,i #aafth ,,congress #ast ,session ,h4 ,r4 #ffj ,,in ,,the ,,house ,,of ,,representatives ,january #ag1 #bjai,mr4 ,fortenberry 7for himself and ,ms4 ,johnson of ,texas7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to improve the health outcomes in communities through community-relevant health information and new health supporting incentives and programs funded without further appropriations4 #a4 ,short title ,this ,act may be cited as the ,community ,health ,improvement1 ,leadership1 and ,development ,act of #bjai or the ,,child ,act4 #b4 ,localized community health improvement programs 7a7 ,making epidemiology and claims data relevant to community health improvement 7#a7 ,in general ,not later than ,april #a1 #bjbj1 the ,secretary of ,health and ,human ,services1 through the ,director of the ,centers for ,disease ,control and ,prevention in collaboration with the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall1 subject to paragraph 7#b71 provide for the maintenance of a database of de-identified epidemiological and claims health information for the purpose of making such information available in a useful and informative manner to participating communities 7as referenced in subsection 7b77#c77;,b77 in participating ,states 7as referenced in subsection 7b77#a77 to support such communities in reducing rates of illness 7as compared to the rate of illness within such community as of a period specified by the ,secretary7 and improving the management of illnesses to reduce the cost of health care delivery4 ,in carrying out this subsection1 the ,director and ,administrator shall1 subject to paragraph 7#b71 provide-- 7,a7 for a mechanism that enables the integration of such epidemiological and claims health information for such purposes2 7,b7 that such health information is available for at least the #bj health conditions and treatments that are associated with the highest expenditures under the ,medicaid program under title ,,xix of the ,social ,security ,act2 7,c7 that such health information is made available to participating ,states in such a manner that enables participating communities within such ,states to access such information that is relevant specifically to such communities2 and 7,d7 for a mechanism by which the ,director and ,administrator may-- 7i7 update such information specific to each such community1 to the extent practicable1 in real-time or near real-time and as specified by the ,director and ,administrator2 7ii7 verify the validity of such information and the validity of the changes in such information for each such community over such specified periods2 and 7iii7 assess and measure the extent of such changes for each such participating community1 including the amount of any reductions in expenditures under the ,state plan under title ,,xix of the ,social ,security ,act and the extent to which such reductions are attributable to such changes with respect to each such community in such ,state4 7#b7 ,no additional funding ,no additional funds are authorized to be appropriated to carry out this subsection4 ,this subsection shall be carried out using amounts otherwise made available to the ,secretary4 7b7 ,localized community health improvement program grants 7#a7 ,in general ,the ,secretary of ,health and ,human ,services shall1 subject to paragraph 7#e71 carry out a grant program under which the ,secretary may award grants to ,states for purposes of carrying out localized community health improvement programs described in paragraph 7#c74 ,in this section such ,states awarded such grants are referred to as participating ,states4 7#b7 ,application ,to be eligible for a grant under this subsection1 a ,state shall-- 7,a7 submit to the ,secretary an application1 in such manner1 at such time1 and containing such information as specified by the ,secretary2 and 7,b7 enter into an arrangement with the ,secretary under which-- 7i7 the ,state agrees to establish and maintain a localized community health improvement program described in paragraph 7#c72 7ii7 the ,secretary agrees to provide the ,state with integrated epidemiological and claims health information maintained in the database established under subsection 7a7 specific to each participating community within the ,state2 and 7iii7 the ,state and ,secretary carry out the community shared savings account agreement terms described in subsection 7c74 7#c7 ,localized community health improvement program ,for purposes of this subsection1 a localized community health improvement program of a ,state is a program under which the ,state-- 7,a7 maintains the integrated health information provided to the ,state by the ,secretary pursuant to the arrangement described in paragraph 7#b77;,b72 7,b7 makes such information available to qualifying communities 7as defined in paragraph 7#d77 within such ,state which request such information and agree to the terms described in subparagraph 7,d7 and subsection 7c7 7in this section referred to as participating communities7 in a secure manner and format that is most informative to such communities in assisting such communities in analyzing and applying such data to the specific needs of such communities to reduce the rates of illness and reduce the costs of health care within such communities2 7,c7 submits such data as is required by the ,secretary to assess the extent to which the health care interventions implemented to address needs of such communities identified through the program are affecting the rates of illness and costs of health care within the ,state and communities within the ,state2 and 7,d7 requires that in order for communities to participate in such program1 the communities agree-- 7i7 to provide for a secure method to make such information available to health care and other relevant community workers1 including through an interactive dashboard system2 and 7ii7 to submit such data as is required by the ,state or ,secretary to assess the extent to which health care interventions implemented to address needs of such communities identified through the program are affecting the rates of illness and costs of health care within the communities4 7#d7 ,qualifying community defined ,for purposes of this section1 the term qualifying community means a local community determined by census block or census track level 7based on geographic information system data7 with a defined jurisdictional boundary 7such as a local community established by a high school feeder pattern or by the boundaries of a town if such town has a population of fewer than #be1jjj residents7 or a county4 7#e7 ,no additional funding ,no additional funds are authorized to be appropriated to carry out this subsection4 ,this subsection shall be carried out using amounts otherwise made available to the ,secretary4 7c7 ,community shared savings account agreement terms ,for purposes of subsection 7b77#b77;,b77iii71 community shared savings account terms described in this subsection1 with respect to the ,secretary1 a participating ,state1 and participating communities within such ,state1 are the following3 7#a7 ,in the case that the database established under subsection 7a71 through the mechanism provided for under subsection 7a77#d71 demonstrates for any specified period 7as determined by the ,secretary7 that there are verified reductions in expenditures under the ,state plan under title ,,xix of the ,social ,security ,act1 which results in reductions in expenditures by the ,federal ,government under such title1 and attributes such reductions to one or more of the participating communities within such ,state1 the ,secretary shall transfer to the community shared savings account established by the ,state under subsection 7e7 an amount equal to #gj percent of the amount of such reduction so demonstrated for such specified period4 7#b7 ,the ,state establishes such a community shared savings account in accordance with subsection 7e7 and agrees to transfer to each participating community within such ,state #ajj percent of such amounts transferred under paragraph 7#a7 that are verified by the ,secretary as attributable to such community4 7#c7 ,each participating community in such ,state-- 7,a7 establishes a community shared savings board described in subsection 7d7 that determines how funds transferred to such community under paragraph 7#b7 are to be used for purposes of promoting the health and wellness of residents of such community2 and 7,b7 uses such funds only for such purposes and in accordance with the uses determined by such board4 7d7 ,community shared savings board ,for purposes of this section1 a community shared savings board1 with respect to a participating community 7which may be a county7 within a participating ,state1 is a board-- 7#a7 consisting of at least #g members1 appointed by the governing officials of the community through such a process that is specified by the community 7and approved by the ,state71 including-- 7,a7 at least #a member with public health experience2 and 7,b7 members with business1 civic1 educational1 or faith-based experience2 7#b7 that is representative of the geographic components that are included in the community2 and 7#c7 that hires a fiduciary agent to manage a community shared savings account on behalf of the board4 7e7 ,community shared savings account ,for purposes of this section1 the term community shared savings account means1 with respect to a participating community within a participating ,state1 a trust created or organized in the ,united ,states for the exclusive benefit of the community1 as defined by the community shared savings board under subsection 7d7 for such participating community1 but only if the written governing instrument creating the trust meets the following requirements3 7#a7 ,the trustee is a bank 7as defined in section #djh7n7 of the ,internal ,revenue ,code of #aihf7 or such other person who demonstrates to the satisfaction of the ,director that the manner in which such other person will administer the trust will be consistent with the requirements of this section4 7#b7 ,no contribution will be accepted unless it is in cash4 7#c7 ,withdrawals may only be made by the fiduciary agent described in subsection 7d77#c7 hired by such board pursuant to a plan developed by the community and approved by the ,state and local government4