,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #djjd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #be1 #bjai,mrs4 
,bu/os 7= h]self1 ,mr4 ,cole1 ,mr4      
,mc,govern1 ,mrs4 ,rodg]s ( ,wa%+ton1   
,mr4 ,ru%1 ,ms4 ,b>ragn1 ,mr4 ,engel1   
,mr4 ,butt]field1 ,mr4 ,crd5as1 ,mr4    
,morelle1 ,mr4 ,fitzpatrick1 ,mr4       
,s*rad]1 ,mr4 ,soto1 ,mr4 ,mi*ael ,f4   
,doyle ( ,p5nsylvania1 & ,ms4 ,blunt    
,ro*e/]7 introduc$ ! foll[+ bill2 :i* 0 
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to direct !       
,secret>y ( ,heal? & ,human ,s]vices to 
e/abli% an int]ag5cy c\ncil on social   
det]m9ants ( heal?1 & = o!r purposes4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,social ,det]m9ants ,accel]ator ,act (
 #bjai4  #b4 ,f9d+s2 purposes  7a7      
,f9d+s ,congress f9ds ! foll[+3  7#a7   
,!re is a significant body ( evid5ce %[+
 t economic & social conditions h a     
p[]ful impact on individual & population
 heal? outcomes & well-be+1 z well z    
m$ical co/s4  7#b7 ,/ate1 local1 &      

,tribal gov]nm5ts & ! s]vice deliv]y    
p>tn]s ( su* gov]nm5ts face significant 
*all5ges 9 coord9at+ b5efits & s]vices  
deliv]$ ?r\gh ! ,m$icaid program & o!r  
social s]vices programs because ( !     
fragm5t$ & complex nature ( ,f$]al &    
,/ate fund+ & adm9i/rative requirem5ts4 
7#c7 ,! ,f$]al ,gov]nm5t %\ld prioritize
 & proactively assi/ ,/ate & local      
gov]nm5ts to /r5g!n ! capacity ( ,/ate &
 local gov]nm5ts to improve heal? &     
social outcomes = individuals1 !reby    
improv+ co/-effectiv5ess & return on    
inve/m5t4  7b7 ,purposes ,! purposes (  
?is ,act are z foll[s3 7#a7 ,to e/abli% 
effective1 coord9at$ ,f$]al te*nical    
assi/ance to help ,/ate & local         
gov]nm5ts to improve outcomes &         
co/-effectiv5ess (1 & return on inve/m5t
 f1 heal? & social s]vices programs4    
7#b7 ,to build a pipel9e ( ,/ate &      
locally design$1 cross-sector           
int]v5tions & /rategies t g5]ate rigor\s
 evid5ce ab\t h[ to improve heal? &     
social outcomes1 & increase !           

co/-effectiv5ess (1 & return on inve/m5t
 f1 ,f$]al1 ,/ate1 local1 & ,tribal     
heal? & social s]vices programs4  7#c7  
,to enli/ ,/ate & local gov]nm5ts & !   
s]vice provid]s ( su* gov]nm5ts z p>tn]s
 9 id5tify+ ,f$]al /atutory1 regulatory1
 & adm9i/rative *all5ges 9 improv+ !    
heal? & social outcomes (1              
co/-effectiv5ess (1 & return on inve/m5t
 f1 ,f$]al sp5d+ on individuals enroll$ 
9 ,m$icaid4  7#d7 ,to develop /rategies 
to improve heal? & social outcomes )\t  
d5y+ s]vices to1 or re/rict+ !          
eligibility (1 vuln]able populations4   
#c4 ,social det]m9ants accel]ator c\ncil
  7a7 ,e/abli%m5t ,! ,secret>y ( ,heal? 
& ,human ,s]vices 7ref]r$ to 9 ?is ,act 
z ! ,secret>y71 9 coord9ation ) !       
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices 7ref]r$ to 9 ?is ,act 
z ! ,adm9i/rator71 %all e/abli% an      
int]ag5cy c\ncil1 to be kn[n z ! ,social
 ,det]m9ants ,accel]ator ,int]ag5cy     
,c\ncil 7ref]r$ to 9 ?is ,act z !       
,c\ncil7 to a*ieve ! purposes li/$ 9    

section #b7;b74  7b7 ,memb]%ip  7#a7    
,f$]al composition ,! ,c\ncil %all be   
compos$ ( at lea/ "o designee f ea* ( ! 
foll[+ ,f$]al ag5cies3 7,a7 ,! ,(fice ( 
,managem5t & ,budget4  7,b7 ,! ,dep>tm5t
 ( ,agriculture4  7,c7 ,! ,dep>tm5t (   
,education4  7,d7 ,! ,indian ,heal?     
,s]vice4  7,e7 ,! ,dep>tm5t ( ,h\s+ &   
,urban ,developm5t4  7,f7 ,! ,dep>tm5t (
 ,labor4  7,g7 ,! ,dep>tm5t (           
,transportation4  7,h7 ,any o!r ,f$]al  
ag5cy ! ,*air ( ! ,c\ncil det]m9es      
necess>y4  7#b7 ,designation  7,a7 ,9   
g5]al ,! head ( ea* ag5cy specifi$ 9    
p>agraph 7#a7 %all designate at lea/ "o 
employee describ$ 9 subp>agraph 7,b7 to 
s]ve z a memb] ( ! ,c\ncil4  7,b7       
,responsibilities ,an employee describ$ 
9 ?is subp>agraph %all be a s5ior       
employee ( ! ag5cy-- 7i7 ^:             
responsibilities relate to au?orities1  
policies1 & proc$ures ) respect to !    
heal? & well-be+ ( individuals receiv+  
m$ical assi/ance "u a ,/ate plan 7or a  
waiv] ( su* plan7 "u title ,,xix ( !    

,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq472 or  7ii7 :o has au?ority
 to implem5t & evaluate trans=mative    
initiatives t h>ness data or conducts   
rigor\s evaluation to improve ! impact &
 co/-effectiv5ess ( f$]ally fund$       
s]vices & b5efits4  7#c7 ,,hhs          
repres5tation ,9 addition to ! designees
 "u p>agraph 7#a71 ! ,c\ncil %all       
include designees f at lea/ ?ree ag5cies
 )9 ! ,dep>tm5t ( ,heal? & ,human       
,s]vices1 includ+ ! ,c5t]s = ,m$ic>e    
,m$icaid ,s]vices1 at lea/ "o ( :om %all
 meet ! crit]ia "u p>agraph 7#b77;,b74  
7#d7 ,,omb role ,! ,director ( ! ,(fice 
( ,managem5t & ,budget %all facilitate !
 timely resolution ( ,gov]nm5twide &    
multiag5cy issues to help ! ,c\ncil     
a*ieve cons5sus recomm5dations describ$ 
"u subsection 7c77#a74  7#e7 ,non-,f$]al
 composition ,! ,comptroll] ,g5]al ( !  
,unit$ ,/ates may designate up to #f    
,c\ncil designees-- 7,a7 :o h relevant  
subject matt] exp]tise1 includ+ exp]tise
 implem5t+ & evaluat+ trans=mative      

initiatives t h>ness data & conduct     
evaluations to improve ! impact &       
co/-effectiv5ess ( ,f$]al ,gov]nm5t     
s]vices2 &  7,b7 t ea* repres5t-- 7i7   
,/ate1 local1 & ,tribal heal? & human   
s]vices ag5cies2  7ii7 public h\s+      
au?orities or ,/ate h\s+ f9ance ag5cies2
  7iii7 ,/ate & local gov]nm5t budget   
(fices2  7iv7 ,/ate ,m$icaid ag5cies2 or
  7v7 national consum] advocacy         
organizations4  7#f7 ,*air  7,a7 ,9     
g5]al ,! ,secret>y %all select ! ,*air (
 ! ,c\ncil f among ! memb]s ( ! ,c\ncil4
  7,b7 ,initiat+ guidance ,! ,*air1 on  
behalf ( ! ,c\ncil1 %all id5tify &      
invite individuals f div]se entities to 
provide ! ,c\ncil ) advice & in=mation  
p]ta9+ to address+ social det]m9ants (  
heal?1 includ+--  7i7 individuals f     
,/ate & local gov]nm5t heal? & human    
s]vices ag5cies2  7ii7 individuals f    
,/ate ,m$icaid ag5cies2  7iii7          
individuals f ,/ate & local gov]nm5t    
budget (fices2  7iv7 individuals f      
public h\s+ au?orities or ,/ate h\s+    

f9ance ag5cies2  7v7 individuals f      
nonpr(it organizations1 small bus9esses1
 & philan?ropic organizations2  7vi7    
advocates2  7vii7 rese>*]s2 &  7viii7   
any o!r individuals ! ,*air det]m9es to 
be appropriate4  7c7 ,duties ,! duties (
 ! ,c\ncil are-- 7#a7 to make           
recomm5dations to ! ,secret>y & !       
,adm9i/rator reg>d+ ! crit]ia = mak+    
aw>ds "u section #d2  7#b7 to id5tify   
,f$]al au?orities & opportunities = use 
by ,/ates or local gov]nm5ts to improve 
coord9ation ( fund+ & adm9i/ration (    
,f$]al programs1 ! b5efici>ies ( :om    
include individuals describ$ 9 section  
#b1 & :i* may be unkn[n or und]utiliz$ &
 to make in=mation on su* au?orities &  
opportunities publicly available2  7#c7 
to provide t>get$ te*nical assi/ance to 
,/ates develop+ a social det]m9ants     
accel]ator plan "u section #d1 includ+  
id5tify+ pot5tial /atutory or regulatory
 pa?ways = implem5tation ( ! plan &     
assi/+ 9 id5tify+ pot5tial s\rces (     
fund+ to implem5t ! plan2  7#d7 to      

report to ,congress annually on !       
subjects set =? 9 subsection 7e72  7#e7 
to develop & dissem9ate evaluation      
guidel9es & /&>ds t c be us$ to reliably
 assess ! impact ( an int]v5tion or     
approa* t may be implem5t$ pursuant to  
?is ,act on outcomes1 co/-effectiv5ess  
(1 & return on inve/m5t f ,f$]al1 ,/ate1
 local1 & ,tribal gov]nm5ts1 & to       
facilitate te*nical assi/ance1 :]e ne$$1
 to help to improve ,/ate & local       
evaluation designs & implem5tation2     
7#f7 to seek fe$back f ,/ate1 local1 &  
,tribal gov]nm5ts1 includ+ ?r\gh an     
annual survey by an indep5d5t ?ird p>ty1
 on h[ to improve ! te*nical assi/ance !
 ,c\ncil provides to bett] equip ,/ate1 
local1 & ,tribal gov]nm5ts to coord9ate 
heal? & social s]vice programs2  7#g7 to
 solicit applications = grants "u       
section #d2 &  7#h7 to coord9ate ) o!r  
cross-ag5cy initiatives focus$ on       
improv+ ! heal? & well-be+ ( l[-income &
 at-risk populations 9 ord] to prev5t   
unnecess>y duplication betwe5 ag5cy     

initiatives4  7d7 ,s*$ule ,n lat] ?an   
#fj days aft] ! date ( ! enactm5t ( ?is 
,act1 ! ,c\ncil %all conv5e to develop a
 s*$ule & plan = c>ry+ out ! duties     
describ$ 9 subsection 7c71 includ+      
solicitation ( applications = ! grants  
"u section #d4  7e7 ,report to ,congress
 ,! ,c\ncil %all submit an annual report
 to ,congress1 :i* %all include-- 7#a7 a
 li/ ( ! ,c\ncil memb]s2  7#b7          
activities & exp5ditures ( ! ,c\ncil2   
7#c7 summ>ies ( ! int]v5tions &         
approa*es t w be support$ by ,/ate1     
local1 & ,tribal gov]nm5ts t receiv$ a  
grant "u section #d1 includ+--  7,a7 !  
be/ practices & evid5ce-bas$ approa*es  
su* gov]nm5ts plan to employ to a*ieve !
 purposes li/$ 9 section #b7;b72 &  7,b7
 a description ( h[ ! practices &       
approa*es w impact ! outcomes1          
co/-effectiv5ess (1 & return on inve/m5t
 f1 ,f$]al1 ,/ate1 local1 & ,tribal     
gov]nm5ts ) respect to su* purposes2    
7#d7 ! fe$back receiv$ f ,/ate & local  
gov]nm5ts on ways to improve ! te*nical 

assi/ance ( ! ,c\ncil1 includ+ f9d+s f a
 ?ird-p>ty survey & actions ! ,c\ncil   
plans to take 9 response to su* fe$back2
 &  7#e7 ! major /atutory1 regulatory1 &
 adm9i/rative *all5ges id5tifi$ by      
,/ate1 local1 & ,tribal gov]nm5ts t     
receiv$ a grant "u section #d1 & !      
actions t ,f$]al ag5cies are tak+ to    
address su* *all5ges4  7f7 ,,faca       
applicability ,! ,f$]al ,advisory       
,committee ,act 7#e ,u4,s4,c4 ,app47    
%all n apply to ! ,c\ncil4  7g7 ,c\ncil 
proc$ures ,! ,secret>y1 9 consultation )
 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates 
& ! ,director ( ! ,(fice ( ,managem5t & 
,budget1 %all e/abli% proc$ures = !     
,c\ncil to--  7#a7 ensure t adequate    
res\rces are available to effectively   
execute ! responsibilities ( ! ,c\ncil2 
7#b7 effectively coord9ate ) o!r        
relevant advisory bodies & work+ gr\ps  
to avoid unnecess>y duplication2  7#c7  
create transp>5cy to ! public &         
,congress ) reg>d to ,c\ncil memb]%ip1  
co/s1 & activities1 includ+ ?r\gh use ( 

mod]n te*nology & social m$ia to        
dissem9ate in=mation2 &  7#d7 avoid     
conflicts ( int]e/ t w\ld jeop>dize !   
ability ( ! ,c\ncil to make decisions & 
provide recomm5dations4  #d4 ,social    
det]m9ants accel]ator grants to ,/ates  
or local gov]nm5ts  7a7 ,grants to      
,/ates1 local gov]nm5ts1 & tribes ,n    
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,adm9i/rator1 9  
consultation ) ! ,secret>y & ! ,c\ncil1 
%all aw>d on a competitive basis n m ?an
 #be grants to eligible applicants      
describ$ 9 subsection 7b71 = !          
developm5t ( social det]m9ants          
accel]ator plans1 z describ$ 9          
subsection 7f74  7b7 ,eligible applicant
 ,an eligible applicant describ$ 9 ?is  
section is a ,/ate1 local1 or ,tribal   
heal? or human s]vices ag5cy t--  7#a7  
demon/rates ! support ( relevant p>ties 
across relevant ,/ate1 local1 or ,tribal
 jurisdictions2 &  7#b7 9 ! case ( an   
applicant t is a local gov]nm5t ag5cy1  
provides to ! ,secret>y a lett] (       

support f ! lead ,/ate heal? or human   
s]vices ag5cy = ! ,/ate 9 :i* ! local   
gov]nm5t is locat$4  7c7 ,am\nt ( grant 
,! ,adm9i/rator1 9 coord9ation ) !      
,c\ncil1 %all det]m9e ! total am\nt t ! 
,adm9i/rator w make available to ea*    
grantee "u ?is section4  7d7            
,application ,an eligible applicant     
seek+ a grant "u ?is section %all       
include 9 ! application ! foll[+        
in=mation3  7#a7 ,! t>get population 7or
 populations7 t w\ld b5efit f           
implem5tation ( ! social det]m9ants     
accel]ator plan propos$ to be develop$  
by ! applicant4  7#b7 ,a description ( !
 objective or objectives & outcome goals
 ( su* propos$ plan1 :i* %all include at
 lea/ "o heal? outcome & at lea/ "o o!r 
important social outcome4  7#c7 ,!      
s\rces & scope ( ineffici5cies t1 if    
address$ by ! plan1 c\ld result 9       
improv$ co/-effectiv5ess ( or return on 
inve/m5t f ,f$]al1 ,/ate1 local1 &      
,tribal gov]nm5ts4  7#d7 ,a description 
( pot5tial int]v5tions t c\ld be design$

 or enabl$ us+ su* propos$ plan4  7#e7  
,! ,/ate1 local1 ,tribal1 academic1     
nonpr(it1 community-bas$ organizations1 
& o!r private sector p>tn]s t w\ld      
p>ticipate 9 ! developm5t ( ! propos$   
plan & subsequ5t implem5tation (        
programs or initiatives includ$ 9 su*   
propos$ plan4  7#f7 ,su* o!r in=mation z
 ! ,adm9i/rator1 9 consultation ) !     
,secret>y & ! ,c\ncil1 det]m9es necess>y
 to a*ieve ! purposes ( ?is ,act4  7e7  
,use ( funds ,a recipi5t ( a grant "u   
?is section may use funds receiv$ ?r\gh 
! grant = ! foll[+ purposes3  7#a7 ,to  
conv5e & coord9ate ) relevant gov]nm5t  
entities & o!r /akehold]s across sectors
 to assi/ 9 ! developm5t ( a social     
det]m9ant accel]ator plan4  7#b7 ,to    
id5tify populations ( individuals       
receiv+ m$ical assi/ance "u a ,/ate plan
 7or a waiv] ( su* plan7 "u title ,,xix 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq47 :o may b5efit f
 ! propos$ approa*es to improv+ ! heal? 
& well-be+ ( su* individuals ?r\gh !    

implem5tation ( ! propos$ social        
det]m9ants accel]ator plan4  7#c7 ,to   
engage qualifi$ rese>* exp]ts to advise 
on relevant rese>* & to design a propos$
 evaluation plan1 9 accordance ) ! /&>ds
 & guidel9es issu$ by ! ,adm9i/rator4   
7#d7 ,to collaborate ) ! ,c\ncil to     
support ! developm5t ( social det]m9ants
 accel]ator plans4  7#e7 ,to prep>e &   
submit a f9al social det]m9ants         
accel]ator plan to ! ,c\ncil4  7f7      
,cont5ts ( plans ,a social det]m9ant    
accel]ator plan develop$ "u ?is section 
%all include ! foll[+3  7#a7 ,a         
description ( ! t>get population 7or    
populations7 t w\ld b5efit f            
implem5tation ( ! social det]m9ants     
accel]ator plan1 includ+ an analysis    
describ+ ! project$ impact on ! well-be+
 ( individuals describ$ 9 subsection    
7e77#b74  7#b7 ,a description ( !       
int]v5tions or approa*es design$ "u !   
social det]m9ants accel]ator plan & !   
evid5ce = select+ su* int]v5tions or    
approa*es4  7#c7 ,! objectives & outcome

 goals ( su* int]v5tions or approa*es1  
includ+ at lea/ "o heal? outcome & at   
lea/ "o o!r important social outcome4   
7#d7 ,a plan = access+ & l9k+ relevant  
data to enable coord9at$ b5efits &      
s]vices = ! jurisdictions describ$ 9    
subsection 7b77#a7 & an evaluation ( !  
propos$ int]v5tions & approa*es4  7#e7  
,a description ( ! ,/ate1 local1        
,tribal1 academic1 nonpr(it1 or         
community-bas$ organizations1 or any o!r
 private sector organizations t w\ld    
p>ticipate 9 implem5t+ ! propos$        
int]v5tions or approa*es1 & ! role ea*  
w\ld play to contribute to ! success ( !
 propos$ int]v5tions or approa*es4  7#f7
 ,! id5tification ( ! fund+ s\rces t    
w\ld be us$ to f9ance ! propos$         
int]v5tions or approa*es4  7#g7 ,a      
description ( any f9ancial inc5tives t  
may be provid$1 includ+ outcome-focus$  
contract+ approa*es to enc\rage s]vice  
provid]s & o!r p>tn]s to improve        
outcomes (1 co/-effectiv5ess (1 & return
 on inve/m5t f1 ,f$]al1 ,/ate1 local1 or

 ,tribal gov]nm5t sp5d+4  7#h7 ,!       
id5tification ( ! applicable ,f$]al1    
,/ate1 local1 or ,tribal /atutory &     
regulatory au?orities1 includ+ waiv]    
au?orities1 to be lev]ag$ to implem5t ! 
propos$ int]v5tions or approa*es4  7#i7 
,a description ( pot5tial consid]ations 
t w\ld enhance ! impact1 scalability1 or
 su/a9ability ( ! propos$ int]v5tions or
 approa*es & ! actions ! grant aw>dee   
w\ld take to address su* consid]ations4 
7#aj7 ,a propos$ evaluation plan1 to be 
c>ri$ out by an indep5d5t evaluator1 to 
measure ! impact ( ! propos$ int]v5tions
 or approa*es on ! outcomes (1          
co/-effectiv5ess (1 & return on inve/m5t
 f1 ,f$]al1 ,/ate1 local1 & ,tribal     
gov]nm5ts4  7#aa7 ,precautions = ensur+ 
t vuln]able populations w n be d5i$     
access to ,m$icaid or o!r ess5tial      
s]vices z a result ( implem5t+ ! propos$
 plan4  #e4 ,fund+  7a7 ,9 g5]al ,out ( 
any money 9 ! ,treasury n o!rwise       
appropriat$1 !re is appropriat$ to c>ry 
out ?is ,act #be1jjj1jjj1 ( :i* up to   

#e1jjj1jjj may be us$ to c>ry out ?is   
,act1 to rema9 available = obligation   
until ! date t is #e ye>s aft] ! date ( 
enactm5t ( ?is ,act4  7b7 ,res]vation ( 
funds  7#a7 ,9 g5]al ,( ! funds made    
available "u subsection 7a71 ! ,secret>y
 %all res]ve n less ?an #bj p]c5t to    
aw>d grants to eligible applicants = !  
developm5t ( social det]m9ants          
accel]ator plans "u section #d int5d$ to
 s]ve rural populations4  7#b7          
,exception ,9 ! case ( a fiscal ye> =   
:i* ! ,secret>y det]m9es t !re are n    
suffici5t eligible applicants to aw>d up
 to #be grants "u section #d t are      
int5d$ to s]ve rural populations & !    
,secret>y _c satisfy ! #bj-p]c5t        
requirem5t1 ! ,secret>y may res]ve an   
am\nt t is less ?an #bj p]c5t ( am\nts  
made available "u subsection 7a7 to aw>d
 grants = su* purpose4  7c7 ,rule (     
con/ruction ,no?+ 9 ?is ,act %all prev5t
 ,f$]al ag5cies repres5t$ on ! ,c\ncil f
 contribut+ additional fund+ f o!r      
s\rces to support activities to improve 

! effectiv5ess ( ! ,c\ncil4