Social Determinants Accelerator Act of 2019

II 116TH CONGRESS 1ST SESSION S. 2986 To amend part A of title XI of the Social Security Act to establish an interagency council on social determinants of health, and for other purposes. IN THE SENATE OF THE UNITED STATES DECEMBER 5, 2019 Mr. YOUNG (for himself and Ms. STABENOW) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend part A of title XI of the Social Security Act to establish an interagency council on social determinants of health, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Social Determinants 4 Accelerator Act of 2019’’. 5 SEC. 2. SOCIAL DETERMINANTS ACCELERATOR COUNCIL. 6 Part A of title XI of the Social Security Act (42 7 U.S.C. 1301 et seq.) is amended by inserting after section 8 1139B, the following new section: 9 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 2 •S 2986 IS ‘‘SEC. 1139C. SOCIAL DETERMINANTS ACCELERATOR COUN- 1 CIL. 2 ‘‘(a) ESTABLISHMENT.—There is established an 3 interagency council to be known as the Social Deter- 4 minants Accelerator Interagency Council (referred to in 5 this section as the ‘Council’). 6 ‘‘(b) MEMBERSHIP.— 7 ‘‘(1) FEDERAL COMPOSITION.—The Council 8 shall be composed of at least 1 designee from each 9 of the following Federal agencies: 10 ‘‘(A) The Office of Management and 11 Budget. 12 ‘‘(B) The Department of Agriculture. 13 ‘‘(C) The Department of Education. 14 ‘‘(D) The Indian Health Service. 15 ‘‘(E) The Department of Housing and 16 Urban Development. 17 ‘‘(F) The Department of Labor. 18 ‘‘(G) The Department of Transportation. 19 ‘‘(H) The Department of Justice. 20 ‘‘(I) Any other Federal agency the Chair of 21 the Council determines necessary. 22 ‘‘(2) DESIGNATION.— 23 ‘‘(A) IN GENERAL.—The head of each 24 agency specified in paragraph (1) shall des- 25 ignate at least one employee described in sub- 26 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 3 •S 2986 IS paragraph (B) to serve as a member of the 1 Council. 2 ‘‘(B) RESPONSIBILITIES.—An employee 3 described in this subparagraph shall be a senior 4 employee of the agency— 5 ‘‘(i) whose leadership responsibilities 6 relate to authorities, policies, and proce- 7 dures with respect to the health and well- 8 being of individuals receiving medical as- 9 sistance under a State plan (or a waiver of 10 such plan) under title XIX; or 11 ‘‘(ii) who has authority to implement 12 and evaluate initiatives that harness data 13 or conducts rigorous evaluation to improve 14 the impact and cost-effectiveness of feder- 15 ally funded services and benefits. 16 ‘‘(3) HHS REPRESENTATION.—In addition to 17 the designees under paragraph (1), the Council shall 18 include designees from at least 3 agencies within the 19 Department of Health and Human Services, includ- 20 ing the Centers for Medicare & Medicaid Services, 21 who shall meet the criteria under paragraph (2)(B). 22 ‘‘(4) NON-FEDERAL COMPOSITION.—The Comp- 23 troller General of the United States may designate 24 up to 6 Council designees— 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 4 •S 2986 IS ‘‘(A) who have relevant subject matter ex- 1 pertise, including expertise implementing and 2 evaluating initiatives that harness data and 3 conduct evaluations to improve the impact and 4 cost-effectiveness of Federal Government serv- 5 ices; and 6 ‘‘(B) that each represent— 7 ‘‘(i) State, local, and Tribal health 8 and human services agencies; 9 ‘‘(ii) public housing authorities or 10 State housing finance agencies; 11 ‘‘(iii) State and local government 12 budget offices; 13 ‘‘(iv) State Medicaid agencies; or 14 ‘‘(v) national consumer advocacy orga- 15 nizations. 16 ‘‘(5) CHAIR.— 17 ‘‘(A) IN GENERAL.—The Chair of the 18 Council shall be the representative from the Of- 19 fice of Management and Budget to— 20 ‘‘(i) ensure a government-wide and 21 multi-agency response, when applicable; 22 and 23 ‘‘(ii) facilitate the timely resolution of 24 government-wide and multi-agency issues 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 5 •S 2986 IS to help the Council achieve consensus rec- 1 ommendations described under subsection 2 (c)(1). 3 ‘‘(B) INITIATING GUIDANCE.—The Chair, 4 on behalf of the Council, shall identify and in- 5 vite individuals from diverse entities to provide 6 the Council with advice and information per- 7 taining to addressing social determinants of 8 health, including— 9 ‘‘(i) individuals from State and local 10 government health and human services 11 agencies; 12 ‘‘(ii) individuals from State Medicaid 13 agencies; 14 ‘‘(iii) individuals from State and local 15 government budget offices; 16 ‘‘(iv) individuals from public housing 17 authorities or State housing finance agen- 18 cies; 19 ‘‘(v) individuals from nonprofit orga- 20 nizations, small businesses, and philan- 21 thropic organizations; 22 ‘‘(vi) advocates; 23 ‘‘(vii) researchers; and 24 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 6 •S 2986 IS ‘‘(viii) any other individuals the Chair 1 determines to be appropriate. 2 ‘‘(c) DUTIES.—The duties of the Council are— 3 ‘‘(1) to make recommendations to the Secretary 4 regarding the criteria for making awards under sub- 5 section (g); 6 ‘‘(2) to identify Federal authorities and oppor- 7 tunities for use by States or local governments to 8 improve coordination of funding and administration 9 of Federal programs, and which may be unknown to 10 or underutilized by State or local governments and 11 to make information on such authorities and oppor- 12 tunities publicly available; 13 ‘‘(3) to provide targeted technical assistance to 14 States developing models focused on case manage- 15 ment of individuals receiving services administered 16 by State or local health and social services agencies, 17 including by identifying potential statutory or regu- 18 latory pathways for implementation of the models 19 and assisting in identifying potential sources of 20 funding to implement the models; 21 ‘‘(4) to report to Congress annually on the sub- 22 jects set forth in subsection (e); 23 ‘‘(5) to develop and disseminate evaluation 24 guidelines and standards that can be used to reliably 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 7 •S 2986 IS assess the impact of an intervention or approach 1 that may be implemented pursuant to this section on 2 outcomes, cost-effectiveness of, and return on invest- 3 ment from Federal, State, local, and Tribal govern- 4 ments, and to facilitate technical assistance, where 5 needed, to help to improve State and local evaluation 6 designs and implementation; 7 ‘‘(6) to seek feedback from State, local, and 8 Tribal governments on how to improve the technical 9 assistance the Council provides to better equip State, 10 local, and Tribal governments to coordinate health 11 and social service programs; 12 ‘‘(7) to solicit applications for grants under 13 subsection (g); and 14 ‘‘(8) to coordinate with other cross-agency ini- 15 tiatives focused on improving the health and well- 16 being of low-income and at-risk populations in order 17 to prevent unnecessary duplication between agency 18 initiatives. 19 ‘‘(d) SCHEDULE.—Not later than 60 days after the 20 date of the enactment of this section, the Council shall 21 convene to develop a schedule and plan for carrying out 22 the duties described in subsection (c), including solicita- 23 tion of applications for the grants under subsection (g). 24 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 8 •S 2986 IS ‘‘(e) REPORT TO CONGRESS.—The Council shall sub- 1 mit an annual report to Congress, which shall include— 2 ‘‘(1) a list of the Council members; 3 ‘‘(2) activities and expenditures of the Council; 4 ‘‘(3) summaries of the approaches that will be 5 supported by State, local, and Tribal governments 6 that received a grant under subsection (g) includ- 7 ing— 8 ‘‘(A) evidence-based approaches such gov- 9 ernments plan to employ to, at a minimum, ad- 10 dress the economic, social, and health needs of 11 the affected populations; and 12 ‘‘(B) a description of how the practices 13 and approaches will impact the outcomes, cost- 14 effectiveness of, and return on investment from, 15 Federal, State, local, and Tribal governments 16 with respect to such purposes; and 17 ‘‘(4) the major barriers identified by State, 18 local, and Tribal governments that received a grant 19 under subsection (g), and the actions that Federal 20 agencies are taking to address such challenges. 21 ‘‘(f) COUNCIL PROCEDURES.—The Director of the 22 Office of Management and Budget, in consultation with 23 the Comptroller General of the United States, shall estab- 24 lish procedures for the Council to— 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 9 •S 2986 IS ‘‘(1) ensure that adequate resources are avail- 1 able to effectively execute the responsibilities of the 2 Council; 3 ‘‘(2) effectively coordinate with other relevant 4 advisory bodies and working groups to avoid unnec- 5 essary duplication; 6 ‘‘(3) create transparency to the public and Con- 7 gress with regard to Council membership, costs, and 8 activities to disseminate information; and 9 ‘‘(4) avoid conflicts of interest that would jeop- 10 ardize the ability of the Council to make decisions 11 and provide recommendations. 12 ‘‘(g) SOCIAL DETERMINANTS ACCELERATOR GRANTS 13 TO STATES OR LOCAL GOVERNMENTS.— 14 ‘‘(1) GRANTS TO STATES, LOCAL GOVERN- 15 MENTS, AND TRIBES.—Not later than 180 days after 16 the date of the enactment of this section, the Sec- 17 retary, in consultation with the Council, shall award 18 on a competitive basis not more than 25 grants to 19 eligible applicants described in paragraph (2), for 20 the development of social determinants accelerator 21 plans, as described in paragraph (6). 22 ‘‘(2) ELIGIBLE APPLICANT.—An eligible appli- 23 cant described in this paragraph is a State, local, or 24 Tribal health or human services agency that— 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 10 •S 2986 IS ‘‘(A) demonstrates the support of relevant 1 parties across relevant State, local, or Tribal ju- 2 risdictions; and 3 ‘‘(B) in the case of an applicant that is a 4 local government agency, provides to the Sec- 5 retary a letter of support from the lead State 6 health or human services agency for the State 7 in which the local government is located. 8 ‘‘(3) AMOUNT OF GRANT.—The Secretary, in 9 coordination with the Council, shall determine the 10 total amount that the Secretary will make available 11 to each grantee under this subsection. 12 ‘‘(4) APPLICATION.—An eligible applicant seek- 13 ing a grant under this subsection shall include in the 14 application the following information: 15 ‘‘(A) The target population (or popu- 16 lations) that would benefit from implementation 17 of the social determinants accelerator plan pro- 18 posed to be developed by the applicant. 19 ‘‘(B) A description of the objective or ob- 20 jectives and outcome goals of such proposed 21 plan, which shall include at least 1 health out- 22 come and at least 1 other important social out- 23 come. 24 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 11 •S 2986 IS ‘‘(C) The sources and scope of inefficien- 1 cies that, if addressed by the plan, could result 2 in improved cost-effectiveness of or return on 3 investment from Federal, State, local, and Trib- 4 al governments. 5 ‘‘(D) A description of potential interven- 6 tions that could be designed or enabled using 7 such proposed plan. 8 ‘‘(E) The State, local, Tribal, academic, 9 nonprofit, community-based organizations, and 10 other private sector partners that would partici- 11 pate in the development of the proposed plan 12 and subsequent implementation of programs or 13 initiatives included in such proposed plan. 14 ‘‘(F) Such other information as the Sec- 15 retary, in consultation with the Council, deter- 16 mines necessary to achieve the purposes of this 17 section. 18 ‘‘(5) USE OF FUNDS.—A recipient of a grant 19 under this subsection may use funds received 20 through the grant for the following purposes: 21 ‘‘(A) To convene and coordinate with rel- 22 evant government entities and other stake- 23 holders across sectors to assist in the develop- 24 ment of a social determinant accelerator plan. 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK79L0C42 with BILLS 12 •S 2986 IS ‘‘(B) To identify approaches to improving 1 the health and well-being of individuals receiv- 2 ing medical assistance under a State plan (or a 3 waiver of such plan) under title XIX through 4 the implementation of the proposed social deter- 5 minants accelerator plan. 6 ‘‘(C) To engage qualified research experts 7 to advise on relevant research and to design a 8 proposed evaluation plan, in accordance with 9 the standards and guidelines issued by the Sec- 10 retary. 11 ‘‘(D) To collaborate with the Council to 12 support the development of social determinants 13 accelerator plans. 14 ‘‘(E) To prepare and submit a final social 15 determinants accelerator plan to the Council. 16 ‘‘(6) CONTENTS OF PLANS.—A social deter- 17 minant accelerator plan developed with a grant made 18 under this subsection shall include the following: 19 ‘‘(A) A description of the target population 20 (or populations) that would benefit from imple- 21 mentation of the social determinants accelerator 22 plan, including an analysis describing the pro- 23 jected impact on the well-being of individuals 24 described in paragraph (5)(B). 25 VerDate Sep 11 2014 05:05 Dec 11, 2019 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S2986.IS S2986 kjohnson on DSK7 [Text truncated for display. 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