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. 
Be it enacted by the Senate and House of Representa-
tives 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. 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6211
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
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 per-
cent 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 
VerDate Sep 11 2014 
22:06 Jan 23, 2025
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
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 af-
fected by social loneliness and isolation, with 75 per-
cent of Latinx and Hispanic adults and 68 percent 
of Black and African American adults categorized as 
lonely. 
(6) Due to fragmented social networks, loneli-
ness is especially pervasive with people experiencing 
homelessness, with 1 in 5 reporting to have no 
friends. 
(7) Farmers and agricultural workers, predomi-
nantly based in rural areas, face heightened risks to 
mental well-being due to social and geographical iso-
lation. 
(8) Older adults face heightened vulnerability to 
loneliness and social isolation due to factors includ-
ing living alone, loss of familial and social ties, 
chronic illness, and impaired hearing. 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(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 seg-
ments of the homeless population. 
(10) Veterans often experience feelings of isola-
tion due to losing touch with their military commu-
nity, physical or mental health issues, and difficul-
ties 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 feel-
ings of loneliness and isolation, finding online inter-
actions less stressful than face-to-face relationships. 
(15) A shortage of 139,000 primary care physi-
cians is projected by 2033, with particularly con-
cerning deficits anticipated rural areas. 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(16) Burnout rates reported by health care 
workers nationally are higher than in any other in-
dustry. 
(17) Nearly half of health workers reported 
often feeling burned out in 2022, up from 32 per-
cent 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 cor-
relate 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 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
better outcomes than living in the general commu-
nity. 
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 foun-
dation to engage in our democracy and fosters an 
appreciation for our shared cultural heritage; 
(4) establish universal early education that sup-
ports 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 pro-
vides working families with stability, which is critical 
to building vibrant communities; 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(6) provide affordable and quality child care 
that is a lifeline for working families, which is crit-
ical 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 essen-
tial to building resilient communities and a sustain-
able 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 mu-
nicipalities to develop policies that have a focus on 
connection and social connectivity. 
VerDate Sep 11 2014 
22:06 Jan 23, 2025
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
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 ‘‘Sec-
retary’’), in consultation with the appropriate Federal offi-
cials, shall establish a program to award grants, on a com-
petitive basis, to State or local governments to support eli-
gible 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 sub-
mit 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 pro-
grams and local institutions referred to in subsection 
(a); and 
(2) may not be used for the construction of any 
facility. 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall prioritize— 
(1) underserved communities; and 
(2) communities with high percentages of chil-
dren or elderly individuals. 
(e) DEFINITIONS.—In this section: 
(1) APPROPRIATE
FEDERAL
OFFICIALS.—The 
term ‘‘appropriate Federal officials’’ means— 
(A) the Administrator of the Administra-
tion 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 Mu-
seum and Library Services. 
(2) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a governmental or nonprofit entity that 
is— 
(A) a library; 
(B) a senior center; 
(C) a childcare center or after-school pro-
gram; 
(D) a recreation center; 
(E) a teen center; 
(F) a veteran service organization; or 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(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 infra-
structure 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 de-
scribed 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 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(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 op-
erations; 
(2) emphasize accessibility for disabled individ-
uals; 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 ‘‘Sec-
retary’’) shall establish a program to make grants, on a 
competitive basis, to covered entities for the purposes de-
scribed 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, 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
and containing such information as the Secretary may re-
quire. 
(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 regard-
ing the health effects of loneliness and social isola-
tion. 
(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 Sec-
retary, developed with multi-stakeholder input. 
(3) To connect at-risk individuals with commu-
nity 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 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(D) has poor indicators of social deter-
minants 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 en-
tity’’ means— 
(A) an area agency on aging; 
(B) a center for independent living; and 
(C) such other community-based organiza-
tion, as the Secretary determines appropriate. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary 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 re-
ferred to as the ‘‘Secretary’’) shall establish a demonstra-
tion program to award grants to States and localities to 
support eligible organizations in— 
VerDate Sep 11 2014 
22:06 Jan 23, 2025
Jkt 059200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS
(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 sec-
tion, the Secretary shall give priority to States and local-
ities that will support eligible organizations in rural areas. 
(c) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance to States and localities seek-
ing or receiving a grant under this section. 
(d) ELIGIBLE ORGANIZATION DEFINED.—In this 
section, the term ‘‘eligible organization’’ means a partner-
ship 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. 
VerDate Sep 11 2014 
21:05 Jan 22, 2025
Jkt 059200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H10448.IH
H10448
ssavage on LAPJG3WLY3PROD with BILLS