,,ii  #aah? ,,congress  #b;d ,session   
,s4 #edgd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #aa1 #bjbd,mr4
 ,"y 7= himself & ,ms4 ,/ab5[7 introduc$
 ! foll[+ bill2 :i* 0 read twice &      
ref]r$ to ! ,committee on ,f9ance  ,a   
,,bill  ,to am5d 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 ( #bjbd4  #b4 ,social 
,det]m9ants ,accel]ator ,c\ncil ,title  
,,xi ( ! ,social ,security ,act 7#db    
,u4,s4,c4 #acja et seq47 is am5d$ by    
add+ at ! end ! foll[+ new "p3  ,f      
,social ,det]m9ants ( ,heal?  #aaia4    
,social ,det]m9ants ,accel]ator ,c\ncil 
7a7 ,e/abli%m5t ,! ,secret>y1 9         
consultation ) ! ,adm9i/rator ( ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices1 !        
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 ! ,director ( ! 
,c5t]s = ,disease ,control & ,prev5tion1
 ! ,director ( ! ,ag5cy = ,heal?c>e     

,rese>* & ,quality1 & ! ,director ( !   
,indian ,heal? ,s]vice1 %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 "p z ! ,c\ncil7
 to a*ieve ! purposes (-- 7#a7 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 programs2    
7#b7 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 programs2
  7#c7 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 receiv+ 

m$ical assi/ance "u a ,/ate plan 7or a  
waiv] ( su* plan7 "u title ,,xix2 &     
7#d7 develop+ /rategies to improve heal?
 & social outcomes )\t d5y+ s]vices to1 
or re/rict+ ! eligibility (1 vuln]able  
populations4  7b7 ,memb]%ip  7#a7 ,f$]al
 memb]s ,! ,c\ncil %all be compos$ ( at 
lea/ #a designee f ea* ( ! foll[+ ,f$]al
 ag5cies3 7,a7 ,! ,(fice ( ,managem5t & 
,budget4  7,b7 ,! ,dep>tm5t (           
,agriculture4  7,c7 ,! ,dep>tm5t (      
,education4  7,d7 ,! ,dep>tm5t ( ,h\s+ &
 ,urban ,developm5t4  7,e7 ,! ,dep>tm5t 
( ,labor4  7,f7 ,! ,dep>tm5t (          
,transportation4  7,g7 ,any o!r ,f$]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/ #a 
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 ,,xix2 or    
7ii7 :o has au?ority to implem5t &      
evaluate trans=mative initiatives t     
h>ness data or :o 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
 ag5cies )9 ! ,dep>tm5t ( ,heal? &      
,human ,s]vices1 includ+ ! ,c5t]s =     
,m$ic>e  ,m$icaid ,s]vices1 ! ,ag5cy =  
,heal?c>e ,rese>* & ,quality1 ! ,c5t]s =
 ,disease ,control & ,prev5tion1 !      
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 & ! ,indian ,heal?       
,s]vice4 ,! designees ( ea* su* ag5cy   
%all include at lea/ #a designee :o     
meets ! crit]ia "u p>agraph 7#b77;,b74  
7#d7 ,non-f$]al memb]s ,! ,c\ncil %all  
include at lea/ #i non-,f$]al memb]s1 to
 be designat$ by ! ,secret>y1 ) exp]i5ce

 9 improv+ ! impact & co/-effectiv5ess (
 ,f$]al ,gov]nm5t heal? & social        
s]vices1 ( :i*-- 7,a7 at lea/ #a su*    
memb] %all be a director ( a ,/ate or   
local human s]vices ag5cy2  7,b7 at lea/
 #a su* memb] %all be a director ( a    
,tribal heal? au?ority2  7,c7 at lea/ #a
 su* memb] %all be a director ( a public
 h\s+ au?ority or ,/ate h\s+ f9ance     
ag5cy2  7,d7 at lea/ #a su* memb] %all  
be a director ( a ,/ate or local        
gov]nm5t budget (fice2  7,e7 at lea/ #a 
su* memb] %all be a ,/ate ,m$icaid      
program director2  7,f7 at lea/ #a su*  
memb] %all be f a ,/ate (fice ( rural   
heal?2  7,g7 at lea/ #a su* memb] %all  
be a repres5tative f a national consum] 
or pati5t advocacy organization2  7,h7  
at lea/ #a su* memb] %all be a prim>y   
c>e provid] ) cl9ical exp]i5ce work+ 9  
m$ically und]s]v$ populations2 &  7,i7  
at lea/ #a su* memb] %all be a          
repres5tative f a comm]cial heal? plan4 
7#e7 ,*air ,! ,secret>y %all select !   
,*air ( ! ,c\ncil f among ! memb]s ( !  

,c\ncil4  7c7 ,duties ,! duties ( !     
,c\ncil are-- 7#a7 to make              
recomm5dations to ! ,secret>y reg>d+ !  
crit]ia = mak+ aw>ds "u section #aaib2  
7#b7 to id5tify ,f$]al au?orities &     
opportunities = use by ,/ates or local  
gov]nm5ts to improve coord9ation ( fund+
 & adm9i/ration ( ,f$]al programs t s]ve
 individuals ) significant unmet heal? &
 social ne$s1 z def9$ by ! ,secret>y1 & 
= :om coord9at$ heal? & social          
int]v5tions may be unkn[n or            
und]utiliz$2  7#c7 to make in=mation on 
su* au?orities & opportunities publicly 
available2  7#d7 to provide t>get$      
te*nical assi/ance to ,/ates develop+   
social det]m9ants ( heal? int]v5tions2  
7#e7 to report to ,congress annually 9  
accordance ) subsection 7e72  7#f7      
solicit fe$back f ,/ate1 local1 &       
,tribal gov]nm5ts on be/ practices =    
address+ social det]m9ants ( heal? & =  
coord9at+ heal? & social s]vice         
programs2  7#g7 to develop & dissem9ate 
su* be/ practices2  7#h7 to develop &   

dissem9ate p]=mance measures to reliably
 assess ! impact ( local int]v5tions or 
approa*es2  7#i7 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     
initiatives2 &  7#aj7 to draft & make   
publicly available a report on ,f$]al   
cross-ag5cy opportunities to address    
social det]m9ants ( heal?1 :i* %all     
include ! b5efits ( grants to ,/ate1    
local1 or ,tribal jurisdictions4  7d7   
,s*$ule ,n lat] ?an #ij days aft] ! date
 ( ! enactm5t ( ! ,social ,det]m9ants   
,accel]ator ,act ( #bjbd1 ! ,c\ncil %all
 conv5e to develop a s*$ule & plan =    
c>ry+ out ! duties describ$ 9 subsection
 7c71 includ+ solicitation (            
applications = ! grants "u section      
#aaib4  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 summ>ies ( ! 
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 #aaib1 includ+         
evid5ce-bas$ be/ practices & approa*es  
grantees h employ$ to improve heal?     
outcomes1 & improve ! co/-effectiv5ess  
(1 & return on inve/m5t f1 ,f$]al1      
,/ate1 local1 & ,tribal gov]nm5ts2  7#d7
 ! fe$back receiv$ f ,/ate & local      
gov]nm5ts on ways to improve ! te*nical 
assi/ance ( ! ,c\ncil1 & 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  
#aaib1 & ! 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  #aaib4 ,grants 
to address social det]m9ants ( heal?    
7a7 ,grants to ,/ates1 local gov]nm5ts1 
& ,tribes ,! ,secret>y1 9 consultation )
 ! ,c\ncil1 %all aw>d on a competitive  
basis up to #be grants to eligible      
applicants describ$ 9 subsection 7b7 =  
address+ social det]m9ants ( heal? 9    
und]s]v$ populations4 ,n lat] ?an #ahj  
days aft] ! date ( ! enactm5t ( !       
,social ,det]m9ants ,accel]ator ,act (  

#bjbd1 ! ,secret>y %all aw>d all su*    
grants4  7b7 ,eligible applicant ,9 ord]
 to be eligible to apply = a grant "u   
?is section1 an entity %all be-- 7#a7 a 
,/ate1 local1 t]ritorial1 or ,tribal    
heal? ag5cy or organization2  7#b7 a    
qualifi$ nongov]nm5tal entity1 z def9$  
by ,secret>y2 or  7#c7 a consortium (   
entities t includes a ,/ate1 local1     
t]ritorial1 or ,tribal heal? ag5cy or   
organization4  7c7 ,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 
section4  7d7 ,application ,an eligible 
applicant seek+ a grant "u ?is section  
%all submit an application at su* "t1 9 
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 & submit a       
propos$ process = develop+ a social     
det]m9ants accel]ator plan 9 accordance 
) subsection 7e74  7e7 ,use ( funds ,a  
grant "u ?is section %all be us$-- 7#a7 
to engage qualifi$ rese>* exp]ts to     
advise on rese>* relevant to1 & to      

design1 a propos$ social det]m9ants     
accel]ator plan1 9 accordance ) /&>ds & 
guidel9es issu$ by ! ,secret>y2  7#b7 to
 collaborate ) ! ,c\ncil to support !   
developm5t ( a social det]m9ants        
accel]ator plan2  7#c7 to prep>e &      
submit a f9al social det]m9ants         
accel]ator plan to ! ,secret>y2 &  7#d7 
to address social det]m9ants ( heal? 9 a
 t>get community 9 a ,/ate1 c\nty1 city1
 or o!r municipality1 by design+ &      
implem5t+ innovative1 evid5ce-bas$1     
cross-sector /rategies to improve !     
heal? & well-be+ ( individuals 9 su*    
community ?r\gh ! implem5tation ( ! f9al
 social det]m9ants accel]ator plan4  7f7
 ,priority ,9 aw>d+ grants "u ?is       
section1 ! ,secret>y %all prioritize    
applicants propos+ to s]ve t>get        
communities ) significant unmet heal? & 
social ne$s1 z def9$ by ! ,secret>y4    
7g7 ,cont5ts ( plans ,a social          
det]m9ants accel]ator plan develop$     
?r\gh a grant "u ?is section %all       
include ! foll[+3 7#a7 ,a description ( 

! population 7or populations7 9 ! t>get 
community 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#d74  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 = !        
relevant jurisdictions & 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 ,su* 
entities may include-- 7,a7 heal?       
sy/ems2  7,b7 payors1 includ+1 z        
appropriate1 m$icaid manag$ c>e entities
 7z def9$ 9 section #aijc7m77#a77;,a771 
,m$ic>e ,advantage plans "u "p ,c (     
title ,,xviii1 & heal? insurance issu]s 
& gr\p heal? plans 7z su* t]ms are def9$
 9 section #bgia ( ! ,public ,heal?     
,s]vice ,act72  7,c7 o!r relevant       
/akehold]s & initiatives 9 areas ( ne$1 
su* z ! ,acc\ntable ,heal? ,communities 
,model ( ! ,c5t]s = ,m$ic>e  ,m$icaid   
,s]vices1 heal? homes "u ! ,m$icaid     
program "u title ,,xix1 community-bas$  
organizations1 & human s]vices          
organizations2  7,d7 o!r non-heal? c>e  
sector organizations1 includ+           
organizations focus+ on transportation1 
h\s+1 or food access2 &  7,e7 local     
employ]s4  7#f7 ,! id5tification ( any  
supplem5tal 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 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 program "u title   

,,xix or o!r ess5tial s]vices z a result
 ( implem5t+ ! social det]m9ants        
accel]ator plan4  7h7 ,monitor+ &       
evaluation ,z a condition ( receipt ( a 
grant "u ?is section1 a grantee %all    
agree to submit an annual report to !   
,secret>y describ+ ! activities c>ri$   
out ?r\gh ! grant & ! outcomes ( su*    
activities4  7i7 ,indep5d5t national    
evaluation  7#a7 ,9 g5]al ,n lat] ?an #c
 ye>s aft] ! fir/ grants are aw>d$ "u   
?is section1 ! ,secret>y %all provide = 
! comm5cem5t ( an indep5d5t national    
evaluation ( ! program "u ?is section4  
7#b7 ,report to congress ,n lat] ?an #ij
 days aft] receiv+ ! results ( su*      
indep5d5t national evaluation1 !        
,secret>y %all report su* results to !  
,congress4  7j7 ,au?orization (         
appropriations  7#a7 ,9 g5]al ,!re is   
au?oriz$ to be appropriat$ to !         
,secret>y #aj1jjj1jjj = ea* ( fiscal    
ye>s #bjbe ?r\gh #bjbi to c>ry out ?is  
section4  7#b7 ,res]vation ,( ! funds   
made available to c>ry out ?is section1 

! ,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 ?is      
section int5d$ to s]ve rural            
populations4  4