Highlights

• CMS Innovation Center publishes Health Affairs article on progress toward its health equity initiative
• U.S. Surgeon General raises alarm on impact of the epidemic of loneliness and isolation
• HHS awards additional $8.2M to expand pilot diaper distribution program
• USDA publishes blog on how easier enrollment in WIC leads to healthier moms and babies

Member News 

Vizient: Care At Home Programs Bolster Everything from Cost Savings to Health Equity to Supplier Innovation – All While Boosting Patient Satisfaction (5/11) – This Vizient blog outlines how shifting to care at home offers several benefits beyond improving patient preference and satisfaction. For example, moving care into the home can advance health equity by allowing providers to adapt treatment plans to the patient’s daily environment and address living conditions that impact health.

American Hospital Association: AHA Letter to Senate Leadership Regarding Funding for Health Care Programs for FY2024 (5/9) – The American Hospital Association (AHA) wrote to Senators Baldwin and Capito, the Chair and Ranking Member of the Senate Appropriations Committee, Subcommittee on Labor, HHS, Education and Related Agencies, outlining its priorities for funding for health care programs for fiscal year (FY) 2024. Among the priorities includes funding the CDC Social Determinants Accelerator Plan grants at $100 million in FY2024 to continue to expand SDOH efforts through another round of such plans.

Unite Us: Better Together – Collaborating for Family Resilience with Sarasota Memorial Health Care System (5/8) – First 1,000 Days Suncoast, a regional initiative led by Sarasota Memorial Health Care System, was launched in 2018 to reduce systemic barriers to health for young families, and includes over 80 organizations that work together to support families through cross-sector collaboration. First 1,000 Days leverages navigators who work with patients to address care needs and send referrals to appropriate services through Unite Us, a partnership which is described in more detail through this blog.

3M: Exploring Technology and the Promise of AI in Health Equity – A HIMSS23 Recap (5/3) – In this blog post by 3M Health Information Systems, Chief Population Officer Dr. Melissa Clarke discusses her experience at the 2023 HIMSS conference, including insight on health equity. She notes how AI can be used to gather SDOH documentation no matter what clinician documented it in the record and present it to the coder to capture Z codes. Increasing the richness of the available claims data to incorporate social risk and social concerns allows us to realize the complex interplay between social and clinical data.

UPMC Health Beat: Health Equity Q&A With Johanna Vidal-Phelan, MD (5/1) – Johanna Vidal-Phelan, MD, chief medical officer of the Quality Department at the UPMC Insurance Services Division, develops and evaluates strategies and interventions for the division’s diversity and equity initiatives. In this Health Equity Q&A, Dr. Vidal-Phelan discusses some of the barriers to quality health care for Latinos and other underrepresented communities both in Pennsylvania and beyond.

Legislative Roundup 

Universal School Meals Program Act (5/11) – Sens. Sanders (I-VT), Gillibrand (D-NY), and Heinrich (D-NM) and Reps. Omar (D-MN), McGovern (D-MA) and Moore (D-WS), along with 15 colleagues in the Senate and 68 colleagues in the House, introduced the Universal School Meals Program Act of 2023 (S. 1568/H.R. 3204), which would provide a permanent solution to end child hunger in schools by offering free breakfast, lunch, dinner and a snack to all students, preschool through high school, regardless of income. This would eliminate school meal debt and strength local economies by incentivizing local food procurement.

Health Center Service Expansion and Provider Shortage Reduction Act (5/8) - Reps. Blunt Rochester (D-DE), Kuster (D-NH), and Barragan (D-CA) introduced the Health Center Service Expansion and Provider Shortage Reduction Act (H.R. 3080), which would expand services provided at community health centers. Specifically, the bill would increase access to mental and behavioral health services provided through health centers, expand weekend and evening hours, create new service sites, and invest in strengthening the primary care workforce through the National Health Service Corps (NHSC).

No Hungry Kids in School Act (5/5) - Reps. Porter (D-CA), Aguilar (D-CA), and 11 cosponsors introduced the No Hungry Kids in School Act (H.R. 3112), which would establish statewide community eligibility for certain special assistance payments.

Expanding Access to School Meals Act (5/5) - Rep. Porter (D-CA) and nine cosponsors introduced the Expanding Access to School Meals Act (H.R. 3113), which would eliminate reduced price breakfasts and lunches and require that the income guidelines for determining eligibility for free breakfasts and free lunches be 200 percent of the poverty-level to ensure students from low-income families get nutritious food.

Hotels for Housing Conversion Act (5/5) - Reps. Schiff (D-CA), Vargas (D-CA), and Mullin (D-CA) introduced the Hotels to Housing Conversion Act (H.R. 3117), which would establish a program for the Secretary of Housing and Urban Development to make grants to states and continua of care to carry out conversions of structures for use as emergency shelters and housing for homeless persons and families.

Transit to Trails Act (5/4) - Rep. Gomez (D-CA) and 35 cosponsors introduced the Transit to Trails Act (H.R. 3092), would establish a program to award grants to entities that provide transportation connectors from critically underserved communities to green spaces. Sen. Booker (D-NJ) and eight cosponsors introduced companion legislation in the Senate (S. 1440).

Closing the Meal Gap Act (5/2) - Rep. Adams (D-NC) and 64 cosponsors introduced the Closing the Meal Gap Act (H.R. 3037), which would require that supplemental nutrition assistance program benefits be calculated using the value of the low-cost food plan.

Equal Health Care for All Act (5/2) - Rep. Schiff (D-CA) and 18 cosponsors introduced the Equal Health Care for All Act (H.R. 3068), which would prohibit discrimination in health care and require the provision of equitable health care.

John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act (5/2) - Rep. Sewell (D-AL) and six cosponsors introduced the John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act (H.R. 3069), which would improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation.

Community Mental Wellness & Resilience Act (5/2) - Reps. Tonko (D-NY), Fitzpatrick (R-PA), Castor (D-FL), Bacon (R-NE), and Peltola (D-AK) introduced the Community Mental Wellness & Resilience Act (H.R. 3073), which would promote mental wellness and resilience and prevent and heal mental health, behavioral health, and psychosocial conditions through developmentally and culturally appropriate community programs, and award grants for the purpose of establishing, operating, or expanding community-based mental wellness and resilience programs.

Rural Housing Service Reform Act (5/2) - Sens. Smith (D-MN) and Rounds (R-SD) introduced the Rural Housing Service Reform Act of 2023 (S. 1389), which would reform rural housing programs and strengthen the supply of affordable housing.

To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health in the 118^th Congress, click here. 

Administration Updates

Health Affairs: Advancing Health Equity Through the CMS Innovation Center – First Year Progress And What’s to Come (5/11) – In this article, CMS Innovation Center Chief Medical Officer Dora Hughes provides a one-year look back at what the Innovation Center has accomplished as part of its health equity initiative and describes additional areas of focus moving forward. In 2023, the Innovation Center intends to sharpen its focus on the needs of other underserved populations that are not well represented in models, explore options to build upon and support earlier investments in rural health, and examine mechanisms for social risk adjustment of payment.

HUD: HUD Allocates $382M to Help States Produce Affordable Housing (5/3) – The U.S. Department of Housing and Urban Development (HUD) allocated $382 million through the nation’s Housing Trust Fund, an affordable housing production program that complements existing Federal, state and local efforts to increase and preserve the supply of decent, safe, and sanitary affordable housing for extremely low- and very-low income households, including families experiencing homelessness.

HHS: New Surgeon General Advisory Raises Alarm about the Devastating Impact of the Epidemic of Loneliness and Isolation (5/3) – U.S. Surgeon General Murthy released an Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in the U.S. The Advisory lays out a framework for a National Strategy to Advance Social Connection based on six foundational pillars: strengthen social infrastructure; enact pro-connection public policies; mobilize the health sector; reform digital environments; deepen our knowledge; and cultivate a culture of connection.

HHS: HHS Awards an Additional $8.2M to Expand Pilot Diaper Distribution Program (5/2) - HHS Administration of Children and Families (ACF) announced an additional $8.2 million to support the first-ever federally-funded diaper distribution program for low-income families. The Diaper Distribution Demonstration and Research Pilot will add an additional six states and one tribe to the original grant recipients to address widespread diaper need.

SAMHSA: SAMHSA to Sponsor Equity Challenge to Identify Organizations’ Successful Outreach Strategies to Connect Historically Underserved Communities to Services (5/2) – The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will sponsor a Behavioral Health Equity Challenge, which will identify and highlight outreach and engagement strategies used by community-based organizations to increase access to mental health and substance use prevention and treatment services for racial and ethnic underserved communities.

HHS ASPE: Variation Across States in Loss of Medicaid Coverage Among Pregnant Beneficiaries with Substance Use Disorders (5/1) – The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report finding that 13 percent of pregnant Medicaid beneficiaries with substance use disorder (SUD) lost Medicaid coverage between 60 and 90 days postpartum in 2019. The results of the study indicate the need for improved continuity of coverage in the postpartum period, and the potential roles of the ACA and American Rescue Plan in addressing this policy challenge.

USDA: Easier Enrollment in WIC Leads to Healthier Moms and Kids (4/27) – The U.S. Department of Agriculture (USDA) released a blog post, “Easier Enrollment in WIC Leads to Healthier Moms and Kids,” highlighting steps USDA is taking to help more eligible families connect to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

SDoH & Health Equity in the News

HIT Consultant: Get Well to Roll Out New SDOH Screening Solution Nationwide (5/10) – Get Well announced it has expanded its digital patient engagement portfolio to include new SDOH screening solutions. The new solution will be available to more than 200 enterprise health care organizations nationwide that are using GetWell Inpatient, an interactive patient care and hospital experience management product, at no additional cost.

Health Affairs: Medicaid Reinvestment Requirements Can Improve Community Health and Equity (5/10) - In the past few years, multiple states have implemented new policies requiring Medicaid managed care plans (MCPs) to reinvest a percentage of revenue or profit back into the communities they serve. This is one of the many developments in Medicaid policy and practice that reflect a willingness to address individual social needs and commitment to invest in positively impacting social determinants of health. This article describes several key learnings to assist states in developing and implementing MCP reinvestment policies.

Politico: COVID brought a community health worker boom. Now come the layoffs (5/8) – Congress invested nearly half a billion dollars in pandemic funding into building up a workforce of community health workers to help reach people at particular risk from COVID-19. The workers used their local ties to convince minority groups to get vaccinated and connect them with treatment. Without the funding’s continuation, some government officials and health experts say their work – which can go beyond COVID to make progress on other chronic diseases – will be cut short.

Fierce Healthcare: L.A. Care, Health Net commit $114M to Los Angeles County’s effort to support the unhoused (5/4) – L.A. Care Health Plan and Health Net announced they will invest $114 million over five years to help address the homelessness crisis in Los Angeles County. Funding will be used to help the county secure housing units in the private rental market for people with rental vouchers experiencing homelessness, and will help the county identify daily living needs among unhoused people through field assessments and connect them with caregiver help.

UC San Diego: Pilot Project to Help Patients with Transportation Barriers Get to Appointments (5/4) – A collaboration between UC San Diego Health and 211 San Diego aims to help improve patient outcomes by addressing social determinants. The region’s only academic medical center is the first hospital system in the county to participate in the pilot project, which will improve access to transportation resources for UC San Diego Health patients who have been discharged from the hospital and may have barriers getting to follow-up appointments.

National Association of Counties: Counties Address the SDOH Through Mobile Health Services (5/3) - County leaders are well-positioned to understand the influence of SDOH on residents’ health and leverage them to create comprehensive systems change and eliminate barriers to health equity. Counties across the U.S. are actively exploring innovative ways to address the needs of their residents through the lens of SDOH. This article outlines examples of county investments in SDOH to deliver equitable health services to their communities.

 Maternal Health

The Commonwealth Fund: How Expanding the Role of Midwives in US Health Care Could Help Address the Maternal Health Crisis (5/5) - Midwives, integrated fully into U.S. maternity care, could help reduce perinatal health disparities and address provider workforce shortages. The demand for midwives is growing, however legislation and regulations restricting autonomous practice, lack of federal funding for education and training, and inequitable Medicaid reimbursement rates all limit broad access to midwifery care.

GW Public Health: Inaugural Maternal Mental Health State Report Cards Released (5/4) – The Policy Center for Maternal Mental Health, in collaboration with the George Washington University, released the first-ever grading of state efforts in addressing maternal mental health. The results show 42 states received a D or below across three key domains: providers and programs; screening requirements and reimbursements; and insurance coverage and payment.

Health Affairs: Trend Toward Older Maternal Age Contributed to Growing Racial Inequity in Very-Low-Birthweight Infants in the US (May 2023) - In 2016 the CDC reported that for the first time, US women in their thirties were bearing more children than those in their twenties. Analyzing US vital statistics data from the period 1989–2019, this study simulated the effect that the distributional shift to older maternal ages at first birth had on health inequity between Black and White infants.

MACPAC: Access to Maternity Providers – Midwives and Birth Centers (May 2023) - Medicaid finances a significant portion of births, particularly for women who are more likely to have disparities in maternal health outcomes. This issue brief highlights evidence that midwives and the midwifery-led model of care provided in birth centers can improve maternal and child health outcomes at a lower overall cost to Medicaid.

 Data & Innovation

Benefits Data Trust: We Asked State Agencies What They Need to Share Data Well – and Found Broad Agreement (5/8) – Benefits Data Trust and the Center for Health Care Strategies reached out to all 50 states’ SNAP and Medicaid agencies to learn more about improving data coordination across two of the largest federal entitlement programs. In the responses received from 46 states, the groups heard resounding similarities. Four recurring themes appeared across the responses: provide clearer and aligned federal guidance; build cross-agency alignment; utilize expedited enrollment options; and use data to work with third parties.

 New Research and Reports

NEJM Catalyst: The Impact of SNAP Enrollment on Health and Cost Outcomes (5/11) – This study looked at an innovative collaboration between a health care payer and a nonprofit organization to enroll Pennsylvania residents dually eligible for Medicare and Medicaid in SNAP. The study found that SNAP participation was linked to a double-digit percentage reduction in total health care costs and pharmacy costs in both the first and second year of enrollment.

JAMA Network: Assessment of Use of ICD-9 and ICD-10 Codes for SDOH in the US, 2011-2021 (5/9) – The ICD-9 and ICD-10 diagnosis codes for SDOH provide a means to comprehensively document SDOH variables, but they have been underused historically. This study aimed to observe the trends in use of SDOH codes in the US from 2011 to 2021, finding an increase in the use of these codes for SDOH.

Cureus: Preliminary Pilot-Testing of SDOH Screener for Individuals with Intellectual and Developmental Disabilities in Med-Peds (5/4) – In this study, an interdisciplinary combined internal medicine and pediatrics (Med-Peds) team of physicians, psychologists, and researchers within a large, diverse, academic health system aimed to pilot-test the implementation of a five-item SDOH screener within a Med-Peds specialty clinic focused on the developmental needs of individuals with I/DD and their families and a general primary care practice. The study describes the process of implementing this screener, which included five items from the Accountable Health Communities Health-Related Social Needs Screening Tool, and collecting initial pilot data from 747 patients between October 2022 and April 2023.

Health Affairs: The Neighborhood Atlas Area Deprivation Index for Measuring Socioeconomic Status – An Overemphasis on Home Value (May 2023) - The Area Deprivation Index (ADI), popularized by the Neighborhood Atlas, is a multifaceted proxy measure for assessing socioeconomic disadvantage that captures social risk factors that are not available in typical clinical registries and that are related to adverse health outcomes. In applying the ADI to New York State, this study found that the downstate regions (New York City and its suburbs) were as deprived as or more deprived than the other regions for 13 of the 17 ADI variables, but the Neighborhood Atlas–computed overall ADI deprivation was much less in the downstate areas.

Upcoming Events

• May 15 – NIH National Institute of Diabetes and Digestive and Kidney Diseases, “Pre-Application Webinar for Pilot Interventions to Integrate Social Care and Medical Care to Improve Health Equity Funding Opportunity.” Virtual.

• May 15 – Center for Health Care Strategies, “Equitably Identifying Individuals for Care Management: Strategies for CalAIM and Beyond.” Virtual.

• May 15 – AHRQ and NIHMD, “Expert Panel on Racial Bias and Healthcare Algorithms: Public Meeting.” Virtual.

• May 16 – Socially Determined and Pharmaceutical Executive, “Social Determinants of Health Data Evolution: Improve Access, Adherence, and Achieve More Equitable Outcomes.” Virtual.

• May 16-18 – American Hospital Association, “Accelerating Health Equity Conference.” Minneapolis, MN.

• May 17 – Systems for Action, “An Aligned Delivery & Financing Model to Address Food Insecurity & Social Needs of Low-income, Pregnant Women.” Virtual.

• May 17 – Health Care Payment Learning & Action Network (LAN), “Health Equity: Partnering with Community-Based Organizations.” Virtual.

• May 23 – ONC, “SDOH Information Exchange Learning Forum – Implementation, Measurement and Evaluation.” Virtual.

• May 23 – Health Affairs, “Lunch and Learn: A Seat for All – Advancing Racial Equity in Scholarly Publishing of Health Policy and Health Services Research.” Virtual.

• May 31 – Systems for Action, “Research to Understand Systems of Housing (RUSH): Feasibility & Acceptability of Aligning Systems for Fathers.” Virtual.

• May 31 – June 2 – Corporation for Supportive Housing, “CSH Supportive Housing Summit: Building the Field.” Philadelphia, PA.

• June 7-8 – CMS, “Health Equity Conference.” Washington, D.C. and Virtual.

• June 7 – Systems for Action, “Systems Aligning to Optimize Health Services for Youth Experiencing Homelessness.” Virtual.

• June 13 – Coalition to End Social Isolation and Loneliness, “Global Loneliness Awareness Week 2023: Advocating for Connection.” Washington, D.C. or Virtual.

• June 22 – Bipartisan Policy Center, “Terwilliger Center Summit on Housing Supply Solutions.” Washington, D.C.

• June 29 – ONC, “SDOH Information Exchange Learning Forum Summary.” Virtual.

• August 7-11 – National Institute on Minority Health and Health Disparities, “Health Disparities Research Institute.” Bethesda, MD.

• December 4-6 – RISE and Aligning for Health, “Social Determinants of Health Policy Forum.” Washington, D.C.

SDoH Opportunities

May - October

• Deadline: May 22 – SAMHSA, Notice of Funding Opportunity: Minority AIDS Initiative – Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High Risk for HIV/AIDS

• Deadline: May 31 – Robert Wood Johnson Foundation, Funding Opportunity: Health Equity Scholars for Action 2023

• Deadline: May 31 – SAMHSA, Solicitation of Nominations: Organizations to Serve as Non-Voting Liaison Representatives to the Advisory Committee on Women’s Services (ACWS) Subcommittee on Maternal Mental Health

• Deadline: June 1 – HHS Administration for Community Living, Grants Notice: No Wrong Door Community Infrastructure Grants – Scaling Community Care Hubs through Lead Entities

• Deadline: June 5 – USDA, Comment Request: Improving Coordination Between SNAP and Medicaid in State Agencies

• Deadline: June 6 – HRSA, Comment Request: Information Request on Rural Maternity and Obstetrics Management Strategies (RMOMS) Program

• Deadline: June 20 – SAMHSA, Notice of Funding Opportunity: Minority AIDS Initiative – The Substance Use and Human Immunodeficiency Virus Prevention Navigator Program for Racial/Ethnic Minorities

• Deadline: June 26 – USDA Food and Nutrition Service, Request for Comments: How Have SNAP State Agencies Shifted Operations in the Aftermath of COVID-19? (SNAP COVID Study)

• Deadline: June 26 – USDA Food and Nutrition Service, Request for Comments: Understanding States’ SNAP Customer Service Strategies

• Deadline: June 26 – Administration for Community Living, Funding Opportunity to Improve Support for Family Caregivers

• Deadline: June 30 – National Institutes of Health, Request for Information: Food is Medicine Research Opportunities

• Deadline: June 30 – HRSA, Request for Nominations: Advisory Committee on Interdisciplinary, Community-Based Linkages

• Deadline: July 7 – NIMHD, Funding Opportunity: Community Level Interventions to Improve Minority Health and Reduce Health Disparities

• Deadline: July 24 – FDA, Request for Information: Food Labeling in Online Grocery Shopping

• Deadline: September 6 – NIH, Funding Opportunity: Innovations for Healthy Living – Improving Minority Health and Eliminating Health Disparities

• Deadline: September 19 – NIH National Institute of Diabetes and Digestive and Kidney Diseases, Funding Opportunity: Pilot Interventions to Integrate Social Care and Medical Care to Improve Health Equity

• Deadline: October 19 – NIH, Funding Opportunity: Pilot Interventions to Integrate Social Care and Medical Care to Improve Health Equity

Rolling Basis 

• Deadline: Open – HRSA, Request for Nominations: Membership to Serve on the National Advisory Council on Migrant Health

• Deadline: Open – U.S. Breastfeeding Committee, Request for Applications: Creating Space Scholarship

• Deadline: Open - House Committee on Rules, Request for Stories: Experiences, Research, and Solutions to Guide Committee Work in Addressing Hunger

• Deadline: Open - Robert Wood Johnson Foundation, Open Call for Proposals - Evidence for Action: Innovative Research to Advance Racial Equity

• Deadline: Open - Sepsis Alliance, Pledge for Equity, Diversity, and Inclusion In the Fight Against Antimicrobial Resistance, Sepsis and its Underlying Causes

• Deadline: Open - Arnold Ventures Advancing Medicare & Medicaid Integration initiative, Funding Opportunity: Technical Assistance to Advance Medicare and Medicaid Integration for Dual-Eligible Individuals.

• Deadline: Open - Robert Wood Johnson Foundation, Evidence for Action: Investigator-Initiated Research to Build a Culture of Health.

• Deadline: Open - American Hospital Association, Hospital Community Collaborative National Cohort Application.

• Deadline: Open - The de Beaumont Foundation and Johns Hopkins University, Stories of Alignment: Share a reflection related to the “Seven Ways Business Can Align with Public Health for Bold Action and Innovation” report

• Deadline: Open – NIH, Notice of Special Interest: Health Care Models for Persons with Multiple Chronic Conditions from Populations that Experience Health Disparities: Advancing Health Care towards Health Equity