REDUCE Act of 2020

II 116TH CONGRESS 2D SESSION S. 3169 To direct the Secretary of Health and Human Services to carry out a Health in All Policies Demonstration Project, and for other purposes. IN THE SENATE OF THE UNITED STATES JANUARY 8, 2020 Mr. BOOKER introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To direct the Secretary of Health and Human Services to carry out a Health in All Policies Demonstration Project, 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 ‘‘Researching and End- 4 ing Disparities by Understanding and Creating Equity Act 5 of 2020’’ or the ‘‘REDUCE Act of 2020’’. 6 SEC. 2. HEALTH IN ALL POLICIES DEMONSTRATION 7 PROJECT. 8 (a) IN GENERAL.—The Secretary of Health and 9 Human Services (in this section referred to as the ‘‘Sec- 10 VerDate Sep 11 2014 22:17 Jan 13, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 2 •S 3169 IS retary’’) acting through the Director of the Centers for 1 Disease Control and Prevention and in coordination with 2 relevant agencies including the Department of Education, 3 the Department of Agriculture, the Department of Hous- 4 ing and Urban Development, the Department of Justice, 5 the Department of Labor, the Environmental Protection 6 Agency, and the Department of Transportation, shall im- 7 plement a grant program, to be known as the Health in 8 All Policies Demonstration Project. 9 (b) GRANTS.—In carrying out subsection (a), the 10 Secretary shall award grants to eligible entities to estab- 11 lish, implement, or enhance, in the jurisdiction of the re- 12 spective entity, a collaborative, interdisciplinary, and com- 13 munity-focused approach to improve the health of all com- 14 munities and individuals that— 15 (1) integrates and articulates health consider- 16 ations in policymaking across sectors; 17 (2) addresses— 18 (A) health; 19 (B) equity; and 20 (C) sustainability; and 21 (3) targets a significant proportion of Medicare 22 beneficiaries, Medicare-Medicaid dual eligibles, or 23 long-term care Medicaid recipients. 24 VerDate Sep 11 2014 22:34 Jan 09, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 3 •S 3169 IS (c) EVALUATION.—The Secretary shall identify 1 metrics for evaluating the implementation of a grant 2 under this section and, using such metrics, evaluate each 3 grantee on the extent to which the approach implemented 4 through the grant— 5 (1) supports intersectoral collaboration; 6 (2) benefits multiple partners; 7 (3) engages stakeholders; 8 (4) creates structural or procedural change; 9 (5) impacts or relates to a model or demonstra- 10 tion project administered by the Centers for Medi- 11 care & Medicaid Services, such as an advanced pay- 12 ment model; and 13 (6) provides cost savings, delivers efficiencies, 14 and improves overall health, including health dis- 15 parity reduction and health equity improvements. 16 (d) ELIGIBILITY.—To be eligible to receive a grant 17 under this section, an entity shall— 18 (1) be a State, territory, Indian Tribe, or local 19 governmental entity; and 20 (2) submit an application to the Secretary at 21 such time, in such manner, and containing such in- 22 formation as the Secretary may require. 23 VerDate Sep 11 2014 22:34 Jan 09, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 4 •S 3169 IS (e) PRIORITIZATION; GEOGRAPHICAL DIVERSITY.— 1 In awarding grants under this section, the Secretary 2 shall— 3 (1) give priority to eligible entities seeking to 4 use a grant to improve, as described in subsection 5 (b), the health of populations that— 6 (A) are target populations described in 7 subsection (b)(3); and 8 (B) have significant health inequities 9 throughout the populations; and 10 (2) seek to ensure geographical diversity among 11 grantees. 12 (f) REPORTS BY GRANTEES.—As a condition on re- 13 ceipt of a grant under this section, the Secretary shall re- 14 quire grantees to— 15 (1) provide a report to the Secretary upon com- 16 pletion of the Health in All Policies Demonstration 17 Project; and 18 (2) include in such report the extent to which 19 the approach implemented achieved the goals listed 20 in paragraphs (1) through (6) of subsection (c). 21 (g) REPORT TO CONGRESS.— 22 (1) SUBMISSION.—The Secretary shall submit 23 to Congress— 24 VerDate Sep 11 2014 22:34 Jan 09, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 5 •S 3169 IS (A) not later than one year after the date 1 of enactment of this Act, an initial report on 2 the Health in All Policies Demonstration 3 Project; and 4 (B) not later than one year after the com- 5 pletion of the project, a final report on the 6 project. 7 (2) CONTENTS OF INITIAL REPORT.—The re- 8 port under paragraph (1)(A) shall include— 9 (A) evaluation the success of soliciting ap- 10 plications; 11 (B) identification of the number of applica- 12 tions received; 13 (C) specification of the timeline for award- 14 ing funding; and 15 (D) identification of barriers to imple- 16 menting the Health in All Policies Demonstra- 17 tion Project, if any. 18 (3) CONTENTS OF FINAL REPORT.—The report 19 under paragraph (1)(B) shall include— 20 (A) an assessment of the Health in All 21 Policies Demonstration Project, including an 22 evaluation of the effectiveness of the Dem- 23 onstration Project; and 24 VerDate Sep 11 2014 22:34 Jan 09, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 6 •S 3169 IS (B) recommendations for Federal legisla- 1 tive actions to— 2 (i) integrate, based on such assess- 3 ment, a collaborative and interdisciplinary 4 approach to improve the health of all com- 5 munities; and 6 (ii) support eligible entities in pur- 7 suing a comparable integration of such an 8 approach across State programs. 9 (h) DEFINITIONS.—In this section: 10 (1) The term ‘‘Medicare beneficiaries’’ means 11 individuals entitled to part A of title XVIII of the 12 Social Security Act (42 U.S.C. 1395c et seq.) and 13 enrolled under part B of such title (42 U.S.C. 1395j 14 et seq.). 15 (2) The term ‘‘Medicare-Medicaid dual eligi- 16 bles’’ means individuals who are dually eligible for 17 benefits under title XVIII of the Social Security Act 18 (42 U.S.C. 1395 et seq.) and title XIX of such Act 19 (42 U.S.C. 1396 et seq.). 20 (i) AUTHORIZATION OF APPROPRIATIONS.—To carry 21 out this section, there is authorized to be appropriated 22 $2,000,000 for the period of fiscal years 2021 through 23 2024. 24 VerDate Sep 11 2014 02:32 Jan 11, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 7 •S 3169 IS SEC. 3. NATIONAL ACADEMIES OF SCIENCES, ENGINEER- 1 ING, AND MEDICINE REPORT. 2 (a) IN GENERAL.—The Secretary of Health and 3 Human Services shall seek to enter into an arrangement, 4 not later than 60 days after the date of enactment of this 5 Act, with the National Academies of Sciences, Engineer- 6 ing, and Medicine (or if the Academies decline to enter 7 into such arrangement, another appropriate entity) under 8 which the Academies (or other appropriate entity) agrees 9 to prepare a report on eliminating health disparities to im- 10 prove health equity. 11 (b) REPORT.— 12 (1) CONTENTS.—The report prepared pursuant 13 to subsection (a) shall— 14 (A) review evidence on how social deter- 15 minants of health affect health outcomes among 16 middle-income Medicare beneficiaries and Medi- 17 care-Medicaid dual eligibles; 18 (B) examine successful interventions, in- 19 cluding with respect to health outcomes, that 20 address social determinants of health (including 21 transportation, meals, housing, access to health 22 care, personal care assistance, and access to 23 long-term services and supports), reduce health 24 disparities, and improve health equity; 25 (C) make conclusions regarding— 26 VerDate Sep 11 2014 22:34 Jan 09, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 8 •S 3169 IS (i) the effectiveness of existing pro- 1 grams and policies of the Centers for 2 Medicare & Medicaid Services intended to 3 reduce health disparities; 4 (ii) best practices and successful 5 strategies that reduce health disparities; 6 and 7 (iii) efforts needed to address health 8 disparities related to health care workforce 9 shortages; and 10 (D) make recommendations regarding— 11 (i) priorities for health disparities 12 interventions within Federal health care 13 programs; and 14 (ii) potential opportunities for expan- 15 sion or replication of successful interven- 16 tions and payment models to reduce health 17 disparities and improve health equity. 18 (2) SUBMISSION.—The arrangement under sub- 19 section (a) shall require the National Academies of 20 Sciences, Engineering, and Medicine (or other ap- 21 propriate entity), not later than 18 months after en- 22 tering into such arrangement, to finalize the report 23 prepared pursuant to such arrangement and submit 24 such report to the Committees on Energy and Com- 25 VerDate Sep 11 2014 22:34 Jan 09, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 9 •S 3169 IS merce and Ways and Means of the House of Rep- 1 resentatives and the Committees on Finance and 2 Health, Education, Labor, and Pensions of the Sen- 3 ate. 4 (c) DEFINITIONS.—In this section: 5 (1) The term ‘‘health equity’’ means a State 6 where all individuals are able to attain their full 7 health potential and no one is hindered from achiev- 8 ing this potential due to social position or another 9 socially determined circumstance. 10 (2) The term ‘‘middle-income Medicare bene- 11 ficiaries’’ means individuals entitled to part A of 12 title XVIII of the Social Security Act (42 U.S.C. 13 1395c et seq.) and enrolled under part B of such 14 title (42 U.S.C. 1395j et seq.) who have an income 15 that is not below 125 percent of the poverty line ap- 16 plicable to a family of the size involved, but not 17 more than 400 percent of the poverty line so appli- 18 cable. 19 (3) The term ‘‘Medicare-Medicaid dual eligi- 20 bles’’ means individuals who are dually eligible for 21 benefits under title XVIII of the Social Security Act 22 (42 U.S.C. 1395 et seq.) and title XIX of such Act 23 (42 U.S.C. 1396 et seq.). 24 VerDate Sep 11 2014 02:32 Jan 11, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS 10 •S 3169 IS (4) The term ‘‘social determinants of health’’ 1 refers to the conditions in the environments in which 2 people live, learn, work, play, worship, and age that 3 affect a wide range of health, functioning, and qual- 4 ity-of-life outcomes and risks. 5 Æ VerDate Sep 11 2014 02:32 Jan 11, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\S3169.IS S3169 jbell on DSKJLSW7X2PROD with BILLS