News & Updates

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).

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).