Aligning for Health Comments on CMS Make Your Voice Heard RFI

Aligning for Health submitted comments in response to the CMS “Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs” Request for Information (RFI).

Through this RFI, CMS is seeking to better understand individual and community-level burdens, health-related social needs, and opportunities for improvement that can reduce disparities and promote efficiency and innovation across our programs. CMS requested information related to strategies that successfully address drivers of health inequities, including opportunities to address social determinants of health and challenges underserved communities face in accessing comprehensive, quality care.

Aligning for Health supports many of the steps that the Biden-Harris Administration has taken to prioritize equity for all, including through initiatives to address social determinants of health. Our comments focused on questions posed in the RFI as it pertains to opportunities to better understand and address health-related social needs and to embed health equity into all CMS efforts, to include:

  • The need for coordination across sectors to reduce siloes and and better coordinate health care and social services;
  • Identifying and addressing social needs and disparities through improved data collection and standardization, screening for social needs, and assessment for if health-related social needs are being met;
  • Addressing data sharing within federal health programs and ensuring community-based organizations have the capacity to assist with connecting individuals to resources to meet their needs; and other areas.

To read our comments, click here or see below:

AFH - CMS Make Your Voice Heard RFI - FINAL
2022-11-07T22:26:47+00:00November 7th, 2022|Press Release|

AFH Holds Briefing on Coordinating Funding & Data to Address SDOH

On September 29, 2022, Aligning for Health held a briefing highlighting programs and best practices on coordinating funding and data to address social determinants of health, featuring perspectives and examples from the federal government, state and local leaders, and their partners.

Addressing social determinants of health requires coordinating services, benefits, and care across both the health care and social services sectors. Often, the funding and administration of each of these programs is siloed, with minimal flexibility to leverage health care funding to pay for social needs, or to share data across programs on eligibility, enrollment, or utilization of services. Organizations across the country have long worked to close these gaps and find ways to coordinate across sectors, and recently there has been growing interest in aligning incentives and providing more flexibility and opportunities for programs to collaborate.

Speakers: 
  • Dr. Sandra Ford, Special Assistant to the President for Public Health and Science at the White House
  • Erica Coletti, CEO, Healthy Alliance
  • Sue Polis, Director, Health & Wellness, National League of Cities
  • Amy Riegel, Executive Director, Coalition on Homelessness & Housing in Ohio (COHHIO)
  • Krista Drobac, Co-Chair, Aligning for Health (moderator)
Recorded on September 29, 2022

2022-10-03T17:16:22+00:00October 3rd, 2022|Press, Press Release|

Aligning for Health Submits Comments to CMS RFI on Medicare Advantage

On August 31, Aligning for Health submitted comments in response to the CMS request for information (RFI) on the Medicare Advantage program.

Aligning for Health supports many of the steps that the Biden-Harris Administration has taken to prioritize equity for all, including through initiatives to address social determinants of health (SDOH). In our response, we provide comments to the specific questions posed in the RFI as it pertains to opportunities to address social determinants of health to advance health equity within the Medicare Advantage program.

To view the full letter, click here or see below:

Aligning for Health - CMS RFI on Medicare Advantage - FINAL
2022-09-01T19:07:47+00:00September 1st, 2022|Press Release|

Key SDOH Inclusions in FY2023 Senate Appropriations Report

On July 28, 2022, the Senate Committee on Appropriations released the Report for the Departments of Labor, Health and Human Services, and Related Agencies for Fiscal Year 2023 Appropriations. The report includes specific instructions with respect to the appropriated amounts. The House previously released its Report for the Departments of Labor, HHS, Education, and Related Agencies for FY2023 on June 29, 2022. Final text merging the House and Senate appropriations provisions will be available later this year. For reference, a list of the notable SDOH provisions included in the House report language can be found here.

Aligning for Health was thrilled to see the many inclusions to support forward movement in addressing social determinants of health, health equity, and maternal health. Notable language in the report includes:

  • CDC – Social Determinants of Health [SDOH]. — The Committee provides $100,000,000 to expand SDOH activities to all States and territories. These activities should include expanding and implementing accelerator plans and providing grants for implementation of SDOH activities. CDC should award grants to improve the capacity of governmental and non-governmental public health organizations and community organizations to address SDOH in communities; support and conduct research on best practices; and improve health outcomes and reduce health inequities by coordinating SDOH activities across CDC. The Committee urges CDC to fund and integrate knowledge from behavioral science research as part of the effort to develop new evidence-based interventions to ameliorate social determinants’ potential negative effects. The Committee believes that behavioral science research focused on understanding SDOH can increase the use of and adherence to healthy behaviors that help prevent chronic conditions such as cancer, heart disease, and diabetes.
  • CDC – Racial and Ethnic Approaches to Community Health [REACH]. — The Committee includes an increase of $10,000,000 to continue scaling this program to all States and territories, and to support grantees in building capacity for collaboration and disseminating evidence-based strategies in communities. REACH is a vital initiative to help eliminate healthcare disparities in minority communities. The Committee’s recommended level includes an increase of $4,000,000 for Good Health and Wellness in Indian Country.
  • CDC – National Center for Health Statistics. —The Committee provides an increase of $10,000,000 for CDC to expand the sample size for the National Health Interview Survey. The Committee intends for this increase to be used to support intersectional analyses of healthcare access, chronic health conditions, including long-COVID, and mental health status by race, ethnicity, sexual orientation, and gender identity. The collection of this disaggregated data should also support the Administration’s initiative to advance equity and racial justice for Asian Americans, Native Hawaiians, and Pacific Islanders and other underserved communities.
  • Office of Minority Health – Achieving Equitable Maternal Health Outcomes. —The Committee recommendation provides $7,000,000 for awards to community-based and other eligible organizations located in geographic areas with high rates of adverse maternal health outcomes, particularly among racial/ethnic minority families. The awards will support activities that include but are not limited to identifying evidence-based and evidence-informed practices for: addressing social determinants of health; promoting evidence-based health literacy, and pregnancy, childbirth, and parenting education programs; providing support from perinatal health workers; and providing culturally congruent, linguistically appropriate, and trauma-informed training to perinatal health workers.
  • HHS Office of the Secretary – Population Health Data Modernization. —The Committee notes that many healthcare providers that treat uninsured patients and Medicaid beneficiaries often lack population health management tools and modernized information technology systems to support comprehensive care for these individuals. To mitigate the risk of increasing disparities and inequity in the care for these patients, the Secretary is encouraged to develop-in coordination with ONC, HRSA and CMS-a roadmap for modernizing the technology systems used by healthcare providers that disproportionately treat underserved populations.
  • SAMHSA – Projects for Assistance in Transition from Homelessness [PATH]. – The Committee recommends $69,635,000 for PATH, which addresses the needs of individuals with serious mental illness who are experiencing homelessness or are at risk of homelessness.
  • HRSA – Community Health Centers. – The Committee provides $1,918,772,000, an increase of $170,000,000 above the fiscal year 2022 enacted level. Programs supported by this funding include community health centers, migrant health centers, healthcare for the homeless, school-based, and public housing health service grants. In addition, within the amount provided, the Committee provides up to $120,000,000 under the Federal Tort Claims Act [FTCA] (Public Law 102–501 and Public Law 104–73), available until expended.
  • HRSA – Maternity Care Target Areas [MCTAs]. —The Committee includes $5,000,000, an increase of $4,000,000 above the fiscal year 2022 enacted level, within the Corps to implement requirements contained in the Improving Access to Maternity Care Act, including establishing criteria for and identifying MCTAs and collecting and publishing data on the availability and need for maternity care health services in health professional shortage areas.

Below, we have pulled notable report language related to social determinants of health, health equity, and maternal health that were included as part of this report for the HHS Office of the Secretary, Assistant Secretary for Health, CMS, CDC, SAMHSA, HRSA, and HHS Office of Minority Health (OMH).

AFH - FY23 Senate Appropriations Report Summary - 28 July 2022
2022-08-04T19:24:45+00:00August 4th, 2022|Press, Press Release|

Aligning for Health Comments on HHS RFI on Strengthening Primary Health Care

On August 1, Aligning for Health Submitted comments in response to the Office of the Assistant Secretary for Health (OASH) request for information on the HHS Initiative to Strengthen Primary Health Care.

Aligning for Health supports the many steps that the Biden-Harris Administration has taken to prioritize equity for all, including through initiatives to address social determinants of health (SDOH). Comments were made in response to specific questions posed in the RFI as it pertains to the intersection of primary health care and SDOH in improving overall health and wellbeing. Specifically, Aligning for Health highlighted innovative initiatives from its members to address social determinants of health in the populations they serve, and outlined common barriers to addressing health and wellbeing, such as barriers to effective cross-sector coordination and partnership. Aligning for Health also proposed several recommendations for HHS to consider as it moves forward in this work, such as advancing policies and strategies that would help to coordinate eligibility and enrollment processes for cross-sector programs, working to improve the health of individuals by taking steps to address screening for social needs within primary care visits, and increasing data sharing.

To read the full comment letter, click here or see below:

Aligning for Health - HHS Initiative on Primary Health Care RFI - 8.1.22
2022-08-02T14:45:10+00:00August 2nd, 2022|Press, Press Release|

Aligning for Health Applauds SDOH Inclusions in FY2023 House Appropriations Report

On June 29, 2022, the House Committee on Appropriations released the Report for the Departments of Labor, Health and Human Services, Education and Related Agencies for Fiscal Year 2023 Appropriations. The report includes specific instructions with respect to the appropriated amounts.

Aligning for Health was thrilled to see the many inclusions to support forward movement in addressing social determinants of health, health equity, and maternal health. Notable language in the report includes:

  • CDC – Social Determinants of Health. —The Committee includes an increase of $92,000,000 to award competitive grants to State, local, territorial, or tribal jurisdictions to support the development of Social Determinants of Health Accelerator Plans, the implementation of those plans, and to improve the health of Medicaid beneficiaries. Such plans should include a description of the health and social outcome objectives of the Social Determinants Accelerator Plan; identify target populations that would benefit from implementation of the plan including Medicaid-eligible individuals; and identify non-governmental, private, or public health organizations and community organizations that would participate in the development of the plan. Grantees may use a portion of grant funding to convene government entities, public and private stakeholders, and to engage qualified research experts in developing Accelerator Plans.
  • CMS – Utilization of Z Codes for Social Determinants of Health. —The Committee commends CMS for publishing a report on the Utilization of Z codes for SDOH among Medicare FFS beneficiaries. As the report notes, the COVID–19 pandemic has disproportionately affected underserved communities. The Committee is concerned about whether the current Z codes definitions are expansive and specific enough to track the SDOH impacting underserved communities. To help reduce these barriers, the Committee encourages HHS to update the current Z code definitions and establish a national standard to review SDOH to ensure physicians nationwide use the same tools to analyze SDOH. The Committee requests a briefing within 180 days of the date of enactment of this Act on the current utilization of Z codes, how HHS suggests the Z codes definitions could be updated to better track SDOH impacting underserved communities and recommendations on how to increase the utilization of Z codes.
  • CMS – Social Determinants of Health Analytics. —The Committee is encouraged that Medicare Advantage (MA) and Medicaid Managed Care Organizations (MCOs) have stated an intent to employ strategies to address SDOH, and the Committee supports work on SDOH given historic inequities that have existed among at-risk populations like communities of color and rural communities. However, in constructing SDOH-based recommendations for beneficiaries, many health plans are regularly using what is described as ‘‘consumer data,’’ which includes clinical, social, economic, behavioral, and environmental data that is individually identified, sometimes combining or allowing other entities to combine it with protected medical information governed by Health Insurance Portability and Accountability Act of 1996. The Committee requests a report within 180 days of the date of enactment of this Act on efforts by CMS to ensure the transparency by MA and MCO plans in the use of data of beneficiaries in addressing SDOH, how CMS ensures that MA and MCO plans notify beneficiaries of the use of protected or consumer data, and how ongoing CMS work with MA and MCOs around SDOH and the use of consumer data and protected medical information aligns with and improves health equity as per the goals of Executive Order 13985 and the HHS’s Equity Action Plan.
  • HHS Office of the Secretary – Social Determinants of Health. —The Committee directs the Social Determinants Council created by House Report 116–450 to continue to provide technical assistance to jurisdictions in this program. The Committee requests a report within 90 days of the date of enactment of this Act on the status of the selection of all Council members.
  • CDC – Racial and Ethnic Approaches to Community Health (REACH).The Committee includes a total increase of $10,000,000 to continue scaling this program to all States and territories, and to support grantees in building capacity for collaboration and disseminating evidence-based strategies in communities. REACH is a vital initiative to help eliminate healthcare disparities in minority communities. The Committee’s recommended level includes an increase of $4,000,000 for Good Health and Wellness in Indian Country.
  • HRSA – Addressing Emerging Issues and Social Determinants of Maternal Health. — The Committee includes $10,000,000 to create an innovation fund for community-based organizations to support reducing maternal mortality and adverse maternal outcomes, as described in the fiscal year 2023 budget request. Projects may include expanding access to maternal mental health and SUD services, providing resources to address social determinants of maternal health, developing digital tools to enhance maternal health care, and technology-enabled collaborative learning and capacity building models for pregnant and postpartum women.

Below, we have pulled notable report language related to social determinants of health, health equity, and maternal health that were included as part of this report for the HHS Office of the Secretary, Assistant Secretary for Health, CMS, CDC, SAMHSA, HRSA, HHS Office of Minority Health (OMH), and HHS Office of the National Coordinator for Health IT (ONC).

AFH - FY23 House Appropriations Report Summary - 29 June 2022
2022-06-30T19:11:04+00:00June 30th, 2022|Press, Press Release|

Rep. Robin Kelly Introduces Health Equity and Accountability Act, Includes SDAA

On April 26, 2022, Reb. Robin Kelly (D-IL), Chair of the Congressional Black Caucus Health Braintrust, introduced the Health Equity and Accountability Act (HEAA) of 2022 (H.R. 7585), which would address social determinants of health, reduce racial and ethnic health inequities, improve access for underserved communities, address maternal health, and more.

Aligning for Health appreciates Rep. Kelly’s leadership on this legislation, and was particularly excited to see the inclusion of the Social Determinants Accelerator Act within this package. The provision included within HEAA would establish an interagency council on social determinants of health and award grants to eligible entities for the development of social determinants accelerator plans.

For more information on the Health Equity and Accountability Act, see the press release, one-pager, and section-by-section.

2022-04-27T14:44:07+00:00April 27th, 2022|Press, Press Release|

Aligning for Health submits comments in response to White House OSTP RFI

Aligning for Health submitted comments in response to the White House Office of Science and Technology Policy (OSTP) request for information on Strengthening Community Health Through Technology.

Digital health technologies – which the request for information defines as tools that improve health or enable better health care delivery by connecting people with other people, with data or with health information – are critical aspects of successful initiatives to address health and social needs.

As such, Aligning for Health provided feedback on questions related to the tools, training and infrastructure needs of community-based organizations to utilize digital health technologies, and to information about how digital health technologies have or could be used in community-based settings to achieve health equity.

To read our comments, click here or see below:

AFH - White House OSTP RFI - 31 March 2022
2022-03-30T20:40:00+00:00March 30th, 2022|Press Release|

Aligning for Health Submits Comments to the Healthy Future Task Force

Aligning for Health submitted comments to the Healthy Future Task Force, Security Subcommittee on its recent request for information on pandemic preparedness, public health, and supply chains. The goal of the Healthy Future Task Force is to build on Republican health policy goals and craft patient-focused agendas for the future.

Specifically, Aligning for Health commented on questions related to addressing social determinants of health and maternal health as part of a broader public health strategy.

Generally, our comments fall into several themes –

  • Reduce silos between existing efforts funded by governments and encourage more collaboration.
  • Improve the screening and collection of social needs data to improve interventions and evaluate outcomes.
  • Enhance coordination between government and non-government organizations working to address social needs through shared regional networks that support coordination, information sharing and referrals.

To read our comments, click here or see below:

AFH - Healthy Future Task Force Security Subcommittee RFI - 30 March 2022
2022-03-30T20:28:28+00:00March 30th, 2022|Press Release|

President’s Budget for FY2023 Includes Key Provisions Related to SDOH

On March 28, 2022, President Biden released his Fiscal Year 2023 (FY23) budget request. The budget proposes $127.3 billion in discretionary and $1.7 trillion in mandatory budget authority for the Department of Health and Human Services for FY 2023.

The budget demonstrates the Administration’s commitment to areas such as health equity and maternal health, among other priority areas. According to HHS, “It also advances equity through the work of the federal government and helps ensure our programs serve people of color and other marginalized populations with the opportunities promised to all Americans.”

Aligning for Health was pleased to see the inclusion of several key provisions related to SDOH, health equity, and maternal health in this budget request, including $153 million in funding to the CDC for the Social Determinants of Health program. Through this particular request, CDC will continue to expand SDOH efforts by funding another round of Social Determinant Accelerator Plans to states, tribes, territories, and/or localities to develop or enhance existing SDOH plans and sustained funding to support SDOH implementation program, evaluation, research, and data collection efforts.

For a full summary of the SDOH-related provisions included in the request, click here or see below:

AFH- FY23 Presidents Budget - Summary - 28 March 2022
2022-03-29T20:31:13+00:00March 29th, 2022|Press Release|
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