,,ii #aagth ,,congress #ast ,session ,s4 #cjci ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,october #ba1 #bjba,mr4 ,young 7for himself and ,ms4 ,stabenow7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xi of the ,social ,security ,act to establish an interagency council on social determinants of health1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,social ,determinants ,accelerator ,act of #bjba4 #b4 ,social ,determinants ,accelerator ,council ,title ,,xi of the ,social ,security ,act 7#db ,u4,s4,c4 #acja et seq47 is amended by adding at the end the following new part3 ,e ,social ,determinants of ,health #aaia4 ,social ,determinants ,accelerator ,council 7a7 ,establishment ,the ,secretary1 in consultation with the ,administrator of the ,centers for ,medicare ,medicaid ,services1 the ,administrator of the ,health ,resources and ,services ,administration1 the ,director of the ,centers for ,disease ,control and ,prevention1 the ,director of the ,agency for ,healthcare ,research and ,quality1 and the ,director of the ,indian ,health ,service1 shall establish an interagency council1 to be known as the ,social ,determinants ,accelerator ,interagency ,council 7referred to in this part as the ,council7 to achieve the purposes of-- 7#a7 establishing effective1 coordinated ,federal technical assistance to help ,state and local governments to improve outcomes and cost-effectiveness of1 and return on investment from1 health and social services programs2 7#b7 building a pipeline of ,state and locally designed1 cross-sector interventions and strategies that generate rigorous evidence about how to improve health and social outcomes1 and increase the cost-effectiveness of1 and return on investment from1 ,federal1 ,state1 local1 and ,tribal health and social services programs2 7#c7 enlisting ,state and local governments and the service providers of such governments as partners in identifying ,federal statutory1 regulatory1 and administrative challenges in improving the health and social outcomes of1 cost-effectiveness of1 and return on investment from1 ,federal spending on individuals receiving medical assistance under a ,state plan 7or a waiver of such plan7 under title ,,xix2 and 7#d7 developing strategies to improve health and social outcomes without denying services to1 or restricting the eligibility of1 vulnerable populations4 7b7 ,membership 7#a7 ,federal members ,the ,council shall be composed of at least #a designee from each of the following ,federal agencies3 7,a7 ,the ,office of ,management and ,budget4 7,b7 ,the ,department of ,agriculture4 7,c7 ,the ,department of ,education4 7,d7 ,the ,department of ,housing and ,urban ,development4 7,e7 ,the ,department of ,labor4 7,f7 ,the ,department of ,transportation4 7,g7 ,any other ,federal agency the ,chair of the ,council determines necessary4 7#b7 ,designation 7,a7 ,in general ,the head of each agency specified in paragraph 7#a7 shall designate at least #a employee described in subparagraph 7,b7 to serve as a member of the ,council4 7,b7 ,responsibilities ,an employee described in this subparagraph shall be a senior employee of the agency-- 7i7 whose responsibilities relate to authorities1 policies1 and procedures with respect to the health and well-being of individuals receiving medical assistance under a ,state plan 7or a waiver of such plan7 under title ,,xix2 or 7ii7 who has authority to implement and evaluate transformative initiatives that harness data or who conducts rigorous evaluation to improve the impact and cost-effectiveness of federally funded services and benefits4 7#c7 ,,hhs representation ,in addition to the designees under paragraph 7#a71 the ,council shall include designees from agencies within the ,department of ,health and ,human ,services1 including the ,centers for ,medicare ,medicaid ,services1 the ,agency for ,healthcare ,research and ,quality1 the ,centers for ,disease ,control and ,prevention1 the ,health ,resources and ,services ,administration1 and the ,indian ,health ,service4 ,the designees of each such agency shall include at least #a designee who meets the criteria under paragraph 7#b77;,b74 7#d7 ,non-federal members ,the ,council shall include at least #i non-,federal members1 to be designated by the ,secretary1 with experience in improving the impact and cost-effectiveness of ,federal ,government health and social services1 of which-- 7,a7 at least #a such member shall be a director of a ,state or local human services agency2 7,b7 at least #a such member shall be a director of a ,tribal health authority2 7,c7 at least #a such member shall be a director of a public housing authority or ,state housing finance agency2 7,d7 at least #a such member shall be a director of a ,state or local government budget office2 7,e7 at least #a such member shall be a ,state ,medicaid program director2 7,f7 at least #a such member shall be from a ,state office of rural health2 7,g7 at least #a such member shall be a representative from a national consumer or patient advocacy organization2 7,h7 at least #a such member shall be a primary care provider with clinical experience working in medically underserved populations2 and 7,i7 at least #a such member shall be a representative from a commercial health plan4 7#e7 ,chair ,the ,secretary shall select the ,chair of the ,council from among the members of the ,council4 7c7 ,duties ,the duties of the ,council are-- 7#a7 to make recommendations to the ,secretary regarding the criteria for making awards under section #aaib2 7#b7 to identify ,federal authorities and opportunities for use by ,states or local governments to improve coordination of funding and administration of ,federal programs that serve individuals with significant unmet health and social needs1 as defined by the ,secretary1 and for whom coordinated health and social interventions may be unknown or underutilized2 7#c7 to make information on such authorities and opportunities publicly available2 7#d7 to provide targeted technical assistance to ,states developing social determinants of health interventions2 7#e7 to report to ,congress annually in accordance with subsection 7e72 7#f7 solicit feedback from ,state1 local1 and ,tribal governments on best practices for addressing social determinants of health and for coordinating health and social service programs2 7#g7 to develop and disseminate such best practices2 7#h7 to develop and disseminate performance measures to reliably assess the impact of local interventions or approaches2 7#i7 to coordinate with other cross-agency initiatives focused on improving the health and well-being of low-income and at-risk populations in order to prevent unnecessary duplication between agency initiatives2 and 7#aj7 to draft and make publicly available a report on ,federal cross-agency opportunities to address social determinants of health1 which shall include the benefits of grants to ,state1 local1 or ,tribal jurisdictions4 7d7 ,schedule ,not later than #ij days after the date of the enactment of the ,social ,determinants ,accelerator ,act of #bjba1 the ,council shall convene to develop a schedule and plan for carrying out the duties described in subsection 7c71 including solicitation of applications for the grants under section #aaib4 7e7 ,report to ,congress ,the ,council shall submit an annual report to ,congress1 which shall include-- 7#a7 a list of the ,council members2 7#b7 summaries of the activities and expenditures of the ,council2 7#c7 summaries of the interventions and approaches that will be supported by ,state1 local1 and ,tribal governments that received a grant under section #aaib1 including evidence-based best practices and approaches grantees have employed to improve health outcomes1 and improve the cost-effectiveness of1 and return on investment from1 ,federal1 ,state1 local1 and ,tribal governments2 7#d7 the feedback received from ,state and local governments on ways to improve the technical assistance of the ,council1 and actions the ,council plans to take in response to such feedback2 and 7#e7 the major statutory1 regulatory1 and administrative challenges identified by ,state1 local1 and ,tribal governments that received a grant under section #aaib1 and the actions that ,federal agencies are taking to address such challenges4 7f7 ,,faca applicability ,the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to the ,council4 7g7 ,council procedures ,the ,secretary1 in consultation with the ,comptroller ,general of the ,united ,states and the ,director of the ,office of ,management and ,budget1 shall establish procedures for the ,council to-- 7#a7 ensure that adequate resources are available to effectively execute the responsibilities of the ,council2 7#b7 effectively coordinate with other relevant advisory bodies and working groups to avoid unnecessary duplication2 7#c7 create transparency to the public and ,congress with regard to ,council membership1 costs1 and activities1 including through use of modern technology and social media to disseminate information2 and 7#d7 avoid conflicts of interest that would jeopardize the ability of the ,council to make decisions and provide recommendations4 #aaib4 ,grants to address social determinants of health 7a7 ,grants to ,states1 local governments1 and ,tribes ,the ,secretary1 in consultation with the ,council1 shall award on a competitive basis up to #be grants to eligible applicants described in subsection 7b7 for addressing social determinants of health in underserved populations4 ,not later than #ahj days after the date of the enactment of the ,social ,determinants ,accelerator ,act of #bjba1 the ,secretary shall award all such grants4 7b7 ,eligible applicant ,in order to be eligible to apply for a grant under this section1 an entity shall be-- 7#a7 a ,state1 local1 territorial1 or ,tribal health agency or organization2 7#b7 a qualified nongovernmental entity1 as defined by ,secretary2 or 7#c7 a consortium of entities that includes a ,state1 local1 territorial1 or ,tribal health agency or organization4 7c7 ,amount of grant ,the ,secretary1 in coordination with the ,council1 shall determine the total amount that the ,secretary will make available to each grantee under this section4 7d7 ,application ,an eligible applicant seeking a grant under this section shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require1 and submit a proposed process for developing a social determinants accelerator plan in accordance with subsection 7e74 7e7 ,use of funds ,a grant under this section shall be used-- 7#a7 to engage qualified research experts to advise on research relevant to1 and to design1 a proposed social determinants accelerator plan1 in accordance with standards and guidelines issued by the ,secretary2 7#b7 to collaborate with the ,council to support the development of a social determinants accelerator plan2 7#c7 to prepare and submit a final social determinants accelerator plan to the ,secretary2 and 7#d7 to address social determinants of health in a target community in a ,state1 county1 city1 or other municipality1 by designing and implementing innovative1 evidence-based1 cross-sector strategies to improve the health and well-being of individuals in such community through the implementation of the final social determinants accelerator plan4 7f7 ,priority ,in awarding grants under this section1 the ,secretary shall prioritize applicants proposing to serve target communities with significant unmet health and social needs1 as defined by the ,secretary4 7g7 ,contents of plans ,a social determinants accelerator plan developed through a grant under this section shall include the following3 7#a7 ,a description of the population 7or populations7 in the target community that would benefit from implementation of the social determinants accelerator plan1 including an analysis describing the projected impact on the well-being of individuals described in subsection 7e77#d74 7#b7 ,a description of the interventions or approaches designed under the social determinants accelerator plan and the evidence for selecting such interventions or approaches4 7#c7 ,the objectives and outcome goals of such interventions or approaches1 including at least #a health outcome and at least #a other important social outcome4 7#d7 ,a plan for accessing and linking relevant data to enable coordinated benefits and services for the relevant jurisdictions and an evaluation of the proposed interventions and approaches4 7#e7 ,a description of the ,state1 local1 ,tribal1 academic1 nonprofit1 or community-based organizations1 or any other private sector organizations that would participate in implementing the proposed interventions or approaches1 and the role each would play to contribute to the success of the proposed interventions or approaches4 ,such entities may include-- 7,a7 health systems2 7,b7 payors1 including1 as appropriate1 medicaid managed care entities 7as defined in section #aijc7m77#a77;,a771 ,medicare ,advantage plans under part ,c of title ,,xviii1 and health insurance issuers and group health plans 7as such terms are defined in section #bgia of the ,public ,health ,service ,act72 7,c7 other relevant stakeholders and initiatives in areas of need1 such as the ,accountable ,health ,communities ,model of the ,centers for ,medicare ,medicaid ,services1 health homes under the ,medicaid program under title ,,xix1 community-based organizations1 and human services organizations2 7,d7 other non-health care sector organizations1 including organizations focusing on transportation1 housing1 or food access2 and 7,e7 local employers4 7#f7 ,the identification of any supplemental funding sources that would be used to finance the proposed interventions or approaches4 7#g7 ,a description of any financial incentives that may be provided1 including outcome-focused contracting approaches to encourage service providers and other partners to improve outcomes of1 cost-effectiveness of1 and return on investment from1 ,federal1 ,state1 local1 or ,tribal government spending4 7#h7 ,the identification of the applicable ,federal1 ,state1 local1 or ,tribal statutory and regulatory authorities1 including waiver authorities1 to be leveraged to implement the proposed interventions or approaches4 7#i7 ,a description of potential considerations that would enhance the impact1 scalability1 or sustainability of the proposed interventions or approaches and the actions the grant awardee would take to address such considerations4 7#aj7 ,a evaluation plan1 to be carried out by an independent evaluator1 to measure the impact of the proposed interventions or approaches on the outcomes of1 cost-effectiveness of1 and return on investment from1 ,federal1 ,state1 local1 and ,tribal governments4 7#aa7 ,precautions for ensuring that vulnerable populations will not be denied access to the ,medicaid program under title ,,xix or other essential services as a result of implementing the social determinants accelerator plan4 7h7 ,monitoring and evaluation ,as a condition of receipt of a grant under this section1 a grantee shall agree to submit an annual report to the ,secretary describing the activities carried out through the grant and the outcomes of such activities4 7i7 ,independent national evaluation 7#a7 ,in general ,not later than #c years after the first grants are awarded under this section1 the ,secretary shall provide for the commencement of an independent national evaluation of the program under this section4 7#b7 ,report to congress ,not later than #ij days after receiving the results of such independent national evaluation1 the ,secretary shall report such results to the ,congress4 7j7 ,authorization of appropriations 7#a7 ,in general ,there is authorized to be appropriated to the ,secretary #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf to carry out this section4 7#b7 ,reservation ,of the funds made available to carry out this section1 the ,secretary shall reserve not less than #bj percent to award grants to eligible applicants for the development of social determinants accelerator plans under this section intended to serve rural populations4 4