Padilla, Markey Introduce Legislation to Strengthen Health and Homelessness Services Coordination

WASHINGTON, D.C. — Today, U.S. Senators Alex Padilla (D-Calif.) and Edward J. Markey (D-Mass.) introduced legislation to help people experiencing homelessness and behavioral health issues, including substance use disorder, receive coordinated support services. Specifically, the Homelessness and Behavioral Health Care Coordination Act of 2023 would authorize a grant program to better coordinate health and homelessness services. Representative Madeleine Dean (D-Pa.-04) introduced companion legislation in the House of Representatives.

While the lack of affordable housing units is one of the primary drivers of homelessness in the United States, behavioral health conditions, including substance use disorders, can cause and exacerbate homelessness. According to data from the Department of Housing and Urban Development’s 2022 Annual Homeless Assessment Report to Congress, about one in five individuals experiencing homelessness in America has a severe mental health disorder and about one in six has a substance use disorder. Furthermore, these conditions can make it incredibly difficult for those experiencing homelessness to obtain and stay in housing. Moreover, drug overdose and coronary heart disease are some of the leading causes of death for people experiencing homelessness.

“On any given night, hundreds of thousands of people experience homelessness across the country, many of whom are also dealing with a mental health or substance use disorder,” said Senator Padilla. “Our bill would help streamline and coordinate much-needed additional culturally competent, trauma-informed health and housing services to more effectively address the homelessness and behavioral health crises in California and across the nation.”

“Health care and housing are a human right, but for so many, that right is not a reality,” said Senator Markey. “Housing insecurity makes it harder to stay healthy. Health insecurity makes it harder to keep housing, and for too long, we’ve not done enough to support people breaking out of the cycle of homelessness by building a system that guarantees people have a roof over their head and can get the health care they need, when they need it. This bill will break down those silos, give providers on the frontlines the resources they need, and help us move one step closer to ending homelessness. I thank Senator Padilla for his partnership in this work.”

“The Homelessness and Behavioral Health Care Coordination Act will be instrumental in breaking down the barriers between the homelessness and health care sectors so that local homelessness systems will more easily access the supportive housing services including navigation, landlord intervention, case management, and behavioral health care that are necessary to safely and securely house people experiencing homelessness who have acute needs, including substance use and mental health issues. The Alliance commends Senator Padilla for his leadership on this important legislation.  We are eager to work with Senator Padilla to enact his legislation,” said the National Alliance to End Homelessness (NAEH).

“The evidence is irrefutable: affordable, accessible homes, linked with voluntary wrap-around services, are the most effective way to end homelessness,” said NLIHC President and CEO Diane Yentel. “I applaud Senator Padilla and Congresswoman Dean for their leadership in reintroducing the ‘Homelessness and Behavioral Health Care Coordination Act,’ which builds on decades of research, learning and bipartisan support to expand access to proven solutions to homelessness.”

Specifically, the bill would establish a grant program through the Department of Health and Human Services (HHS) that would award five-year grants of up to $500,000 to eligible entities to improve their capacity to coordinate culturally competent, trauma-informed behavioral and homelessness services. Grantees would have to provide annual reports to HHS to evaluate the efficacy of their programs no later than six years after receiving the grant. The bill would also direct HHS to establish an interagency working group, with representatives from the Department of Housing and Urban Development, the U.S. Interagency Council on Homelessness, the Department of Agriculture, and the Bureau of Indian Affairs, to advise on how to carry out the program.

This legislation is endorsed by the National Alliance to End Homelessness (NAEH), the National Low-Income Housing Coalition (NLIHC), the National Alliance on Mental Illness (NAMI), American Psychological Association Services, the Global Alliance for Behavioral Health and Social Justice, Clinical Social Worker Association, National Council for Mental Wellbeing, the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD), the National Association of Addiction Professionals (NAADAC), and the American Mental Health Counselors Association.

Senator Padilla has been a steadfast supporter of efforts to address the intersecting mental health and homelessness crises in California and across the country, including through the launch of the bipartisan Senate Mental Health Caucus and the introduction of his comprehensive Housing For All Act. Earlier this year, Padilla and Markey introduced the Housing Alignment and Coordination of Critical and Effective Supportive Health Services (ACCESS) Act, legislation focused on addressing the intersecting crises of homelessness, mental health, and substance use disorder by increasing support for millions of low-income Americans on Medicaid.

During National Recovery Month, Padilla, Markey, and Senator Tim Kaine (D-Va.) also wrote a letter to the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Housing and Urban Development (HUD), calling for increased oversight of interagency coordination and the implementation of a pilot program to provide mental health, substance use, and other supportive services for people experiencing homelessness, at risk of becoming homeless, or living in HUD-assisted housing. Padilla and the late Senator Dianne Feinstein also introduced the Fighting Homelessness Through Services and Housing Act earlier this year, a bill to authorize $1 billion annually to help local governments address homelessness by bolstering affordable housing supply alongside comprehensive mental health care, substance use disorder treatment, and job training.

A one-pager of the bill is available here.

Full text of the bill is available here.


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