Social Determinants Updates |
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March 3 to March 17, 2023
Welcome to Aligning for Health's bi-weekly Social Determinants Updates newsletter.
To add news or events to this newsletter, email info@aligningforhealth.org.
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Member News
American Hospital Association: Delaware’s Commitment to Advancing Health Equity – One Hospital at a Time (3/13) - All acute care hospitals in Delaware have agreed to embark on a journey to eliminate health disparities and create healthier communities. Janice E. Nevin, M.D., president and chief executive officer of ChristianaCare and American Hospital Association Board of Trustees member, helped make this statewide commitment possible through the Institute for Diversity and Health’s Health Equity Roadmap and encouraging hospitals to take the Health Equity Transformation Assessment.
Digital Blue: Digital Blue and Healthy Alliance Partner to Demonstrate the Value of SDOH through Data Aggregation (3/8) – Digital Blue has helped Healthy Alliance design and build a data factory to ingest and aggregate data throughout Healthy Alliance’s social, behavioral, and clinical provider network. Once aggregated, this data is used to track, analyze, and provide insight into how social determinants impact the health of individuals within and across demographic and other categories.
Benefits Data Trust: UPMC Health Plan and Benefits Data Trust Partnership Connects Over 2,250 Pennsylvanians to Over $7M in Additional Benefits (3/7) – UPMC Health Plan and Benefits Data Trust (BDT) announced that their joint initiative has helped UPMC for You Medicaid managed care members access an estimated $7.35 million in benefits since April 2021, helping address health disparities by increasing access to available support services. Under the partnership, UPMC’s Navigation Resources Hub screens UPMC for You members for additional benefit eligibility and, when appropriate, connects them with BDT to directly apply for programs that support more affordable access to groceries, housing, medicine, and other critical services.
CareSource: Norton Children’s Prescriptive Food Pantries Expand Offerings Thanks to CareSource Foundation Grant (3/3) – The CareSource
Foundation announced a grant of $45,000 to Norton Children’s Hospital Foundation to support two prescriptive food pantries located in Clarksville and Jeffersonville, Indiana. This award will support the Norton Children’s Hospital Foundation in expanding its offerings to stock baby supplies, car seats, safe sleep sacks, Pack ‘N Plays, bike helmets, gun locks and healthy food options for patients.
Unite Us: Mobilizing for Action – The Importance of Cross-Sector Collaboration (3/3) – Unite Us has collaborated with Intermountain Health and CyncHealth to reduce barriers to community-engaged social care coordination and advocate for the use of effective tools that facilitate and encourage cross-sector collaboration. The organizations recently conducted a multi-network evaluation to understand the motivators, facilitators, and barriers community-based organizations encounter when participating in coordinated care networks.
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Legislative Roundup
Improving Access to Nutrition Act (3/9) - Rep. Lee (D-CA) and 41 cosponsors introduced the Improving Access to Nutrition Act (H.R. 1510), which would repeal the particular work requirement that disqualifies able-bodied adults for eligibility to participate in SNAP to ensure that all Americans have access to nutritious food and the ability to stay healthy in everyday life.
Connected MOM Act
(3/8) - Sens. Cassidy (R-LA), Hassan (D-NH), Young (R-IN), Carper (D-DE), Thune (R-SD), and Rosen (D-NV) introduced the Connected Maternal Online Monitoring (MOM) Act (S. 712), which would identify and address barriers to coverage of remote physiologic devices under State Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women.
Physicians for Underserved Areas Act (3/8) - Sens. Rosen (D-NV) and Boozman (R-AR) introduced the Physicians for Underserved Areas Act (S. 703), which would make improvements to the redistribution of residency slots under the Medicare program after a hospital closes.
SPARC Act
(3/8) - Sens. Rosen (D-NV) and Wicker (R-MS) introduced the Specialty Physicians Advancing Rural Care (SPARC) Act (S. 705), which would authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians.
SNAP Second Chance Act (3/7) - Reps. Trone (D-MD), Correa (D-CA), McGovern (D-MA), Watson Coleman (D-NJ), Smith (D-WA), and Del. Norton (D-DC) introduced the SNAP Second Chance Act (H.R. 1427), which would limit the use of business integrity and reputation factors when determining the eligibility of a retail food store or a wholesale food concern to be approved to redeem supplemental nutrition assistance program benefits. One pager
Digital Equity Foundation Act (3/7) - Reps. Matsui (D-CA), Bonamici (D-OR), Eshoo (D-CA), Smith (D-WA), Grijalva (D-AZ), and Carter (D-LA) introduced the Digital Equity Foundation Act (H.R. 1412), which would establish the Foundation for Digital Equity to channel public and private investments into making progress to close the divide on digital equity, inclusion, and literacy.
Neighborhood Homes Investment Act (3/7) - Sens. Cardin (D-MD), Young (R-IN), Wyden (D-OR), Moran (R-KS), and Brown (D-OH) introduced the Neighborhood Homes Investment Act (NHIA) (S. 657), which would establish a tax credit for neighborhood revitalization in distressed neighborhoods. The bill would cover the cost between building or renovating a home in these areas so that homeowners can renovate and stay in their homes, and caps the price of sales for each home to ensure they are affordable housing options in the community.
Healthy Meals Help Kids Learn Act (3/6) - Rep. McGovern (D-MA) introduced the Healthy Meals Help Kids Learn Act (H.R. 1269), which would permanently increase federal reimbursement rates of school meals to help address funding challenges, enhance menus, increase access to locally grown food, and support expanded services like afterschool snacks and breakfast in classrooms.
Conrad State 30 and Physician Access Reauthorization Act (3/6) – Sens. Klobuchar (D-MN), Collins (R-ME), Rosen (D-NV), and Tillis (R-NC) introduced the Conrad 30 and Physician Access Reauthorization Act (S. 665), which would provide incentives to physicians to practice in rural and medically underserved communities. The bill would allow international doctors to remain in the U.S. upon completing their residency under the condition that they practice in areas experiencing doctor shortages.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health in the 118th Congress, click here.
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On March 9, President Biden released the Fiscal Year (FY) 2024 Budget Request. The budget proposes $144.3 billion in discretionary and $1.7 trillion in mandatory budget authority for HHS for FY 2024. The budget demonstrates the Administration’s commitment to areas such as health equity and maternal health, among other priority areas. The HHS Budget in Brief can be found here.
Aligning for Health was pleased to see the inclusion of several key provisions related to SDOH, health equity, and maternal health in this budget request. Key highlights include:
- $100M to CDC for the Social Determinants of Health program to implement and evaluate SDOH Accelerator Plans and to build the evidence base for SDOH-directed interventions through applied research, data collection, and surveillance.
- Various proposals at CMS to address SDOH and advance health equity, including:
- Allowing for the collection of demographic and SDOH data through CMS quality reporting and payment programs
- Conducting a subnational Medicare medically-tailored meal demonstration
- Adding Medicare coverage of services furnished by community health workers
- $25M to advance health equity, including through the development of a Health Equity Policy Collaborative and Health Equity Data Analysis System.
- $52M to ONC for ONC’s Standards, Interoperability, and Certification work, which includes furthering Administration priorities around an equity-by-design approach, collection of race/ethnicity data, and integrating SDOH and human and social services data to improve health outcomes and the patient experience.
- $86M for the Office of Minority Health to increase focus on areas with high rates of adverse maternal health outcomes or with significant racial or ethnic disparities in maternal health outcomes.
- $276M to HRSA to reduce maternal mortality and morbidity.
A full summary of the various SDOH provisions included in the budget request for HHS can be found here. In addition to the HHS Budget in Brief, see here for the USDA Budget in Brief and HUD Budget in Brief.
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Administration Updates
HHS: HHS Awards Nearly $1.6B to Support Low Income Households to Lower Heating and Cooling Costs (3/16) – HHS, through the Administration for Children and Families (ACF), announced an award of $560 million, in addition to an award of $1 billion last month, for a total of $1.56 billion to help cover American households home heating and cooling costs. The grant awards are part of the Low Income Home Energy Assistance Program (LIHEAP) to help low-income households with their energy costs.
CDC: Maternal Mortality Rates in the United States, 2021 (3/16) – The CDC released a report
representing maternal mortality rates for 2021, which found that the number of maternal deaths increased nearly 40 percent, with rates of pregnancy-related death highest among Black individuals. In 2021, 1,205 women died of maternal causes — equivalent to a rate of 32.9 deaths per 100,000 live births — compared to 861 deaths in 2020, or 23.8 deaths per 100,000 live births. For Black women, the rate of death was 69.9 – which is 2.6 times higher than the rate for white women and 1.3 times higher than it was in 2020.
HUD: HUD Awards $6M to Improve the Safety and Health of Homes of Low-Income Families (3/16) – The U.S. Department of Housing and Urban Development (HUD) awarded nearly $6 million to public housing agencies and a state housing authority to protect children and families from housing-related hazards, including radon exposure. HUD is also awarding a grant to improve the energy efficiency of 60 homes under its Healthy Homes and Weatherization Coordination Demonstration grant program
HHS ASPE: Advancing Primary Prevention in Human Services – Convening Findings (3/8) – The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report highlighting key themes and ideas from a HHS Convening on Advancing Primary Prevention in Human Services in August 2022. With a particular focus on prevention of youth and family homelessness, discussion highlighted the opportunity for human services to shift from responding to families once they are in crisis to preventing the crisis before it occurs.
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SDoH & Health Equity in the News
NEJM Catalyst: Pathways to Success in Meeting Health-Related Social Needs (3/15) - This article outlines an approach to understand and improve whether and how social drivers of health programs connect participants with resources to address their health-related social needs (HRSNs). The authors focus on a predominant SDOH program model in which activities are initiated within a health care organization. The article proposes a pathways strategy to appreciate, synthesize, and manage the ecosystem in which an SDOH program operates and the pathways by which program participants do or do not get connected to social resources that meet their needs.
MedCity News: How Providers Across the US Are Caring for the Country’s 580,000+ Homeless People (3/13) - More than 580,000 individuals are experiencing homelessness in the U.S., and hospitals across the country have dedicated programs to caring for this incredibly at-risk population. Initiatives at UCLA Health, Boston Health Care for the Homeless Program and University of Illinois Health focus on street medicine, connecting patients to housing and integrating behavioral and preventive care into primary care.
AP News: What do race and ethnicity mean? The US government is asking (3/13) – The White House Office of Management and Budget (OMB) is working on setting new classifications and standards for race and ethnicity data, looking to update the nation’s racial and ethnic categories for the first time since 1997. The idea of revising categories for ethnic and racial identities, both in the census and in gathering demographic information between head counts, has fueled thousands of written comments by individuals, many of which are summarized in this article.
CityHealth: Through Local Policy and Investments, Health Care Systems are Addressing SDOH (3/13) – CityHealth partnered with Healthcare Anchor Network, a national collaboration of more than 70 leading health care systems, and Multiplier Advisors, a national health care impact investing consultant, to explore ways in which health systems can work with cities to address the social determinants of health. The organizations recently kicked off a six-month learning cohort focused on the alignment of impact investments and policy advocacy at the local level.
The Washington Post: Medicaid can help people eat healthier. Here’s how (3/9) – One of the best and most cost effective ways to address diabetes is with a healthy diet, yet one of the largest sources of coverage in the US – the Medicaid program – has had limited authority to tackle this fundamental need. The same is true of many other lifestyle-dependent health conditions. This article explores the concept of allowing Medicaid funds to be used on nutrition and healthy food to improve health outcomes.
New Republic: Food Banks Will Bear the Brunt of America’s Looming Hunger Cliff (3/8) – The end of emergency allotments for SNAP aimed at addressing food insecurity during the pandemic will result in millions of SNAP beneficiaries facing a “hunger cliff” at the end of the public health emergency, as a significant decrease in benefits is expected. The increase in demand spurred by the end of emergency allotments could put further stress on food banks and their partners, which have already been overwhelmed by increased costs, supply chain issues, and insufficient volunteer help throughout the pandemic.
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Maternal Health
JAMA Network Open: Association of Antenatal COVID-19-Related Stress with Postpartum Maternal Mental Health and Negative Affectivity in Infants (3/14) - Antenatal stress is a significant risk factor for poor postpartum mental health. The association of pandemic-related stress with postpartum outcomes among mothers and infants is, however, less well understood. This study examined the association of antenatal COVID-19–related stress with postpartum maternal mental health and infant outcomes.
AP News: Mississippi backs one year of postpartum Medicaid for new moms (3/7) – The Mississippi state legislature passed a bill to allow low-income new mothers in the state to be eligible for a full year of Medicaid coverage. This bipartisan move is the culmination of a two-year effort to convince a majority of the Republican-controlled House to provide longer postpartum coverage across the state.
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New Research and Reports
NEJM Catalyst: System Approaches to SDOH Screening and Intervention (3/15) – This case study examines how UNC Health Care System aimed to increase screening and action on SDOH across its large organization in North Carolina. UNC Health aimed to increase screening both to inform patient care and to understand population level needs. Using existing infrastructure and governance, new workflows, and modifying responsibilities for existing population health employees, UNC Health developed and spread new processes for collecting and acting on social needs.
AJMC: COVID-19 and MCO-Community Partnerships to Address Enrollee Social Needs (3/14) - Many Medicaid managed care organizations (MCOs) now screen enrollees and connect them to community-based organizations (CBOs) to address unmet social needs. COVID-19 has significantly disrupted health care delivery and overall economic activity in the United States. This study examined how partnerships between Medicaid MCOs and CBOs to address social determinants of health have been affected by the pandemic.
Urban Institute: Advancing Equitable Government 2.0 (3/6) – The Biden Administration released Executive Order 14091 with the intent to advance racial equity and support for underserved communities, calling on agencies to submit annual agency equity plans to assess obstacles to equity in their organizations. The Urban Institute published a preview to a forthcoming analysis of these plans, which showed that large federal agencies charted paths toward the EO’s goals but had not yet outlined details of implementation plans.
Health Affairs: Can Capitalism Drive Health Equity? Considering the Benefits and Risks of Social Drivers of Health Bonds (March 2023) - Numerous health care advances and innovations have stemmed from the financial incentives that a capitalistic society fosters, but individuals and communities achieving optimal health is not always tied to a financial gain. The impact of capitalism-derived financial tools such as social bonds to address social drivers of health therefore needs to be carefully scrutinized, not only for the potential benefits but also for the potential unintended consequences.
Health Affairs: Proposing An Innovative Bond to Increase Investments in Social Drivers of Health Interventions in Medicaid Managed Care (March 2023) – Interventions to address the social drivers of health (SDH) can reduce future health care costs but require up-front investments. This study proposes a financial innovation, an SDH bond, to increase investments in SDH interventions. Issued by multiple managed care organizations in a Medicaid coverage region, the bond would raise immediate funds for SDH interventions that are coordinated across the organizations and delivered to all enrollees of the region.
Health Affairs: Proposed Social Drivers of Health Bonds Offer Promising Improvements But Face Many Challenges to Implementation (March 2023) - Social drivers of health (SDH) bonds have been proposed as a way of incentivizing investment in SDH interventions by Medicaid managed care organizations. The success of SDH bonds is predicated on the acceptance of shared responsibilities and resources for corporate and public-sector stakeholders. The Community Reinvestment Act model allows for innovation to meet business needs of health organizations, and cooperative competition can facilitate needed technology improvements for community social service organizations.
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SDoH Opportunities
March - October
Rolling Basis
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