Social Determinants Accelerator Act (H.R. 2503, S. 3039)

U.S. Senate bill: S. 3039, introduced by Senator Todd Young (R-IN) — Social Determinants Accelerator Act of 2021

Committees:

Committee on Finance

Status:

The bill has not yet been formally considered.

U.S. House bill: H.R. 2503, introduced by Representative Cheri Bustos (D-IL-17) — Social Determinants Accelerator Act

Committees:

House Committee on Energy and Commerce

Status:

The bill has not yet been formally considered.

Cosponsors:

48 (see all cosponsors)

Rep. Cole, Tom [R-OK-4]* 04/14/2021
Rep. McGovern, James P. [D-MA-2]* 04/14/2021
Rep. Mullin, Markwayne [R-OK-2]* 04/14/2021
Rep. Welch, Peter [D-VT-At Large]* 04/14/2021
Rep. Underwood, Lauren [D-IL-14]* 04/14/2021
Rep. Moolenaar, John R. [R-MI-4]* 04/14/2021
Rep. Clarke, Yvette D. [D-NY-9]* 04/14/2021
Rep. Fitzpatrick, Brian K. [R-PA-1]* 04/14/2021
Rep. O’Halleran, Tom [D-AZ-1]* 04/14/2021
Rep. Cárdenas, Tony [D-CA-29]* 04/14/2021
Rep. Cicilline, David N. [D-RI-1]* 04/14/2021
Rep. Cohen, Steve [D-TN-9]* 04/14/2021
Rep. Butterfield, G. K. [D-NC-1]* 04/14/2021
Rep. Morelle, Joseph D. [D-NY-25]* 04/14/2021
Rep. Lee, Barbara [D-CA-13]* 04/14/2021
Rep. Doyle, Michael F. [D-PA-18]* 04/14/2021
Rep. Hayes, Jahana [D-CT-5]* 04/14/2021
Rep. Walorski, Jackie [R-IN-2]* 04/14/2021
Rep. Kuster, Ann M. [D-NH-2]* 04/14/2021
Rep. Rush, Bobby L. [D-IL-1]* 04/14/2021
Rep. Williams, Nikema [D-GA-5]* 04/14/2021
Rep. Carbajal, Salud O. [D-CA-24]* 04/14/2021
Rep. Strickland, Marilyn [D-WA-10] 05/11/2021
Rep. Trone, David J. [D-MD-6] 05/11/2021
Rep. Blunt Rochester, Lisa [D-DE-At Large] 06/17/2021
Rep. Suozzi, Thomas R. [D-NY-3] 06/17/2021
Rep. Kildee, Daniel T. [D-MI-5] 06/17/2021
Rep. Craig, Angie [D-MN-2] 06/22/2021
Rep. Sarbanes, John P. [D-MD-3] 06/22/2021
Rep. Kelly, Robin L. [D-IL-2] 06/22/2021
Rep. Schrader, Kurt [D-OR-5] 06/22/2021
Rep. Sires, Albio [D-NJ-8] 06/22/2021
Rep. Peters, Scott H. [D-CA-52] 06/29/2021
Rep. Larson, John B. [D-CT-1] 06/30/2021
Rep. Ruppersberger, C. A. Dutch [D-MD-2] 07/01/2021
Rep. Pocan, Mark [D-WI-2] 07/09/2021
Del. Norton, Eleanor Holmes [D-DC-At Large] 07/09/2021
Rep. McNerney, Jerry [D-CA-9] 07/09/2021
Rep. Matsui, Doris O. [D-CA-6] 07/19/2021
Rep. Barragan, Nanette Diaz [D-CA-44] 07/19/2021
Rep. Harder, Josh [D-CA-10] 07/19/2021
Rep. Ruiz, Raul [D-CA-36] 07/26/2021
Rep. Costa, Jim [D-CA-16] 07/26/2021
Rep. Lucas, Frank D. [R-OK-3] 07/30/2021
Rep. Tonko, Paul [D-NY-20] 09/20/2021
Rep. Aguilar, Pete [D-CA-31] 10/25/2021
Rep. Yarmuth, John A. [D-KY-3] 12/02/2021
Rep. McBath, Lucy [D-GA-6] 02/07/2022

Impact

What are social determinants of health (SDoH)?  The Department of Health and Human Services (HHS) defines SDoH as “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”[i]  Changes in social determinants can both improve health and reduce the cost of health care.  HHS puts SDOH into five categories: economic stability, education, social and community context, health and health care, and neighborhood and built environment.  The lattermost category includes access to foods that support healthy eating patterns, crime and violence, environmental conditions, and quality of housing.[ii] 

What would these bills do?  Although the bills are not the same, essentially, they would create funding and promote opportunities for state Medicaid agencies to address SDoH by helping states and communities to devise strategies to leverage existing programs and authorities to take into account SDoH.  States and local governments are increasingly attempting to monitor and influence SDoH in order to manage health care costs and improve health outcomes within their Medicaid programs.

What prevents states from taking SDoH into account?   Perhaps the greatest challenge is the fragmentation and complexity of government programs.  The bills would advance cross-sector collaboration and planning through the:

Establishment of an inter-agency (SDoH) technical advisory board under the Secretary of HHS, which would authorize nearly $25 million in grants for state, local, and Tribal governments to use in the development of Social Determinants Accelerator Plans that would demonstrate how target populations would benefit from accounting for SDoH.

Why are these bills relevant to homelessness?  Health care services are more effective and less expensive when vulnerable populations are stably housed, and, in turn, being stably housed is more likely if those vulnerable populations have reliable access to health care services.  According to the Center for Disease Control (CDC), people who experience homelessness are at greater risk of infectious and chronic illness, poor mental health, and substance abuse.

Moreover, people experiencing homelessness typically have more complex care needs and utilization patterns that result in costly, often uncompensated charges for hospitals and health systems.  Compared with housed patients, homeless patients are​ 4.5 times more likely to use the emergency room (ER), typically have longer lengths of stay, and are at much greater risk for returning to the ER and being readmitted after discharge.[iii]

How would these bills help to reduce homelessness?  While there are many factors that influence health, stable housing is a key SDoH, one that directly impacts health outcomes as well as the cost of health care.  Even the best health care for the homeless is undermined if not negated if that vulnerable population’s health is continually compromised because of lives spent on the streets or in shelters. 

Communities that invest in affordable housing incur lower public costs, achieve better health outcomes, and reduce homelessness.  In helping states to account for SDoH, the factors that determine the quality of our health and the cost of our health care, H.R. 2503 and S. 3039 would ultimately promote better health for the homeless and at a lower cost to taxpayers. 

Summary

H.R. 2503 / S. 3039, although not identical, would create funding and promote opportunities for state Medicaid agencies to address Social Determinants of Health (SDoH) by helping states and communities to devise strategies to leverage existing programs and authorities to take into account SDoH.  If you support this NAEH-endorsed legislation, please urge your Representative to cosponsor this legislation.  

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