I 
116TH CONGRESS 
1ST SESSION H. R. 3272 
To amend the Public Health Service Act to establish a grant program to 
place in permanent supportive housing, and provide supportive services, 
to individuals who have physical or mental health conditions or substance 
use disorders and are chronically homeless or at risk of becoming chron-
ically homeless, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 13, 2019 
Mr. HASTINGS (for himself, Ms. LEE of California, Ms. JACKSON LEE, Mr. 
MCGOVERN, Mr. COHEN, Ms. NORTON, and Mr. GOMEZ) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To amend the Public Health Service Act to establish a grant 
program to place in permanent supportive housing, and 
provide supportive services, to individuals who have phys-
ical or mental health conditions or substance use dis-
orders and are chronically homeless or at risk of becom-
ing chronically homeless, 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. 
This Act may be cited as the ‘‘Services for Ending 
Long-Term Homelessness Act’’. 
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SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Point-in-time data collected by the Depart-
ment of Housing and Urban Development in 2018 
found that, nationally, on any given night, there are 
approximately 96,913 people who are experiencing 
chronic homelessness. Chronically homeless people 
often live in shelters or on the streets for years at 
a time, experience repeated episodes of homelessness 
without achieving housing stability, or cycle between 
homelessness, jails, mental health facilities, and hos-
pitals. 
(2) In 2003, the New Freedom Commission on 
Mental Health recommended the development and 
implementation of a comprehensive plan designed to 
facilitate access to 150,000 units of permanent sup-
portive housing for consumers and families who are 
chronically homeless. The Commission found that af-
fordable housing alone is insufficient for many peo-
ple with severe mental illness, and that flexible, mo-
bile, individualized support services are also nec-
essary to support and sustain consumers in their 
housing. 
(3) The United States Interagency Council on 
Homelessness (USICH), originally authorized by 
title II of the McKinney-Vento Homeless Assistance 
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Act (42 U.S.C. 11311 et seq.) and reauthorized by 
the Homeless Emergency Assistance and Rapid 
Transition to Housing (HEARTH) Act of 2009 (di-
vision B of Public Law 111–22), is responsible for 
coordinating the Federal response to homelessness in 
cooperation with the Secretaries and senior leaders 
of the 19 Federal member agencies. Since the 
USICH’s implementation of ‘‘Opening Doors: Fed-
eral Strategic Plan to Prevent and End Homeless-
ness’’, chronic homelessness in the United States 
has been reduced by 18 percent. 
(4) Research indicates that permanent sup-
portive housing is a cost-effective solution to chronic 
homelessness that leads to improved residential sta-
bility and reduction in psychiatric symptoms. Stud-
ies have also shown that supportive housing is asso-
ciated with significant reductions in costs for emer-
gency room visits, hospitalizations, shelters, sobering 
centers, jails, and other public services used by peo-
ple experiencing homelessness. 
(5) By implementing permanent supportive 
housing, communities are making progress toward 
ending chronic homelessness. 
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SEC. 3. DUTIES OF ASSISTANT SECRETARY FOR MENTAL 
HEALTH AND SUBSTANCE USE. 
Section 501(d) of the Public Health Service Act (42 
U.S.C. 290aa(d)) is amended— 
(1) in paragraph (24), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (25), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(26) collaborate with Federal departments and 
programs that are part of the United States Inter-
agency Council on Homelessness, particularly the 
Department of Housing and Urban Development, 
the Department of Labor, and the Department of 
Veterans Affairs, and with other agencies within the 
Department of Health and Human Services, particu-
larly the Health Resources and Services Administra-
tion, the Administration for Children and Families, 
and the Centers for Medicare & Medicaid Services, 
to design national strategies for providing services in 
supportive housing that will assist in ending chronic 
homelessness and to implement programs that ad-
dress chronic homelessness.’’. 
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SEC. 4. GRANTS FOR SERVICES FOR CHRONICALLY HOME-
LESS INDIVIDUALS AND FAMILIES IN SUP-
PORTIVE HOUSING. 
(a) IN GENERAL.—Title V of the Public Health Serv-
ice Act (42 U.S.C. 290aa et seq.), as amended by sub-
section (b), is further amended by adding at the end the 
following: 
‘‘PART L—GRANTS FOR SERVICES TO END 
CHRONIC HOMELESSNESS 
‘‘SEC. 598. GRANTS FOR SERVICES TO END CHRONIC HOME-
LESSNESS. 
‘‘(a) IN GENERAL.— 
‘‘(1) GRANTS.—The Secretary shall make 
grants to entities described in paragraph (2) for 
projects— 
‘‘(A) to place in permanent supportive 
housing— 
‘‘(i) individuals who have physical or 
mental health conditions or substance use 
disorders and are chronically homeless or 
at risk of becoming chronically homeless; 
and 
‘‘(ii) their families; and 
‘‘(B) to provide the supportive services de-
scribed in subsection (d) to such individuals and 
their families. 
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‘‘(2) ELIGIBLE
ENTITIES.—For purposes of 
paragraph (1), an entity described in this paragraph 
is— 
‘‘(A) a State or political subdivision of a 
State, an Indian tribe or tribal organization, or 
a public or nonprofit private entity, including a 
community-based provider of homelessness serv-
ices, health care, housing, or other services im-
portant to individuals and families who are 
chronically homeless; or 
‘‘(B) a consortium composed of entities de-
scribed in subparagraph (A), which consortium 
includes a public or nonprofit private entity 
that serves as the lead applicant and has re-
sponsibility for fiscal management, project man-
agement, and coordinating the activities of the 
consortium. 
‘‘(b) PRIORITIES.— 
‘‘(1) IN
SELECTING
GRANTEES.—In making 
grants under subsection (a), the Secretary shall give 
priority to applicants demonstrating that the appli-
cants— 
‘‘(A) prioritize the services described in 
subsection (d) and related funds to individuals 
or families who— 
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‘‘(i) have been homeless for longer pe-
riods of time or have experienced more epi-
sodes of homelessness than are required to 
be individuals or families who are chron-
ically homeless; 
‘‘(ii) have high rates of utilization of 
emergency public systems of care; or 
‘‘(iii) have a history of interactions 
with law enforcement and the criminal jus-
tice system; 
‘‘(B) have greater funding commitments 
from State or local government agencies respon-
sible for overseeing mental health treatment, 
substance use disorder treatment, medical care, 
and employment (including commitments to 
provide Federal funds in accordance with sub-
section (e)(2)(B)(ii)); 
‘‘(C) will provide for an increase in the 
number of units of permanent supportive hous-
ing that would serve chronically homeless indi-
viduals and families in the community as a re-
sult of an award of a grant under subsection 
(a); and 
‘‘(D) have demonstrated experience pro-
viding services to address the mental health and 
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substance use disorder problems of chronically 
homeless individuals and families living in per-
manent supportive housing settings. 
‘‘(2) IN PROVIDING SUPPORTIVE SERVICES.—A 
condition for the receipt of a grant under subsection 
(a) is that the applicant agrees that, in using the 
grant to place individuals and their families in per-
manent supportive housing, and to provide sup-
portive services described in subsection (d), the ap-
plicant will give priority to individuals and families 
described in subsection (a)(1) who, at the time of 
their placement in permanent supportive housing, 
are chronically homeless. 
‘‘(c) GEOGRAPHIC DISTRIBUTION.—The Secretary 
shall ensure that consideration is given to geographic dis-
tribution (such as urban and rural areas) in the awarding 
of grants under subsection (a). 
‘‘(d) SERVICES.—The services referred to in sub-
section (a) are the following: 
‘‘(1) Services provided by the grantee or by 
qualified subcontractors that promote recovery and 
self-sufficiency and address barriers to housing sta-
bility, including the following: 
‘‘(A) Mental health services, including 
treatment and recovery support services. 
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‘‘(B) Substance use disorder treatment and 
recovery support services, including counseling, 
treatment planning, recovery coaching, peer 
support, and relapse prevention. 
‘‘(C) Integrated, coordinated treatment 
and recovery support services for co-occurring 
disorders. 
‘‘(D) Health education, including referrals 
for medical and dental care. 
‘‘(E) Services designed to help individuals 
and families make progress toward self-suffi-
ciency and recovery, including benefits advo-
cacy, money management, life-skills training, 
self-help programs, and engagement and moti-
vational interventions. 
‘‘(F) Services designed to help individuals 
obtain employment. 
‘‘(G) Parental skills and family support. 
‘‘(H) Case management. 
‘‘(I) Other supportive services that pro-
mote an end to chronic homelessness. 
‘‘(J) Coordination or partnership with 
other agencies, programs, or mainstream bene-
fits to maximize the availability of services and 
resources to meet the needs of chronically 
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homeless individuals and families living in sup-
portive housing using cost-effective approaches 
that avoid duplication. 
‘‘(K) Data collection and measuring per-
formance outcomes as specified in subsection 
(k). 
‘‘(2) Services, as described in paragraph (1), 
that are delivered to individuals and families who 
are chronically homeless and who are scheduled to 
become residents of permanent supportive housing 
within 90 days pending the location or development 
of an appropriate unit of housing. 
‘‘(3) For individuals and families who are oth-
erwise eligible, and who have voluntarily chosen to 
seek other housing opportunities after a period of 
tenancy in supportive housing, services, as described 
in paragraph (1), that are delivered, for a period of 
90 days after exiting permanent supportive housing 
or until the individuals have transitioned to com-
prehensive services adequate to meet their current 
needs, provided that the purpose of the services is to 
support the individuals in their choice to transition 
into housing that is responsive to their individual 
needs and preferences. 
‘‘(e) MATCHING FUNDS.— 
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‘‘(1) IN GENERAL.—A condition for the receipt 
of a grant under subsection (a) is that, with respect 
to the cost of the project to be carried out by an ap-
plicant pursuant to such subsection, the applicant 
agrees as follows: 
‘‘(A) In the case of the initial grant pursu-
ant to subsection (j)(1)(A), the applicant will, 
in accordance with paragraphs (2) and (3), 
make available contributions toward such costs 
in an amount that is not less than $1 for each 
$4 of Federal funds provided in the grant. 
‘‘(B) In the case of a renewal grant pursu-
ant to subsection (j)(1)(B), the applicant will, 
in accordance with paragraphs (2) and (3), 
make available contributions toward such costs 
in an amount that is not less than $1 for each 
$2 of Federal funds provided in the grant. 
‘‘(2) SOURCE
OF
CONTRIBUTION.—For pur-
poses of paragraph (1), contributions made by an 
applicant are in accordance with this paragraph if 
made as follows: 
‘‘(A) The contribution is made from funds 
of the applicant or from donations from public 
or private entities. 
‘‘(B) Of the contribution— 
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‘‘(i) not less than 80 percent is from 
non-Federal funds; and 
‘‘(ii) not more than 20 percent is from 
Federal funds provided under programs 
that— 
‘‘(I) are not expressly directed at 
services for homeless individuals, but 
whose purposes are broad enough to 
include the provision of a service or 
services described in subsection (d) as 
authorized expenditures under such 
program; and 
‘‘(II) do not prohibit Federal 
funds under the program from being 
used to provide a contribution that is 
required as a condition for obtaining 
Federal funds. 
‘‘(3) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—Contributions required in paragraph (1) 
may be in cash or in-kind equipment or services. 
Amounts provided by the Federal Government, or 
services assisted or subsidized to any significant ex-
tent by the Federal Government, may not be in-
cluded in determining the amount of non-Federal 
contributions required in paragraph (2)(B)(i). 
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‘‘(f) ADMINISTRATIVE EXPENSES.—A condition for 
the receipt of a grant under subsection (a) is that the ap-
plicant involved agrees that not more than 10 percent of 
the grant will be expended for administrative expenses 
with respect to the grant. Expenses for data collection and 
measuring performance outcomes as specified in sub-
section (k) shall not be considered as administrative ex-
penses subject to the limitation in this subsection. 
‘‘(g) CERTAIN USES OF FUNDS.—Notwithstanding 
other provisions of this section, a grantee under subsection 
(a) may expend not more than 20 percent of the grant 
to provide supportive services as described in subsection 
(a)(1)(B). 
‘‘(h) APPLICATION FOR GRANT.—A grant may be 
made under subsection (a) only if an application for the 
grant is submitted to the Secretary and the application 
is in such form, is made in such manner, and contains 
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this section. 
‘‘(i) CERTAIN REQUIREMENTS.—A condition for the 
receipt of a grant under subsection (a) is that the appli-
cant involved demonstrate the following: 
‘‘(1) The applicant and all direct providers of 
services have the experience, infrastructure, and ex-
pertise needed to ensure the quality and effective-
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ness of services, which may be demonstrated by any 
of the following: 
‘‘(A) Compliance with all local, city, coun-
ty, or State requirements for licensing, accredi-
tation, or certification (if any) which are appli-
cable to the proposed project. 
‘‘(B) A minimum of 2 years experience 
providing comparable services that do not re-
quire licensing, accreditation, or certification. 
‘‘(C) Certification as a Medicaid service 
provider, including health care for the homeless 
programs and community health centers. 
‘‘(D) An executed agreement with a rel-
evant State or local government agency that 
will provide oversight over the mental health, 
substance use disorder, or other services that 
will be delivered by the project. 
‘‘(2) There is a mechanism for determining 
whether residents of permanent supportive housing 
are, at the time of being placed in such housing, 
chronically homeless or at risk of becoming chron-
ically homeless. Such a mechanism may rely on local 
data systems or records of shelter admission. If 
there are no sources of data regarding the duration 
or number of homeless episodes, or if such data are 
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unreliable for the purposes of this subsection, an ap-
plicant must demonstrate that the project will imple-
ment appropriate procedures, taking into consider-
ation the capacity of local homeless service providers 
to document episodes of homelessness and the chal-
lenges of engaging individuals and families who have 
been chronically homeless, to verify that an indi-
vidual or family is chronically homeless or at risk of 
becoming chronically homeless. 
‘‘(3) The applicant participates in a local, re-
gional, or Statewide homeless management informa-
tion system. 
‘‘(j) DURATION OF INITIAL AND RENEWAL GRANTS; 
ADDITIONAL
PROVISIONS
REGARDING
RENEWAL 
GRANTS.— 
‘‘(1) IN GENERAL.—Subject to paragraphs (2) 
and (3), the period during which payments are made 
to a grantee under subsection (a) shall be in accord-
ance with the following: 
‘‘(A) In the case of the initial grant, the 
period of payments shall be 5 years. 
‘‘(B) In the case of a subsequent grant (re-
ferred to in this subsection as a ‘renewal 
grant’), the period of payments shall not be 
more than 5 years. 
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‘‘(2) ANNUAL APPROVAL; AVAILABILITY OF AP-
PROPRIATIONS; NUMBER OF GRANTS.—The provision 
of payments under an initial or renewal grant is sub-
ject to annual approval by the Secretary of the pay-
ments and to the availability of appropriations for 
the fiscal year involved to make the payments. This 
subsection may not be construed as establishing a 
limitation on the number of grants under subsection 
(a) that may be made to an entity. 
‘‘(3) ADDITIONAL PROVISIONS REGARDING RE-
NEWAL GRANTS.— 
‘‘(A) COMPLIANCE WITH MINIMUM STAND-
ARDS.—A renewal grant may be made by the 
Secretary only if the Secretary determines that 
the applicant involved has, in the project car-
ried out with the grant, maintained compliance 
with minimum standards for quality and suc-
cessful outcomes for housing retention, as de-
termined by the Secretary. 
‘‘(B) AMOUNT.—The maximum amount of 
a renewal grant under this subsection for an 
applicant shall not exceed an amount equal to 
75 percent of the amount of Federal funds pro-
vided to the applicant in the final year of the 
initial grant period. 
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‘‘(k) STRATEGIC PERFORMANCE OUTCOMES AND RE-
PORTS.— 
‘‘(1) IN GENERAL.—The Secretary shall, as a 
condition of the receipt of grants under subsection 
(a), require grantees to provide data regarding the 
performance outcomes of the projects carried out 
under the grants. Consistent with the requirements 
and procedures established by the Secretary, each 
grantee shall measure and report specific perform-
ance outcomes related to the long-term goals of in-
creasing stability within the community for individ-
uals and families who have been chronically home-
less, and decreasing the recurrence of periods of 
homelessness. 
‘‘(2) PERFORMANCE OUTCOMES.—The perform-
ance outcomes described under paragraph (1) shall 
include, with respect to individuals and families who 
have been chronically homeless— 
‘‘(A) improvements in housing stability; 
‘‘(B) improvements in employment and 
education; 
‘‘(C) reductions in problems related to sub-
stance use disorders; 
‘‘(D) reductions in problems related to 
mental health disorders; and 
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‘‘(E) other areas as the Secretary deter-
mines appropriate. 
‘‘(3) COORDINATION AND CONSISTENCY WITH 
OTHER HOMELESS ASSISTANCE PROGRAMS.— 
‘‘(A) PROCEDURES.—In establishing stra-
tegic performance outcomes and reporting re-
quirements under paragraph (1), the Secretary 
shall develop and implement procedures that 
minimize the costs and burdens to grantees and 
program participants, and that are practical, 
streamlined, and designed for consistency with 
the requirements of the homeless assistance 
programs administered by the Secretary of 
Housing and Urban Development. 
‘‘(B) APPLICANT
COORDINATION.—Appli-
cants under this section shall coordinate with 
community stakeholders, including participants 
in the local homeless management information 
system, concerning the development of systems 
to measure performance outcomes and with the 
Secretary for assistance with data collection 
and measurements activities. 
‘‘(4) REPORT.—A grantee shall submit an an-
nual report to the Secretary that— 
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‘‘(A) identifies the grantee’s progress to-
ward achieving its strategic performance out-
comes; and 
‘‘(B) describes other activities conducted 
by the grantee to increase the participation, 
housing stability, and other improvements in 
outcomes for individuals and families who have 
been chronically homeless. 
‘‘(l) TRAINING AND TECHNICAL ASSISTANCE.—The 
Secretary, directly or through awards of grants or con-
tracts to public or nonprofit private entities, shall provide 
training and technical assistance regarding the planning, 
development, and provision of services in projects under 
subsection (a). 
‘‘(m) BIENNIAL REPORTS TO CONGRESS.—Not later 
than 2 years after the date of the enactment of the Serv-
ices for Ending Long-Term Homelessness Act, and bienni-
ally thereafter, the Secretary shall submit to the appro-
priate committees of Congress a report on projects under 
subsection (a) that— 
‘‘(1) includes a summary of information re-
ceived by the Secretary under subsection (k); 
‘‘(2) describes how the services provided under 
each such project are coordinated with State and 
local social service programs and homelessness as-
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sistance programs, and services provided by the De-
partment of Veterans Affairs and other relevant 
Federal agencies; and 
‘‘(3) includes an evaluation of the manner in 
which funds are used under such projects, and the 
effectiveness of such projects in ending long-term 
homelessness and improving outcomes for individuals 
with mental illness or substance use disorder prob-
lems. 
‘‘(n) DEFINITIONS.—For purposes of this section: 
‘‘(1) CHRONICALLY HOMELESS.— 
‘‘(A) IN GENERAL.—The term ‘chronically 
homeless’, used with respect to an individual or 
family, means an individual or family who— 
‘‘(i) is homeless; 
‘‘(ii) has been homeless continuously 
for at least 1 year or has been homeless on 
at least 4 separate occasions, totaling 12 
months in one year in the last 3 years; and 
‘‘(iii) has an adult head of household 
(or a minor head of household if no adult 
is present in the household) with a 
diagnosable substance use disorder, a seri-
ous mental illness, a developmental dis-
ability (as defined in section 102 of the 
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