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|

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|

Congressional SDOH Caucus – Briefing on Addressing Food Insecurity & Nutrition as a SDOH

On July 13, 2022, the Congressional Social Determinants of Health Caucus held a briefing to highlight the drivers and health impacts of food insecurity, highlight best practices in helping to connect individuals with access to healthy food, and explore potential policy approaches to alleviate the impact of food insecurity.

The webinar featured remarks from Caucus Members Reps. Cheri Bustos (D-IL)Tom Cole (R-OK)G. K. Butterfield (D-NC), and Jim McGovern (D-MA). Rep. McGovern spoke about the upcoming White House Conference on Hunger, Nutrition, and Health which is set to take place this September. Additional details on the Conference and how to get involved can be found here. The webinar was moderated by Aligning for Health Co-Chair Krista Drobac, and featured remarks from panelists across the health and social services sectors on best practices and models around food as an SDOH, as well as their recommendations for what Congress and the Administration can do to address this issue to improve health outcomes.

Guest panelists included:

Panelist bios can be found here. The slides used in the briefing can be found here, and the recording of the briefing can be found here.

Webinar Recording
Caucus Website

2022-11-17T20:03:25+00:00July 13th, 2022|Events, Press|

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 to Senate HELP Committee leaders in response to PREVENT Pandemics Act request for comments

On Friday, February 4, Aligning for Health sent a letter to Senate HELP Committee leadership in response to request for comments on the discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act).

Aligning for Health strongly supports the Committee’s inclusion of Section 201, Addressing Social Determinants of Health and Improving Health Outcomes, in the discussion draft. In its comments, Aligning for Health encouraged the Committee to consider including bipartisan legislation that would further promote interoperable network development and data sharing; development of evidence-based approaches to coordinate services and improve outcomes; and strengthen capacity to identify and address disparities across sectors.

To read the letter, click here.

2022-02-07T15:18:32+00:00February 7th, 2022|Press, Press Release|

More than 50 organizations send letter to Senate HELP Committee requesting the inclusion of the LINC to Address Social Needs Act in the PREVENT Pandemics Act legislative package

Today, 54 organizations sent a letter to Senate HELP Committee Chair Murray (D-WA) and Ranking Member Burr (R-NC) in response to the request for comments on the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act). This bipartisan legislation is focused on strengthening the nation’s public health and medical preparedness and response systems in the wake of COVID-19.

Section 201 of the PREVENT Pandemics Act discussion draft focused on addressing social determinants of health and improving health outcomes. To strengthen this section of the bill, this stakeholder letter asked the committee to consider including the bipartisan LINC to Address Social Needs Act (S. 509/H.R. 6072) in the final legislative text of the PREVENT Pandemics Act.

While Section 201 of the draft includes elements of the LINC to Address Social Needs Act, including the entirety of this legislation would provide increased and dedicated funding to support cross-sector, interoperable efforts to coordinate and address health-related social needs for those most vulnerable to the impacts of the current and future pandemics.

The letter can be found here and below:

AFH Stakeholder Letter - PREVENT Pandemics Act - 4 Feb 2022
2022-02-04T21:37:23+00:00February 4th, 2022|Press, Press Release|

Poised for Progress: Policymakers Lay the Foundation for Continued Momentum on SDOH

As 2021 draws to a close and we look towards 2022, we reflect on the incredible foundation laid by policymakers this year to improve health and wellbeing for all by creating opportunities and lowering barriers to addressing social determinants of health (SDOH).

2021 started off with the release of long-anticipated guidance from the Centers for Medicare and Medicaid Services outlining opportunities for state Medicaid and CHIP agencies to address social determinants. Additionally, as part of its overarching efforts to advance health equity, the Biden-Harris Administration awarded $3 million in grant funding to state and local governments across the country to develop Social Determinant Accelerator Plans, and requested $153 million in funding for the Center for Disease Control and Prevention’s Social Determinants of Health program; issued several reports on SDOH interventions and data sharing; announced plans to embed health equity and address social needs throughout its Innovation Center models and Medicaid and CHIP and issued a request for information on how alternative payment models can incent the collections of SDOH and health equity data; and incorporated SDOH assessment standards into version two of the U.S. Core Data for Interoperability, among many other exciting steps.

Meanwhile, from January through mid-December 2021, over 270 bills related to SDOH were introduced in Congress – 150 bills related specifically to SDOH, 48 related to health equity, and 75 related to maternal and infant health. Legislation like the Social Determinants Accelerator Act (H.R. 2503/S. 3039) and the LINC to Address Social Needs Act (S. 509/H.R. 6072), among others, have potential to make a significant impact in this space by facilitating cross-sector coordination and the collecting, reporting, and exchange of health and social needs data.

There have also been a number of hearings to consider legislation to address SDOH and advance health equity. The Senate HELP Committee held a hearing entitled “Improving Health Equity and Outcomes by Addressing Health Disparities,” which focused on health inequities in relation to the COVID-19 pandemic. The House Energy & Commerce Committee, Subcommittee on Health held a legislative hearing entitled “Empowered by Data: Legislation to Advance Equity and Public Health” to discuss what actionable steps Congress can take now to improve access to, and the coordination of, public health, health care and social services. The Subcommittee and Full Committee proceeded to hold markups of multiple bills that would address social determinants in important ways, and in December, the House passed two bipartisan bills, the CARING for Social Determinants Act of 2021 (H.R. 3894), and the Social Determinants of Health Data Analysis Act (H.R. 4026).

Additional activity around social determinants of health and health equity in Congress included: House Ways & Means Committee release of its framework to achieve health and economic equity, entitled “A Bold Vision for a Legislative Path Toward Health and Economic Equity”; the creation of the House Ways & Means Committee’s Racial Equity Initiative (REI)  and working group to address the role of racism and other forms of discrimination in perpetuating health inequities; a Senate Finance Committee request for information on evidence-based solutions to improve maternal health; and a hearing held by the House Committee on Oversight and Reform on the maternal health crisis, entitled “Birthing While Black: Examining America’s Black Maternal Health Crisis.” Finally, Representative McGovern (D-MA), the Chair of the House Rules Committee, held a series of roundtables and hearings on Ending Hunger in America to shine a light on the hunger crisis in the US and develop ideas to tackle this problem both legislatively and administratively.

This year also brought about the launch of the bipartisan Congressional Social Determinants of Health Caucus, which will explore opportunities to improve the impact of services delivered to address social determinants with the support of federal funding and amplify evidence-based approaches to holistic well-being. Since its launch in July, the Caucus has held a public launch event and a briefing on transportation as a social determinant, and solicited public comment on challenges and opportunities related to SDOH through a request for information that resulted in hundreds of responses.

As we reflect on the progress made in the past year, we look forward to continuing to work alongside the Administration and Congress to keep this momentum going in 2022 and beyond.

2021-12-16T20:58:37+00:00December 16th, 2021|Press|

Congressional SDOH Caucus – Briefing on Expanding Access to Transportation to Advance Health

On October 21, 2021, the Congressional Social Determinants of Health Caucus held its first briefing event to highlight best practices and innovative models related to transportation as a social determinant of health.

The webinar featured remarks from Caucus Members Representatives Cheri Bustos (D-IL), Markwayne Mullin (R-OK), and Salud Carbajal (D-CA). Aligning for Health Co-Chair Krista Drobac moderated the event. The briefing also featured remarks from panelists from across sectors on best practices and models around transportation that are working to address social needs, what is needed to enhance or replicate those models, and what Congress can do to accelerate this work and address transportation barriers to improve health outcomes for all.

Guest Panelists included:

  • Jeffrey Nelson, Chair, American Public Transportation Association, and CEO/Managing Director, Rock Island County Mass Transit District, Moline, IL
  • Edward P. Ehlinger, MD, MSPH, Past President of ASTHO and former Minnesota State Health Commissioner
  • Nebeyou Abebe, Senior Vice President of Social Determinants of Health, Highmark Health
  • Kathy Chan, Director of Policy, Cook County Health
  • Krista Drobac, Co-Chair, Aligning for Health (moderator)

A recording of the webinar can be found here.

Webinar Recording
Caucus Website

2022-11-17T20:00:04+00:00October 21st, 2021|Events, Press|
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