Aligning for Health Applauds the Launch of the Bipartisan Congressional Social Determinants of Health (SDOH) Caucus
WASHINGTON, DC (July 21, 2021) – Aligning for Health, a coalition of leading health insurers, providers, and vendors, is thrilled that Representatives Cheri Bustos (D-IL), Tom Cole (R-OK), G.K. Butterfield (D-NC), and Markwayne Mullin (R-OK) have launched the bipartisan Congressional Social Determinants of Health Caucus.
Economic and social conditions have a powerful impact on our health and wellness. Known as social determinants of health, a focus on these non-medical factors can improve health outcomes and well-being, address disparities, and increase our return on investment in both health and social services programs.
Congressional responsibility for programs to address social determinants of health is divided among many committees and delivered across multiple federal agencies. The Congressional Social Determinants of Health Caucus will bring together Members of Congress from disparate jurisdictions to highlight opportunities for coordination across federal investments in health, public health, food, housing, transportation, and other important drivers of health.
Aligning for Heath applauds the leadership of Representatives Bustos, Cole, Butterfield, and Mullin in forming this caucus to break down the barriers that impede better coordination between health and social services programs. More information about the Caucus can be found here: www.CongressionalSDOHCaucus.org
“We are thrilled to see Reps. Bustos, Cole, Butterfield, and Mullin taking action on the growing evidence that social factors deeply impact health and wellbeing. This Caucus will catalyze important policy development that will ultimately improve wellbeing, health, and other positive outcomes in communities across the country.” – Krista Drobac, Co-Chair, Aligning for Health
“The COVID-19 pandemic exposed many deep disparities in our health system and greatly exacerbated the already persistent barriers to health that many families in Illinois and across our country face, such as a lack of access to fresh foods, affordable health care and safe housing to name just a few,” said Congresswoman Cheri Bustos, (D-IL), Co-chair, Congressional Social Determinants of Health Caucus, “The Social Determinants of Health Caucus will serve as a platform for Congress and community leaders to come together to put forward the solutions we need to finally tackle these longstanding issues at the root. I’m pleased to join my bipartisan Co-Chairs Cole, Butterfield and Mullin today to launch this key initiative and foster strong partnerships moving forward.”
“I am delighted to join my colleagues in the Congressional Social Determinants of Health Caucus to develop strategies to address factors that adversely impact health outcomes and improve the well-being of Americans,” said Congressman Tom Cole (R-OK), Co-chair, Congressional Social Determinants of Health Caucus. “By focusing on these non-medical factors, we can work toward a healthier population and more efficient spending of federal and state health care dollars.”
“There is no denying there is a health disparities crisis in our country,” said Congressman Butterfield (D-NC), Co-chair, Congressional Social Determinants of Health Caucus. “Patients in minority, rural, and underserved communities experience higher incidences of disease and worse health outcomes than their peers. We know there isn’t a single cause for this disparity, but rather, many factors that contribute to the health of an individual. Congress must take a holistic, whole-person approach when considering policy solutions to address health disparities. I am proud to join my fellow co-chairs to launch the Social Determinants of Health Caucus, which will serve as a hub for collaboration and evidenced-based information sharing as Congress considers policy solutions to address these important issues.”
“Quality health care is more than just treating an illness, ailment, or chronic condition. Social determinants, or non-medical contributors, of health are an important part of our strategy to improve overall health and wellbeing of Americans. In order to improve health outcomes in the long run, we must look at the full picture of patients’ lives and address these social determinants of health. I am proud to join my colleagues in forming this caucus to work towards solutions that improve health care for all Americans.” – Congressman Markwayne Mullin (R-OK), Co-chair, Congressional Social Determinants of Health Caucus
Additional Support for the Congressional SDOH Caucus
“A focused congressional SDOH Caucus will advance policies to bring communities, funding sources and organizations together to foster cross-sector partnerships to address issues like equity, poverty and affordable housing,” said John Lovelace, President, Government Programs, UPMC Health Plan. “Initiatives like UPMC Health Plan’s ‘Cultivating Health for Success’ to support unhoused members would not be possible without strong government and community collaboration – and this bipartisan Caucus will amplify these efforts, which impact communities in every congressional district in the country.”
“I am very glad to see the strong, bi-partisan support for the new Congressional SDOH Caucus,” said Len Nichols, Non-Resident Fellow at the Urban Institute and Professor Emeritus at George Mason University, “While lots of good work in SDOH has been occurring around the country recently, local assets and initiatives can be leveraged most effectively with targeted federal resources and rule changes. The best way to discover and enact them is on a bi-partisan basis.”
“Social factors — like where we live and work, and our access to healthy food and transportation — play a critical role in shaping Americans’ health and the health of our communities,” said Justine Handelman, senior vice president of the Office of Policy and Representation at the Blue Cross Blue Shield Association. “We are thrilled to see Congress come together to form the Social Determinants of Health Caucus, whose work will put people and their needs first, allowing them to live longer, healthier lives. Thank you to Reps. Cheri Bustos, G.K. Butterfield, Tom Cole and Markwayne Mullin, as we look forward to working with the caucus to advance health equity.”
“Improving health – especially in underserved places – requires a holistic approach to addressing interconnected health and non-medical challenges and adequate supports for community-based organizations that provide critical services to people who live in areas with high levels of health disparities,” said Julia Ryan, VP for Health Initiatives, Local Initiatives Support Corporation (LISC), “LISC applauds Representatives Bustos (D-IL), Cole (R-OK), Butterfield (D-NC), and Mullin (R-OK) for launching the Social Determinants of Health Caucus in an effort to better coordinate federal programs and resources across sectors, and for their commitment to eradicating barriers to health and well-being.”
We’re thrilled to see members of Congress coming together to find ways to accelerate progress on addressing social determinants of health and advancing health equity,” said Taylor Justice, Co-Founder and President of Unite Us. “At Unite Us, we believe that social care should be elevated to the same priority level as health care. New policies and better coordination of programs can accelerate the system transformation that’s underway in states around the country.
“At CareSource, we can attest to the critical need to support social determinants of health in order to improve physical and behavioral health and wellbeing. Improving the lives of individuals, families and communities cannot happen through isolated support systems,” explained Karin VanZant, Vice President, Integrated Community Partnerships at CareSource. “The founding of the bipartisan Congressional Social Determinants of Health Caucus is an imperative step to drive federal policies and funds to support healthier communities.”
“On average, 80 percent of a person’s health outcomes are determined by what happens in their community, outside the clinical setting. We cannot improve outcomes in our country unless we address these social determinants of health. The Y commends Representatives Bustos, Butterfield, Cole and Mullin for their leadership in forming the Social Determinants of Health Caucus and their commitment to improve coordination across federal departments and agencies, so that more people get the support they need to live their healthiest life.” – Kevin Washington, President and CEO, YMCA of the USA
“We applaud the Caucus leads for forming this Caucus. Bipartisan Congressional leadership is needed to help advance cross-cutting, impactful policy that will improve health outcomes. We need strong SDOH legislation in the Medicaid program, which will benefit our members and many others nationwide,” Dr. Gloria N. Eldridge, Divisional Vice President from the Health Care Service Corporation.
“This convening of the Congressional Social Determinants of Health Caucus by Representatives Cheri Bustos, Tom Cole, G.K. Butterfield and Markwayne Mullin is a hopeful movement for advancing policy at the federal level. The more we can find common ground to address conditions affecting quality-of-life risks and health outcomes where people live, the better those outcomes are addressed. As a result, it will also reduce the costs to address them. I encourage every individual and entity engaged in the well-being of Americans to back this Caucus.” – Erine Gray, Founder and CEO of Aunt Bertha
“Democratizing access to and use of data is critical in addressing social determinants of health,” said Ginger Zielinskie, Chief Strategy Officer at data.org. “I am thrilled that Representatives Bustos, Cole, Butterfield, and Mullin have launched the Congressional SDOH Caucus to advance data-driven policy that can lead better outcomes for all.”
“Signify Health applauds the creation of the bipartisan Social Determinants of Health Caucus and thanks Representatives Cheri Bustos, Tom Cole, G.K. Butterfield and Markwayne Mullin for their leadership on this important issue. As a company that enables outcomes-focused networks to address social determinants of health, Signify Health knows firsthand how social needs can impact a person’s health. We look forward to working with the Social Determinants of Health Caucus, and offering our expertise so that people can spend more happy, healthy days at home.” – Kim Holland, Senior Vice President, Government Affairs at Signify Health
About Aligning for Health – Aligning for Health members include: Alliance for Better Health, American Hospital Association, Aunt Bertha, Blue Cross Blue Shield Association, CareSource, Centene, HCSC, Signify Health, UPMC Health Plan, and Unite Us.
Additional information about Aligning for Health may be found at www.AligningforHealth.org
Today, the House Energy & Commerce Committee, Subcommittee on Health held a markup of 19 pieces of legislation, several of which seek to provide guidance and funding, and to catalyze activities to address social determinants of health and maternal health.
The Subcommittee voted favorably to advance the bipartisan Social Determinants Accelerator Act (H.R. 2503), which will help states and communities devise strategies to better leverage existing programs and authorities to improve health and wellbeing. The bill now moves to the full Committee for consideration.
Aligning for Health is thrilled to see forward momentum on this important bipartisan piece of legislation, and we look forward to working with the Committee on its continued advancement.
Aligning for Health is thrilled that the House Appropriations Committee has proposed significant funding and support for addressing Social Determinants of Health throughout its Fiscal Year 2022 Appropriations legislation. Today, the full Committee approved the Appropriations bill, which was previously approved by the Labor-HHS Subcommittee on July 12 and will now advance to the full House of Representatives for consideration. The Committee also released the FY22 Report, which includes more details on the funding amounts.
Notably, the Committee matched President Biden’s request of $153M for CDC’s Social Determinants of Health program; a portion of that funding will continue to go towards Social Determinants Accelerator Grants. The Committee also included instructions for HHS to continue to implement the Social Determinants Accelerator Council, as was included by reference in the FY21 Appropriations Report.
Below is the language included in the Report on the Accelerator Grants and the SDOH Council.
- CDC – Social Determinants of Health.—The Committee includes an increase of $150,000,000 for investments in social determinants of health (SDOH) to improve health equity. The Committee includes funding to expand activities to address SDOH in States, local, tribal and territorial jurisdictions to improve outcomes among persons experiencing health disparities and inequalities, including, but not limited to, expanding and implementing Accelerator Plans, initiating a SDOH implementation program, providing technical assistance to communities and continuing to build the evidence base and advance data collection to better understand health disparities. Social Determinants Accelerator Plans should include a description of the health and social outcome objectives; identify 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 Social Determinants Accelerator Plans.
- HHS – Social Determinants of Health Council.—The Committee directs the Social Determinants Council created by H. Rpt. 116–450 to continue to provide technical assistance to State, local, and tribal jurisdictions seeking to develop Social Determinants Accelerator Plans. The Committee directs a report be submitted, no later than 30 days after enactment of this Act, regarding the status of the selection of all Council members outlined in H. Rpt. 116–450.
Additionally, there were several other notable provisions related to social determinants, health equity, and maternal health. Highlights include:
- 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 commends CMS for the guidance on social determinants issued to States in January 2021 and encourages CMS to continue to clarify and disseminate 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.
- CMS – Evidence-Based Home Visiting Programs. — The Committee recognizes the wide range of improved outcomes and cost-savings that evidence-based home visiting programs provide to first-time mothers and their children. Additionally, in light of the impact of the COVID–19 pandemic on care and the rising rates of maternal and infant health disparities among families of color, the need for quality supports in the home is even greater, especially for mothers and babies. The Committee is pleased that CMS is assisting States that choose to design a Medicaid benefit package to provide home visiting services for pregnant and postpartum women, and for families with young children. The Committee urges CMS to continue to build upon its 2016 Joint Informational Bulletin to clearly articulate how Medicaid dollars can be blended and braided appropriately in home visiting programs to reach eligible families, provide streamlined coverage options for home visiting services, and cover specific components of home visiting programs.
- HHS Office of the Secretary – Data Collection to Measure Disparities.—The Committee recognizes that geographic place is a powerful predictor of social determinants of health. The Committee is concerned that due to residential segregation and subsequent disinvestment, the lack of access to health care, safe recreational facilities, quality education, and other resources, is often magnified in highly segregated communities. To fully assess population health, distribution of disease, and the extent of health disparities, health services data should be collected based on residency as opposed to where services are provided. A similar approach was taken to address the HIV/AIDS epidemic. The Committee recommends that all health services data include racial and ethnic data by subgroup, geographic indicators to the lowest levels (i.e., zip code tabulation area), nationality, sex, age, and primary language. This data should be collected in a standardized, uniform manner and include with it the capacity for linkages to various federal data sets. The Committee requests a report within 120 days of enactment of this Act describing the specific steps taken to ensure that geographic disparities were measured in COVID–19 data collection, documentation, and reporting from health care providers to public health agencies. The report shall also include recommendations to sustain data harmonization efforts to expand reporting for all infectious diseases and chronic health conditions and to address emergency prevention preparedness and response in the event of additional future pandemics and other catastrophes.
- HHS Office of the Secretary – National Center on Antiracism and Health Equity.—The Committee strongly supports efforts to advance health equity and reduce disparities for communities of color. The Committee supports the Office of Minority Health (OMH) and its efforts to advance health equity—however, the Committee believes the OMH currently lacks sufficient capacity to lead a broad and bold effort to address health disparities and that HHS should establish a National Center on Antiracism and Health Equity (Center) within the Department to lead efforts to identify and understand the policies and practices that have a disparate impact on the health and well-being of communities of color. The Committee directs the Secretary to submit a report, not later than 180 days after enactment of this Act, that provides detailed proposals to establish a National Center on Antiracism and Health Equity within the Department. The proposals shall include (1) a charter and goals for a National Center on Antiracism and Health Equity; (2) rationale for creating a new entity within the Department or restructuring an existing entity; (3) budgetary resources necessary to establish the Center; (4) the number of full-time equivalent employees needed to effectively carry out the Center’s mission; (5) the resources needed for the Center to establish, through grants or cooperative agreements, at least three regional centers of excellence, located in racial and ethnic minority communities; (6) the resources needed to award grants and cooperative agreements to eligible public and nonprofit private entities, including community-based organizations, to collaborate with underserved communities and for research and collection, analysis, and reporting of data on the public health impacts of health disparities; and (7) the resources needed for the Center to work with eligible public and nonprofit private entities, including community-based organizations, to provide information and education to the public on the public health impacts of health disparities and on health equity interventions, among other details.
- Assistant Secretary for Health – Health and Housing Initiatives.—The Committee is aware of promising initiatives developed by non-profit community groups in collaboration with local health systems and housing authorities that are targeted at homeless and precariously housed individuals who are high utilizers of medical care provided at hospital emergency departments. These programs work across different areas of core competency to provide safe, affordable housing together with ancillary medical, behavioral, substance use disorder, nutritional and employment or job training services. Participants demonstrate significant improvements in their health, sustainable incomes, and reduced use of emergency department and other expensive medical services. The Committee encourages the Department to support these types of initiatives through research, innovation models, health workforce and homeless programs, and other appropriate initiatives.
- HRSA – Alliance for Maternal Health Safety Bundles.—The Committee includes $14,300,000, an increase of $5,300,000 above the fiscal year 2021 enacted level and the same as the fiscal year 2022 budget request, to support continued implementation of the Alliance for Innovation on Maternal Health Program’s maternal safety bundles to all U.S. States, the District of Columbia, and U.S. territories, as well as tribal entities. Maternal safety bundles are a set of targeted and evidence-based best practices that, when implemented, improve patient outcomes and reduce maternal mortality and severe maternal morbidity
- SAMHSA – Projects for Assistance in Transition from Homelessness (PATH). – The Committee includes an increase of $10,000,000 for the PATH program, which supports grants to States and territories for assistance to individuals suffering from severe mental illness and/or substance use disorders and who are experiencing homelessness or at imminent risk of becoming homeless. Grants may be used for outreach, screening and diagnostic treatment services, rehabilitation services, community mental health services, alcohol or drug treatment services, training, case management services, supportive and supervisory services in residential settings, and a limited set of housing services.
- AHRQ – Research on Health Equity.—The Committee includes an increase of $3,000,000 for AHRQ to support investigator-initiated research grants related to health equity and an additional $1,000,000 to support research supplements related to health equity, the same as the fiscal year 2022 budget request.
A full list of provisions related to social determinants, health equity, and maternal health can be found here.
Aligning for Health submitted comments and recommendations in response to the Request for Information (RFI) published by the White House Office of Management and Budget (OMB), entitled “Methods and Leading Practices for Advancing Equity and Support for Underserved Communities Through Government.”
The purpose of this RFI was to seek input from a broad array of stakeholders on available methods, approaches, and tools that could assist OMB in identifying effective methods for assessing whether agency policies and actions equitably serve all eligible individuals and communities, particularly those that are currently and historically underserved. Aligning for Health was pleased to provide comment in response to several of the questions posed in the RFI, highlighted below:
Equity Assessments and Strategies
As OMB notes in the Request for Information, advancing equity will require federal agencies to implement new approaches to assess whether policy and programs are effective in advancing equity. As part of this effort, we believe that it is important for agencies such as the Centers for Medicare and Medicaid Services (CMS), within the U.S. Department of Health and Human Services (HHS), to improve the collection and reporting of standardized social needs data and encourage cross-sector coordination and data sharing across organizations in the health and social service sectors.
Comprehensively documenting social risk and social needs data and promoting greater exchange of such data will ensure payers and providers delivering health and non-health care to individuals have a more comprehensive view of the factors affecting an individuals’ wellbeing as well as the disparities contributing to health inequities. However, collecting social needs and risk factor data has proven to be a continuous challenge. Such data is not always routinely or systematically collected across the health care system and often is not collected in a standardized way, making it difficult to integrate into health records, to share across coordinated entities, or to use for purposes of risk adjustment.
Aligning for Health recommends OMB work with the HHS, and CMS, to encourage and incentivize greater identification, documentation, and exchange of social risk and social needs data across its programs by removing barriers and by providing education and incentives.
Moreover, the siloed way in which health care, public health, and social services are paid for and administered has limited cross-sector coordination and data sharing across organizations in the health and social service sectors. Breaking down the siloes and incentivizing connectivity and coordination between programs and systems will help to ensure that they are most effective in improving health and wellbeing. Statewide or regional efforts to connect health care organizations and CBOs for purposes of electronic referrals, outcomes tracking, electronic resource directories, and care coordination help to bridge some of these gaps.
Aligning for Health recommends OMB work with HHS to continue to promote, and with Congress to catalyze, further development of such statewide or regional, integrated networks.
Barrier and Burden Reduction
Improving coordination of federal programs and services is critical to removing certain barriers faced by individuals in accessing needed benefits and services. States, local governments, health care providers, payers, social services providers, community-based organizations (CBOs), and others are increasingly seeking to partner to better coordinate care and services.
However, one of the greatest challenges to high-impact interventions is the difficulty in navigating and coordinating fragmented and complex programs aimed at addressing health care needs, food insecurity, housing instability, workforce supports, and transportation reliability, among others. In particular, the siloed funding, data systems, and administration of many of these programs at the state and local, and nongovernmental levels create barriers to effective coordination and partnership.
Aligning for Health recommends OMB work with agencies to create, to the extent possible under current law, opportunities for states and local governments to develop strategies to improve cross-sector coordination of programs and services. Additionally, we support the President’s fiscal year 2022 funding request to increase funding for the CDC’s Social Determinants of Health program from $3 million to $153 million. Finally, we encourage OMB to consider advancing policies and strategies that would help to coordinate eligibility and enrollment processes for cross-sector programs.
Procurement and Contracting
OMB’s Request for Information notes that federal agencies should assess opportunities to invest in underserved individuals and communities, including by promoting business diversity and resiliency and by providing opportunities for underserved individuals and communities. As federal, state and local government agencies continue to invest in cross-sector strategies to address both health and social needs of individuals and to advance equity, many have sought to leverage blending and braiding of program and operational funding.
Aligning for Health supports additional flexibility for braiding and blending of programmatic funding, where appropriate, to support innovative, integrated program designs. Moreover, it is important for federal agencies to consider ways to ensure that downstream uses of federal funding maximize competitive contracting or participation opportunities for underserved communities, or business and entities representing underserved populations.
To read the full comment letter, click here.
Aligning for Health sends letter urging the House Energy & Commerce Committee to advance the Social Determinants Accelerator Act
On Thursday, June 24, the House Energy & Commerce Committee, Health Subcommittee held a landmark legislative hearing entitled “Empowered By Data: Legislation to Advance Equity and Public Health.” The hearing featured 13 bills to advance health equity and public health, including the Social Determinants Accelerator Act of 2021 (H.R. 2503).
Today, Aligning for Health sent a letter to the leaders of the House Energy & Commerce Committee and Health Subcommittee, thanking them for their leadership in holding this hearing to discuss and consider important legislation related to social determinants of health.
As a coalition committed to improving health and wellbeing by addressing individual and community social needs, Aligning for Health also expressed support for the forward momentum towards passage of the Social Determinants Accelerator Act of 2021. Included in the letter is an updated endorsement list – which now totals well over 100 leading health and social services organizations who actively support passage of the legislation.
Aligning for Health urged the Subcommittee to consider and advance this important piece of legislation, which will empower communities across the country to work across sectors to share data, leverage available resources, foster partnerships, and coordinate care to drive improved and equitable outcomes.
To read the full letter, click here.
If your organization would like to add its name to the full list of organizations supporting this bill, click here. A recording of the hearing can be found here, and a summary of the hearing can be found here. Aligning for Health also submitted a Statement for the Record, which can be found here.