referred to as the ‘‘Sec-
retary’’), in consultation with the working group estab-
lished pursuant to subsection (b), shall establish a grant 
program to award competitive grants to eligible entities 
to build or increase their capacities for the better coordi-
nation of health care and homelessness services for people 
who are experiencing homelessness and significant behav-
ioral health issues, including substance use disorders, and 
are voluntarily seeking assistance. 
(b) WORKING GROUP.— 
(1) ESTABLISHMENT.—The Secretary shall es-
tablish an interagency working group to provide ad-
vice to the Secretary in carrying out the program 
under subsection (a). The working group shall in-
clude representatives from the Department of Hous-
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ing and Urban Development, the United States 
Interagency Council on Homelessness, Department 
of Health and Human Services, Department of Agri-
culture, and Bureau of Indian Affairs, to be ap-
pointed by the heads of such agencies. 
(2) DEVELOPMENT
OF
ASSISTANCE
TOOLS.— 
The working group shall, not later than 12 months 
after the date of the enactment of this Act, develop 
training, tools, and other technical assistance mate-
rials that simplify homelessness services for pro-
viders of health care and simplify health care serv-
ices for providers of homelessness services by identi-
fying the basic elements the health and homelessness 
sectors need to understand about the other, and 
shall circulate such materials to interested entities, 
particularly those who apply for grants awarded pur-
suant to this Act. 
(c) CAPACITY-BUILDING GRANTS.— 
(1) IN GENERAL.—The Secretary shall award 
5-year grants to eligible entities, which shall be used 
only to build or increase their capacities to coordi-
nate health care and homelessness services. 
(2) PROHIBITION.—None of the proceeds from 
the grants awarded pursuant to this Act may be 
used to pay for health care, with the exception of ef-
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served, and follow trauma-informed best prac-
tices to address those needs using a harm re-
duction approach; and 
(D) demonstrate how its capacity to co-
ordinate health care and homelessness services 
to better serve people experiencing homelessness 
and significant behavioral health issues, includ-
ing substance use disorders, can be increased 
through— 
(i) the designation of a governmental 
official as a coordinator for making con-
nections between health and homelessness 
services and developing a strategy for 
using those services in a holistic way to 
help people experiencing homelessness and 
behavioral health conditions such as sub-
stance use disorders, including those with 
cooccurring conditions; 
(ii) improvements in infrastructure at 
the systems level; 
(iii) improvements in technology for 
voluntary remote monitoring capabilities, 
including internet and video, which can 
allow for more home- and community- 
based behavioral health care services and 
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ensure such improvements maintain effec-
tive communication requirements for per-
sons with disabilities and program access 
for persons with limited English pro-
ficiency; 
(iv) improvements in connections to 
health care services delivered by providers 
experienced in behavioral health care and 
people experiencing homelessness; 
(v) efforts to increase the availability 
of Naloxone and provide training for its 
administration; and 
(vi) any additional activities identified 
by the Secretary that will advance the co-
ordination 
of 
homelessness 
assistance, 
housing, and substance use services and 
other health care services. 
(5) ELIGIBLE ACTIVITIES.—An eligible grantee 
receiving a grant under this subsection may use the 
grant to cover costs related to— 
(A) hiring system coordinators; and 
(B) administrative costs, including staffing 
costs, technology costs, and other such costs 
identified by the Secretary. 
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(6) DISTRIBUTION
OF
FUNDS.—An eligible 
grantee receiving a grant under this subsection may 
distribute all or a portion of the grant amounts to 
private nonprofit organizations, other government 
entities, public housing agencies, tribally designated 
housing entities, or other entities as determined by 
the Secretary to carry out programs and activities in 
accordance with this section. 
(7) OVERSIGHT REQUIREMENTS.— 
(A) ANNUAL REPORTS.—Not later than 6 
years after the date on which grant amounts 
are first received by an eligible entity, such en-
tity shall submit to the Secretary a report on 
the activities carried out under the grant. Such 
report shall include, with respect to activities 
carried out with grant amounts in the commu-
nity served— 
(i) measures of outcomes relating to 
whether people experiencing homelessness 
and significant behavioral health issues, in-
cluding substance use disorders, who 
sought help from an entity that received a 
grant— 
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(I) were housed and did not ex-
perience intermittent periods of home-
lessness; 
(II) were voluntarily enrolled in 
treatment and recovery programs; 
(III) experienced improvements 
in their health; 
(IV) obtained access to specific 
primary care providers; and 
(V) have health care plans that 
meet their individual needs, including 
access to mental health and substance 
use disorder treatment and recovery 
services; 
(ii) how grant funds were used; and 
(iii) any other matters determined ap-
propriate by the Secretary. 
(B) RULE OF CONSTRUCTION.—Nothing in 
this subsection may be construed to condition 
the receipt of future housing and other services 
by individuals assisted with activities and serv-
ices provided with grant amounts on the out-
comes detailed in the reports submitted under 
this subsection. 
(8) DEFINITIONS.—In this section: 
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(A) INDIAN
TRIBE; TRIBAL
ORGANIZA-
TION.—The terms ‘‘Indian Tribe’’ and ‘‘Tribal 
organization’’ have the meanings given such 
terms in section 4 of the Indian Self-Deter-
mination and Education Assistance Act (25 
U.S.C. 5304) and shall include tribally des-
ignated housing entities (as such term is de-
fined in section 4 of the Native American Hous-
ing Assistance and Self-Determination Act of 
1996 (25 U.S.C. 4103)) and entities that serve 
Native Hawaiians (as such term is defined in 
section 338K(c) of the Public Health Service 
Act (42 U.S.C. 254s(c))). 
(B) PERSON
EXPERIENCING
HOMELESS-
NESS.—The term ‘‘person experiencing home-
lessness’’ has the same meaning as the terms 
‘‘homeless’’, ‘‘homeless individual’’, and ‘‘home-
less person’’ as those terms are defined in the 
McKinney-Vento Act (42 U.S.C. 11302). 
(C) SUBSTANCE
USE
DISORDER.—The 
term ‘‘substance use disorder’’ means the dis-
order that occurs when the recurrent use of al-
cohol or drugs, or both, causes clinically signifi-
cant impairment, including health problems, 
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disability, and failure to meet major responsibil-
ities at work, school, or home. 
(d) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$20,000,000 for each of fiscal years 2022 through 2027, 
of which not less than 5 percent of such funds shall be 
awarded to Indian tribes and tribal organizations. 
Æ 
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