On Sunday July 12, the House Appropriations Committee released the report for the FY2021 Labor-HHS-Education Appropriations bill legislation.  The report includes language incorporating parts of the Social Determinants Accelerator Act (SDAA),  providing $10M to CDC to award grants to states to develop Social Determinants Accelerator Plans. It would also instruct the Secretary of HHS to convene a council to oversee the grants and to draft and release a report on federal cross-agency opportunities to address SDH.

On Monday July 13, the legislation was passed out of the Labor-HHS Appropriations Committee and now heads to the House floor for final passage.

“As COVID-19 has shown, social factors play a significant role in our health outcomes. The Social Determinants of Health Pilot Program will provide states with needed funding to develop cross-cutting approaches to address health and social needs, while driving important cross-agency coordination. We are excited to see this program advance and applaud the Committee for including this as part of the fiscal year 2021 appropriations report,” Krista Drobac, Co-Chair Aligning for Health said.

Featured below is the report language related to SDAA and social determinants and lead sponsor Rep. Cheri Bustos (D-IL)’s remarks from the July 13th Appropriations hearing.

The report language on SDAA is highlighted below, and includes several other notable provisions related to social determinants:

FY2021 House Labor-HHS Appropriations Report – SDAA

  • CDC – Social Determinants of Health Pilot Program.—The Committee recognizes the role of public health in working across sectors on social determinants of health. The Committee includes $10,000,000 for CDC to establish a Social Determinants of Health pilot program to award competitive grants to State, local, Territorial, or Tribal jurisdictions to support the development of Social Determinants of Health Accelerator Plans. 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; and identify non-governmental 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 and stakeholders and to engage qualified research experts in developing Social Determinants Accelerator Plans. The Committee directs CDC to submit a report within 120 days of enactment of this Act on how such grants will be administered.
  • HHS, Office of the Secretary – Social Determinants Council.—The Committee directs the Secretary of Health and Human Services to form an interagency-intergovernmental Social Determinants Council, which shall be responsible for drafting and releasing a report on federal cross-agency opportunities to address social determinants of health, including the potential benefits of grants to State, local, or Tribal jurisdictions to address social determinants of health. The Council shall consist of at least one designee from the Office of Management and Budget, the Department of Agriculture, the Department of Education, the Indian Health Service, HUD, the Department of Labor, the Department of Transportation, three designees of the Department of Health and Human Services—including CMS—and others as deemed appropriate. Up to six council designees may be non-federal subject matter experts with experience in areas such as implementing and evaluating transformative initiatives that harness data and conduct evaluations to increase the impact and cost-effectiveness of Federal Government Services and represent State, local, and Tribal health and human service agencies, public housing authorities, budget offices, State Medicaid agencies, or national Consumer organizations. The Council shall provide technical assistance to State, local, and tribal jurisdictions seeking to develop Social Determinants Accelerator Plans through a new pilot program under the CDC.

FY2021 House Labor-HHS Appropriations Report – Social Determinants Provisions

  • CMS – Social Determinants of Health.—The Committee is aware that social determinants of health are critical drivers of health outcomes and health care costs and that early childhood development is affected by social factors. The Committee encourages CMS to clarify and disseminate the strategies that States can implement under current Medicaid and CHIP authority, or through waivers, to address social determinants of health in the provision of health care, including strategies specifically targeting the pediatric population. This should include guidance on how States can encourage and incentivize managed care organizations to address social determinants of health through contracts. In addition, academic medical centers can be leaders in addressing social determinants of health. The Committee encourages CMS to identify opportunities to partner with academic medical centers to find innovative approaches to addressing social determinants of health, especially at academic medical centers that have expertise in addressing health disparities and are affiliated with Historically Black Colleges and Universities, Hispanic-Serving Institutions, or other Minority-Serving Institutions
  • HHS, Office of Minority Health – Racial and Ethnic Health Inequities.—The Committee includes $1,500,000 for the Office of Minority Health to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine to provide an evidence-based, non-partisan analysis of Federal policies that contribute to racial and ethnic health inequities, as well as potential solutions. The study should review current Federal policies that contribute to health inequities, including those policies that impact the social determinants of health. Based on that review, the analysis should identify the most effective or promising strategies to eliminate or modify to advance racial and ethnic health equity. The analysis should be inclusive of all racial and ethnic minority populations in the United States, including Black or African American, Hispanic or Latino, American Indian, Alaska Native, Asian American, Native Hawaiian, and Pacific Islander.
  • HHS, Office of Minority Health – Social Determinants of Health.—The Committee is aware that social determinants of health are critical drivers of health outcomes and health care costs. Social determinants of health can have impacts on the health outcomes of specific populations and impact health disparities in the United States. OMH is encouraged to enter into cooperative agreements with academic institutions with HBCU, HSI, or Minority-Serving Institution status that have expertise in addressing social determinants of health to address the impact of social determinants on minority populations.