,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #bihf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #e1 #bjai,mr4 
,"y 7= himself & ,ms4 ,/ab5[7 introduc$ 
! foll[+ bill2 :i* 0 read twice & ref]r$
 to ! ,committee on ,f9ance  ,a ,,bill  
,to am5d "p ,a ( title ,,xi ( ! ,social 
,security ,act 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 ,social 
det]m9ants accel]ator c\ncil ,"p ,a (   
title ,,xi ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acja et seq47 is am5d$  
by ins]t+ aft] section #aaci;,b1 !      
foll[+ new section3  #aaci;,c4 ,social  
det]m9ants accel]ator c\ncil  7a7       
,e/abli%m5t ,!re is e/abli%$ an         
int]ag5cy c\ncil to be kn[n z ! ,social 
,det]m9ants ,accel]ator ,int]ag5cy      
,c\ncil 7ref]r$ to 9 ?is section z !    
,c\ncil74  7b7 ,memb]%ip  7#a7 ,f$]al   
composition ,! ,c\ncil %all be compos$ (
 at lea/ #a designee f ea* ( ! foll[+   

,f$]al ag5cies3 7,a7 ,! ,(fice (        
,managem5t & ,budget4  7,b7 ,! ,dep>tm5t
 ( ,agriculture4  7,c7 ,! ,dep>tm5t (   
,education4  7,d7 ,! ,indian ,heal?     
,s]vice4  7,e7 ,! ,dep>tm5t ( ,h\s+ &   
,urban ,developm5t4  7,f7 ,! ,dep>tm5t (
 ,labor4  7,g7 ,! ,dep>tm5t (           
,transportation4  7,h7 ,! ,dep>tm5t (   
,ju/ice4  7,i7 ,any o!r ,f$]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 ^: lead]%ip    
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 ,,xix2 or    
7ii7 :o has au?ority to implem5t &      
evaluate 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/ #c ag5cies  
)9 ! ,dep>tm5t ( ,heal? & ,human        
,s]vices1 includ+ ! ,c5t]s = ,m$ic>e    
,m$icaid ,s]vices1 :o %all meet !       
crit]ia "u p>agraph 7#b77;,b74  7#d7    
,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+          
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#e7 ,*air  7,a7 ,9     
g5]al ,! ,*air ( ! ,c\ncil %all be !    
repres5tative f ! ,(fice ( ,managem5t & 
,budget to-- 7i7 ensure a gov]nm5t-wide 
& multi-ag5cy response1 :5 applicable2 &
  7ii7 facilitate ! timely resolution ( 
gov]nm5t-wide & multi-ag5cy issues to   
help ! ,c\ncil a*ieve cons5sus          
recomm5dations describ$ "u subsection   
7c77#a74  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 reg>d+ ! crit]ia = mak+ aw>ds 
"u subsection 7g72  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 & :i* may be unkn[n to 
or und]utiliz$ by ,/ate or local        
gov]nm5ts & to make in=mation on su*    
au?orities & opportunities publicly     
available2  7#c7 to provide t>get$      
te*nical assi/ance to ,/ates develop+   
models focus$ on case managem5t (       
individuals receiv+ s]vices adm9i/]$ by 
,/ate or local heal? & social s]vices   
ag5cies1 includ+ by id5tify+ pot5tial   
/atutory or regulatory pa?ways =        
implem5tation ( ! models & assi/+ 9     
id5tify+ pot5tial s\rces ( fund+ to     
implem5t ! models2  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 section 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$back f ,/ate1 local1 & ,tribal       
gov]nm5ts on h[ to improve ! te*nical   
assi/ance ! ,c\ncil provides to bett]   
equip ,/ate1 local1 & ,tribal gov]nm5ts 
to coord9ate heal? & social s]vice      
programs2  7#g7 to solicit applications 
= grants "u subsection 7g72 &  7#h7 to  
coord9ate ) o!r cross-ag5cy initiatives 
focus$ on improv+ ! heal? & well-be+ (  
l[-income & at-risk populations 9 ord]  
to prev5t unnecess>y duplication betwe5 
ag5cy initiatives4  7d7 ,s*$ule ,n lat] 
?an #fj days aft] ! date ( ! enactm5t ( 
?is section1 ! ,c\ncil %all conv5e to   
develop a s*$ule & plan = c>ry+ out !   

duties describ$ 9 subsection 7c71       
includ+ solicitation ( applications = ! 
grants "u subsection 7g74  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 ( ! approa*es t 
w be support$ by ,/ate1 local1 & ,tribal
 gov]nm5ts t receiv$ a grant "u         
subsection 7g7 includ+--  7,a7          
evid5ce-bas$ approa*es su* gov]nm5ts    
plan to employ to1 at a m9imum1 address 
! economic1 social1 & heal? ne$s ( !    
affect$ populations2 &  7,b7 a          
description ( h[ ! practices & approa*es
 w impact ! outcomes1 co/-effectiv5ess  
(1 & return on inve/m5t f1 ,f$]al1      
,/ate1 local1 & ,tribal gov]nm5ts )     
respect to su* purposes2 &  7#d7 ! major
 b>ri]s id5tifi$ by ,/ate1 local1 &     
,tribal gov]nm5ts t receiv$ a grant "u  
subsection 7g71 & ! actions t ,f$]al    
ag5cies are tak+ to address su*         
*all5ges4  7f7 ,c\ncil proc$ures ,!     

,director ( ! ,(fice ( ,managem5t &     
,budget1 9 consultation ) ! ,comptroll] 
,g5]al ( ! ,unit$ ,/ates1 %all e/abli%  
proc$ures = ! ,c\ncil to--  7#a7 ensure 
t adequate res\rces are available to    
effectively execute ! responsibilities (
 ! ,c\ncil2  7#b7 effectively coord9ate 
) o!r relevant advisory bodies & work+  
gr\ps to avoid unnecess>y duplication2  
7#c7 create transp>5cy to ! public &    
,congress ) reg>d to ,c\ncil memb]%ip1  
co/s1 & activities to dissem9ate        
in=mation2 &  7#d7 avoid conflicts (    
int]e/ t w\ld jeop>dize ! ability ( !   
,c\ncil to make decisions & provide     
recomm5dations4  7g7 ,social det]m9ants 
accel]ator grants to ,/ates or local    
gov]nm5ts  7#a7 ,grants to ,/ates1 local
 gov]nm5ts1 & tribes ,n lat] ?an #ahj   
days aft] ! date ( ! enactm5t ( ?is     
section1 ! ,secret>y1 9 consultation ) !
 ,c\ncil1 %all aw>d on a competitive    
basis n m ?an #be grants to eligible    
applicants describ$ 9 p>agraph 7#b71 = !
 developm5t ( social det]m9ants         

accel]ator plans1 z describ$ 9 p>agraph 
7#f74  7#b7 ,eligible applicant ,an     
eligible applicant describ$ 9 ?is       
p>agraph 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$4  7#c7 ,am\nt ( grant
 ,! ,secret>y1 9 coord9ation ) !        
,c\ncil1 %all det]m9e ! total am\nt t ! 
,secret>y w make available to ea*       
grantee "u ?is subsection4  7#d7        
,application ,an eligible applicant     
seek+ a grant "u ?is subsection %all    
include 9 ! application ! foll[+        
in=mation3  7,a7 ,! t>get population 7or
 populations7 t w\ld b5efit f           
implem5tation ( ! social det]m9ants     
accel]ator plan propos$ to be develop$  
by ! applicant4  7,b7 ,a description ( !

 objective or objectives & outcome goals
 ( su* propos$ plan1 :i* %all include at
 lea/ #a heal? outcome & at lea/ #a 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
 ! ,secret>y1 9 consultation ) !        
,c\ncil1 det]m9es necess>y to a*ieve !  
purposes ( ?is section4  7#e7 ,use (    
funds ,a recipi5t ( a grant "u ?is      
subsection 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 approa*es to improv+ ! heal? &  
well-be+ ( individuals receiv+ m$ical   
assi/ance "u a ,/ate plan 7or a waiv] ( 
su* plan7 "u title ,,xix ?r\gh !        
implem5tation ( ! propos$ 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 ! ,secret>y4  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  7#f7     
,cont5ts ( plans ,a social det]m9ant    
accel]ator plan develop$ ) a grant made 
"u ?is subsection %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      
p>agraph 7#e77;,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/ #a heal? outcome & at   
lea/ #a o!r important social outcome4   
7,d7 ,a plan = access+ & l9k+ relevant  
data to enable coord9at$ b5efits &      
s]vices = ! jurisdictions describ$ 9    
p>agraph 7#b77;,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,j7 ,a propos$ rigor\s 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,k7 ,precautions = 

ensur+ t vuln]able populations w n be   
d5i$ access to ,m$icaid or o!r ess5tial 
s]vices z a result ( implem5t+ ! propos$
 social det]m9ants accel]ator plan4  7h7
 ,fund+  7#a7 ,9 g5]al ,out ( any money 
9 ! ,treasury n o!rwise appropriat$1 !re
 is appropriat$ to c>ry out ?is section 
#bj1jjj1jjj1 ( :i* up to #e1jjj1jjj may 
be us$ = adm9i/rative exp5ses to c>ry   
out ?is section1 to rema9 available =   
obligation until ! date t is #e ye>s    
aft] ! date ( enactm5t ( ?is section4   
7#b7 ,res]vation ( funds  7,a7 ,9 g5]al 
,( ! funds made available "u p>agraph   
7#a71 ! ,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          
subsection 7g7 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  
subsection 7g7 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
 p>agraph 7#a7 to aw>d grants = su*     
purpose4  7#c7 ,rule ( con/ruction ,no?+
 9 ?is section %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  4