Highlights 

• CMS announces AHEAD Model to advance health equity
• Bipartisan members of the House introduce the DIRECT Care for the Homeless Act
• CMS releases infographic about leveraging Z codes to collect SDOH data
• ACL Awards Center of Excellence to Align Health and Social Care

Member News 

findhelp: Findhelp and TennCare: Serving Tennesseans Through Technology (8/31) – findhelp announced that it will work with the State of Tennessee’s Medicaid Agency (TennCare) to help Tennesseans find the non-medical social care assistance they need.

AHA: Best Practices for Equitable Maternal Care (9/1) – The AHA published a new AHA resource highlights ways health care organizations can foster equitable practices in maternal care, individually and systemically.

UPMC: UPMC Program Improved Equity in Allocation of Scarce Medication (9/1) – UPMC equitably distributed Evusheld, a COVID-19 prevention therapy for immunocompromised patients, program based on the national Area of Deprivation Index.

findhelp: Supporting South Dakotans: Our New Partnership with the Dept. of Health (9/6) – findhelp is working with the State of South Dakota’s Department of Health to build a statewide social care referral system, known as a Community Information Exchange (CIE), that will connect South Dakotans in need of social care services.

Unite Us: Azara Healthcare and Unite Us Announce Integration for Seamless Connection to Social Services Support Unite Us (9/7) – Azara Healthcare, the leading provider of population health management solutions, and Unite Us, the nation’s leading software company enabling cross-sector collaboration to improve people’s health and well-being, announced an integration to provide their mutual clients with connections to care.

PR Newswire: Recommendations for Addressing Health-Related Social Needs in Cancer Care Introduced at NCCN Policy Summit (9/12) – At the National Comprehensive Cancer Network (NCCN) Policy Summit, the Blue Cross Blue Sheild Association discussed some of the work being done by payers to address health disparities and called for national data standards to be developed and adopted in order to address social needs.

CareSource: Envisioning a better tomorrow for children and families (9/13) – CareSource HealthAlliance partnered with the Children’s Alliance of Kansas to address child welfare concerns, including parental social determinants of health such as housing, food and safe neighborhoods.

CMS Issues Infographic on SDOH Data Collection Via Z Codes 

Details below

Administration Updates

CMS: Improving the Collection of Social Determinants of Health (SDOH) Data with ICD-10-CM Z Codes (9/1) – CMS issued an infographic about leveraging Z codes to document SDOH.

CMS: CMS Announces Transformative Model to Give States Incentives and Flexibilities to Redesign Health Care Delivery, Improve Equitable Access to Care (9/5) – CMS unveiled the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, under which participating states will be better equipped to promote health equity, increase access to primary care services, set health care expenditures on a more sustainable trajectory, and lower health care costs for patients.

FNS: Agency Information Collection Activities: Assessing Equity in Work Requirements and SNAP Employment & Training (9/6) – The Food and Nutrition Service is inviting public comment on its proposed information request “Assessing Equity in Work Requirements and SNAP Employment and Training.” Comments are due November 6.

ACL: ACL Awards Center of Excellence to Align Health and Social Care (9/12) – ACL’s Office of Network Advancement (ONA) is announcing a new award to USAging for the Center of Excellence (COE) to Align Health and Social Care: Enhancing Community-Based Aging and Disability Organizations to Improve Access to Long-Term Services and Supports. The project period is September 1, 2023 through August 31, 2026, with first-year funding totaling over $5.5 million.

CMS: Accountable Health Communities Model Announced: Communicating the Value of Addressing Health-Related Social Needs posted (9/12) – CMS released a resource to highlight communication efforts from three organizations to address health-related social needs (HRSN) as part of the Accountable Health Communities (AHC) Model.

SDoH & Health Equity in the News

Center for Health Care Strategies: Meeting the Health and Social Needs of LGBTQ+ Older Adults Through Medicaid (9/6) – This brief found that a long history of discrimination against the LGBTQ+ community has led to unmet health and social needs that result in health disparities for these populations when compared with cisgender, heterosexual individuals.

Medical Xpress: Addressing social determinants of health in post-overdose outreach associated with reduction in overdoses (9/14) – Boston Medical Center found that municipalities in Massachusetts that offered overdose survivors ways to access a wide range of social services to address social determinants of health experienced 21% fewer fatal overdoses compared to municipalities that offered less robust social services to overdose survivors.

New Research & Reports

Journal of Medical Systems: Assessing Patient and Community-Level Social Factors; The Synergistic Effect of Social Needs and Social Determinants of Health on Healthcare Utilization at a Multilevel Academic Healthcare System (9/1) – Researchers investigated the role of both individual-level social needs and community-level SDOH in explaining emergency department (ED) utilization rates.

Association for the Study of Medical Education: Preparing students to address the social determinants of health in integrated care settings (9/4) – This paper describes large-scale, community-engaged learning that is required annually of students from nursing, pharmacy, public health, and social work. Students are trained to be SDOH change makers who can readily adopt integrated care service delivery frameworks into their future practice.

American Journal of Emergency Medicine: A descriptive study of screening and navigation on health-related social needs in a safety-net hospital emergency department (9/10) – Researchers evaluated whether navigation services for high-risk patients led to the resolution of HRSN. During the study period, one-third of HRSN were successfully resolved with another one-third in-process.

Upcoming Events

Aligning for Health & Member Events

• September 14-December 14 – Unite Us, “Unite Us Journey | Session 2.” Virtual
• September 12 – Unite Us, “How Addressing Social Needs Will Transform Healthcare: Fireside chat with NCQA and Presbyterian Healthcare Services.” Virtual
• November 7-8 – Socially Determined, “TAHP Health Care Conference + Expo.” Austin, TX
• December 4-6 – RISE and Aligning for Health, “Social Determinants of Health Policy Forum.” Aligning for Health is thrilled to be partnering with RISE for the Second Annual Social Determinants of Health Policy Forum this December, where we will convene leading policymakers with cross-sector practitioners to identify opportunities and advance policies that support stronger communities, better health, and solutions to address health and social needs.
• May 7-9, 2024 – AHA, “Accelerating Health Equity Conference.” Kansas City, MO

Other Events

• September 14-15 – Physicians for a Healthy California, “Health Equity Leadership Summit.” San Jose, CA
• September 19 – LexisNexis, “How SDOH data can knock down barriers to member engagement.” Virtual
• September 19 – Mom Congress, “Congressional Briefing: Saving and Supporting Moms.” Washington, DC
• September 20 – Salud America! “How to Systemically Address Social Needs in Healthcare Settings.” Virtual
• September 26 – HRSA, “NMMHH Informational Webinar for Community-Based Organizations.” Virtual
• September 29 – Center for Health Care Strategies, “Equity-Centered Strategies to Improve Care for People Experiencing Homelessness: Lessons from Kings and Tulare Counties.” Virtual
• September 26-27 & October 3-4 – GW School of Nursing, “2023 Age-Friendly Ecosystem Summit.” Virtual
• October 10 – SIU School of Medicine, “2023 Illinois Rural Health Summit: Exploring Gender Health Equity through Policy.” Springfield, IL and Virtual
• October 14-16 – Society for Public Health Education, “Vote for Health: Advancing health for All Through Community & Civil Engagement.” Washington, DC
• November 30 – National Academies of Sciences, Engineering, and Medicine, “The Food Forum 30th Anniversary Symposium.” Virtual

SDoH Opportunities

September 2023 - July 2024

• 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: September 27 – NIH, Research Coordinating Center on the Exposome and Alzheimer's Disease (AD) and AD-Related Dementias (ADRD): Elucidating the Role of Social and Behavioral Determinants of Health in AD/ADRD Etiology and Disparities
• Deadline: October 3 – Food Research & Action Center, Equitable Access in Child Nutrition Programs (EA-CN) Request for Proposals (RFP)
• Deadline: October 5 – ACL, Benefits Enrollment Center (BEC)
• Deadline: October 19 – NIH, Funding Opportunity: Pilot Interventions to Integrate Social Care and Medical Care to Improve Health Equity
• Deadline: November 22 – NIH, Improving Choice, Use, and Equitable Implementation of Biomedical HIV Prevention for Women
• Deadline: November 28 – DOT, Cooperative Agreements with Technical Assistance Providers for the Fiscal Year 2023 Thriving Communities Program
• Deadline: December 15 – NIH, Notice of Intent to Publish a Funding Opportunity Announcement for Short Courses in Social Determinants of Health for Research Education in Nursing Research
• Deadline: October 30 – HUD, Pathways to Removing Obstacles (PRO) to Housing
• Deadline: November 30 – CMMI, Making Care Primary (MCP) Model RFA
• Deadline: January 12, 2024 – Robert Wood Johnson Foundation, Health Data for Action
• Deadline: March 20, 2024 – HHS ACF, Maternity Group Home Program
• Deadline: June 20 2024 – Administration for Children and Families (ACF), TANF Data Collaborative (TDC) Equity Analysis Awards
• Deadline for Cohort 3: July 23, 2024 – CMS, States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model

Rolling Basis

• Deadline: January 1, 2027 – NIH, Improving Care and Outcomes for Cancer Survivors from Sexual and Gender Minority (SGM) Populations

• Deadline: January 1, 2027 – NIH, Intervention Research to Improve Native American Health

• 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