,,ii #aafth ,,congress #ast ,session ,s4 #bgba ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,october #bh1 #bjai,mr4 ,durbin introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to reduce violence and health disparities by addressing social determinants of health1 enhancing health care recruitment1 and improving the delivery of quality1 coordinated care services1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,healing ,communities through ,health ,care ,act4 #b4 ,medicaid housing and hospital demonstration project 7a7 ,authority ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall select ,states to conduct demonstration projects under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 to test innovative partnership programs between housing agencies and programs1 hospitals and health systems1 and community-based organizations1 to establish screening1 referral1 and supportive housing programs for individuals with behavioral health needs who are experiencing housing insecurity1 that account for disproportionately high rates of emergency room visits and associated ,medicaid spending4 7b7 ,requirements 7#a7 ,number of projects ,the ,secretary shall select not less than #f ,states to conduct demonstration projects under this section4 7#b7 ,eligibility ,in order to be eligible to conduct a demonstration project under this section1 a ,state shall demonstrate the following3 7,a7 ,the ,state has or will establish sufficient processes for furnishing supportive housing services under the ,state ,medicaid program1 working with managed care organizations as applicable in the ,state1 for ,medicaid-eligible individuals described in subsection 7a74 7,b7 ,the ,state ,medicaid program has procedures in place to coordinate care and services for ,medicaid-eligible individuals described in subsection 7a71 including those with behavioral health needs1 across settings1 as appropriate1 which may include with law enforcement1 hospitals and health systems1 housing authorities or agencies1 mental health and substance use treatment facilities1 and community-based organizations4 7#c7 ,priority ,in selecting ,states under this section1 the ,secretary shall give priority to ,states with large urban populations in which there are existing programs that deliver housing1 case management and service coordination1 and establishment of screening and referral processes in health care settings1 including programs that utilize public hospitals and flexible housing pools to serve individuals who are experiencing housing insecurity or have behavioral health needs4 7#d7 ,duration ,each demonstration project under this section shall be conducted for a period of not less than #d years4 7c7 ,payment for services furnished under demonstration project 7#a7 ,in general ,subject to paragraph 7#b71 amounts expended by a ,state under a demonstration project under this section on supportive housing services for ,medicaid-eligible individuals described in subsection 7a7 shall be treated as medical assistance for purposes of section #aijc7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a774 7#b7 ,limitation on ,federal funding 7,a7 ,in general ,the total amount certified by the ,secretary under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 for payment to a ,state with respect to expenditures described in paragraph 7#a7 shall not exceed the amount allocated to the ,state by the ,secretary under subparagraph 7,b74 7,b7 ,allocation 7i7 ,in general ,the ,secretary shall allocate to each ,state selected to conduct a demonstration project under this section an amount determined appropriate by the ,secretary for purposes of reimbursing the ,state for services furnished under the demonstration project in accordance with paragraph 7#a74 7ii7 ,limitation ,the total amount allocated to ,states under this subparagraph shall not exceed #ge1jjj1jjj4 7d7 ,waiver authority ,the ,secretary may waive the following requirements as may be necessary to conduct demonstration projects in accordance with the requirements of this section3 7#a7 ,the requirements of section #aijb7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#a77 7relating to statewideness74 7#b7 ,the requirements of section #aijb7;a77#aj77;,b7 of such ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,b77 7relating to comparability74 7#c7 ,the requirements of section #aijb7;a77#aj77;,c77i77,,iii7 of such 7#db ,u4,s4,c4 #acif;a7a77#aj77;,c77i77,,iii77 7relating to income and resource rules applicable in the community74 7e7 ,definitions ,in this section3 7#a7 ,medicaid ,the term ,medicaid means the medical assistance program established under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and includes any waivers of such program4 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#c7 ,state ,the term ,state has the meaning given that term for purposes of title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#d7 ,supportive housing services ,the term supportive housing services means-- 7,a7 financial assistance with rental payments1 room and board1 or other housing costs1 as appropriate2 7,b7 case management and service coordination services2 and 7,c7 housing support screening and referral services provided in a healthcare setting4 #c4 ,establishing ,,nih clinical trials research network on violence recovery ,part ,b of title ,,iv of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhd et seq47 is amended by adding at the end the following3 #dji,k4 ,clinical trials research network on violence recovery 7a7 ,network ,the ,director of ,,nih shall develop and support a regional clinical research center network1 by awarding funding to participants in accordance with subsection 7b7 through grants1 contracts1 or other mechanisms1 to study and evaluate hospital- and community-based interventions for victims of violent or penetrating injuries to prevent1 mitigate1 and furnish treatments to address the trauma and mental health impacts of those injuries on such victims and prevent re-injury4 7b7 ,participants 7#a7 ,in general ,an entity seeking funding under this section shall-- 7,a7 be a university or hospital2 and 7,b7 submit an application to the ,director of ,,nih at such time1 in such manner1 and containing such information as the ,director may require1 including the information described in paragraph 7#b74 7#b7 ,demonstrated expertise ,an application submitted under paragraph 7#a77;,b7 shall include information demonstrating that the applicant has multidisciplinary expertise in-- 7,a7 furnishing hospital- or community-based interventions to improve outcomes for patients suffering a violent or penetrating injury2 7,b7 quality improvement research2 7,c7 linking clinical research with practice and community outcomes and activities2 and 7,d7 providing1 linking to1 or otherwise facilitating community-based care1 case management1 and treatment4 7#c7 ,selection ,the ,director of ,,nih shall1 subject to available funding1 select not less than #ae entities meeting the requirements of this subsection to receive funding under this section 7provided that fifteen or more entities meeting such requirements apply for such funding74 7c7 ,activities and use of funds ,an entity that receives funding under this section shall use the funds to provide support for a trauma-informed and violence re-injury prevention research center1 including funding for-- 7#a7 clinical1 behavioral1 or translational research to test and evaluate trauma-informed interventions for trauma recovery in an effort to prevent and reduce violence-related re-injury1 readmission1 and mortality2 7#b7 the provision of screening1 delivery of post-injury mental health counseling1 trauma-informed care1 education1 discharge planning1 skills building1 and long-term case management2 and 7#c7 training researchers1 clinicians1 case workers1 mental health professionals1 community health workers1 and other appropriate providers to provide appropriate interventions described in paragraph 7#b74 7d7 ,outcomes measurements ,any activity supported under this section shall be furnished with the aim of preventing and mitigating the impact of trauma and mental health consequences associated with a violent or penetrative injury1 improve the overall health and well-being of individuals with a violent or penetrative injury1 and prevent re-injury1 readmission1 and mortality4 7e7 ,coordination of consortia activities ,the ,director of ,,nih shall1 as appropriate-- 7#a7 provide for the coordination of activities 7including the exchange of information and regular communication7 among the entities receiving funding under this section2 and 7#b7 require each entity receiving funding under this section to prepare and submit to the ,director periodic reports on the activities of the entity that are supported by this section4 4 #d4 ,health professions opportunity grants 7a7 ,funding ,section #bjjh7;c77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;g7c77#a77 is amended by inserting 1 and #agj1jjj1jjj for each of fiscal years #bjba through #bjbe after #bjai4 7b7 ,making hospitals eligible ,section #bjjh7;a77#d77;,a7 of such ,act 7#db ,u4,s4,c4 #acig;g7a77#d77;,a77 is amended by striking or a community-based organization and inserting 1 a community-based organization1 or a hospital 7as defined in section #ahfa7;e774 7c7 ,aid and supportive services ,section #bjjh7;a77#b77;,a77i7 of such ,act 7#db ,u4,s4,c4 #acig;g7a77#b77;,a77i77 is amended-- 7#a7 by inserting affordable before child care2 and 7#b7 by inserting transportation1 basic skills and ,english language proficiency training1 after case management14 #e4 ,health professions training for diversity programs 7a7 ,centers of excellence ,section #gcf7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic7;c77 is amended by adding at the end the following3 7#d7 ,preference 7,a7 ,in general ,in making grants under subsection 7a71 the ,secretary shall give preference to designated health professions schools1 or other public or nonprofit health or educational entities1 meeting the requirements of this section that propose to-- 7i7 carry out the activities supported by this section in communities with a high rate of community trauma2 or 7ii7 recruit participants for activities supported by this section from communities with a high rate of community trauma4 7,b7 ,community with a high rate of community trauma ,for purposes of subparagraph 7,a71 the term community with a high rate of community trauma means a community with a high rate of intergenerational poverty1 civil unrest1 or discrimination1 and may include-- 7i7 a community with an age-adjusted rate of drug overdose deaths that is above the national average for age-adjusted rates of drug overdose deaths1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention2 and 7ii7 a community with an age-adjusted rate of violence-related 7or intentional7 injury deaths that is above the national average for age-adjusted rates of violence-related 7or intentional7 injury deaths1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention4 4 7b7 ,scholarships for disadvantaged students ,section #gcg7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic;a7b77 is amended-- 7#a7 in the subsection heading by striking in ,providing ,scholarships2 7#b7 by striking ,the ,secretary and inserting the following3 7#a7 ,preference in providing scholarships ,the ,secretary 2 and 7#c7 by adding at the end the following3 7#b7 ,preference to eligible entities proposing to serve communities with high rates of community trauma 7,a7 ,in general ,in making grants under this subsection 7a71 the ,secretary shall give preference to eligible entities that propose to-- 7i7 carry out the activities supported by this section in communities with a high rate of community trauma2 or 7ii7 award scholarships under this section to full-time students who are eligible individuals from communities with a high rate of community trauma4 7,b7 ,community with a high rate of community trauma ,for purposes of subparagraph 7,a71 the term community with a high rate of community trauma has the meaning given that term in section #gcf7;c77#d77;,b74 4 7c7 ,health careers opportunity program ,section #gci7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bic;c7b77 is amended-- 7#a7 by redesignating paragraphs 7#a7 through 7#d7 as subparagraphs 7,a7 through 7,d71 respectively1 and indenting appropriately2 7#b7 by striking ,in making and inserting the following3 7#a7 ,in general ,in making 2 and 7#c7 by adding at the end the following3 7#b7 ,preference to eligible entities proposing to serve communities with high rates of community trauma 7,a7 ,in general ,in making awards to eligible entities under subsection 7a77#a71 the ,secretary shall give preference to approved applications for programs proposing to-- 7i7 carry out the activities supported by this section in communities with a high rate of community trauma2 or 7ii7 recruit for activities supported by this section individuals from disadvantaged backgrounds1 as so determined1 from communities with a high rate of community trauma4 7,b7 ,community with a high rate of community trauma ,for purposes of subparagraph 7,a71 the term community with a high rate of community trauma has the meaning given that term in section #gcf7;c77#d77;,b74 4 7d7 ,area health education centers ,section #gea7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;a7b77 is amended by adding at the end the following3 7#c7 ,preference to eligible entities proposing to serve communities with high rates of community trauma 7,a7 ,in general ,in awarding grants under subsection 7a77#a7 or 7a77#b71 the ,secretary shall give preference to eligible entities that propose to-- 7i7 carry out the activities supported by this section in communities with a high rate of community trauma2 or 7ii7 recruit participants for activities supported by this section from communities with a high rate of community trauma4 7,b7 ,community with a high rate of community trauma ,for purposes of subparagraph 7,a71 the term community with a high rate of community trauma has the meaning given that term in section #gcf7;c77#d77;,b74 4 #f4 ,designation of health professional shortage areas2 funding for the ,national ,health ,service ,corps 7a7 ,designation of health professional shortage areas ,section #ccb7;a77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77#b77 is amended-- 7#a7 in subparagraph 7,a71 by inserting 7including for the delivery of care provided by a city or county health department to inmates of a county or municipal jail7 after county health department2 and 7#b7 in subparagraph 7,b71 by striking ,state correctional institution and inserting ,state1 county1 or municipal correctional institution44 7b7 ,funding for the ,national ,health ,service ,corps ,section #ajejc7;b77#b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7;b77#b77 is amended-- 7#a7 in subparagraph 7,f71 by striking 2 and and inserting a semicolon2 7#b7 in subparagraph 7,g71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,g7 #cfj1jjj1jjj for the period beginning on ,november #bb1 #bjai1 and ending on ,september #cj1 #bjbj1 and for each of fiscal years #bjba through #bjbe4 4 #g4 ,incumbent worker training ,section #acd7;d77#d77;,a7 of the ,workforce ,innovation and ,opportunity ,act of #aiih 7#bi ,u4,s4,c4 #cagd7;d77#d77;,a77 is amended-- 7#a7 by redesignating clauses 7ii7 and 7iii7 as clauses 7iii7 and 7iv71 respectively2 7#b7 by inserting after clause 7i7 the following3 7ii7 ,greater reservation of funds ,the local board may reserve and use more than #bj percent of the funds so allocated1 to pay for the ,federal share of the cost described in clause 7i71 if the ,secretary determines that the local board has demonstrated that-- 7,i7 there is a need and demand in the local area for additional incumbent worker training program positions 7beyond the positions that could be offered through the reservation described in clause 7i771 including specifying the number of employers and workers that could be served through the additional program positions2 7,,ii7 training through an incumbent worker training program that is in existence on the day on which information is submitted for the demonstration 7referred to in this clause as an existing incumbent worker training program7 has resulted in an incumbent worker of an employer acquiring new skills that allow the worker to obtain a position with such employer requiring higher skills or a higher-paid position than the pre-training position of the incumbent worker1 and the employer intends to hire an additional worker to fill the pre-training position of the incumbent worker2 and 7,,iii7 the effectiveness of the existing incumbent worker training program of the employer referred to in subclause 7,,ii71 as evaluated on local performance measures based on the primary indicators of performance specified in section #aaf7;b77#b77;,a77i74 2 and 7#c7 in clause 7iii71 as redesignated by paragraph 7#a7 of this subsection1 by striking clause 7i7 and inserting clause 7i7 or 7ii74