Highlights

• ONC releases SDOH Information Exchange Toolkit for the health IT community
• HHS launches 2023 Health Equity DataJam challenge
• USDA receives Equity Commission interim recommendations
• HUD awards $5.6B in annual grants for affordable housing, community development, and homeless assistance

Member News 

WTAE: New clinic at Magee focuses on helping moms heal (3/1) – Doctors at UPMC launched the Magee Postpartum Pelvic Floor Healing Clinic to support moms healing after delivering a baby with a part of labor and delivery that can often be overlooked. The home base is Magee Women's Hospital, affectionately called the Mamma Clinic, but patients can access the clinic in more than a dozen satellite locations crossing western Pennsylvania to start healing postpartum.

Drug Store News: Walmart, CareSource partner to address racial health inequities (2/28) – Walmart and CareSource have partnered on a three-year agreement to address racial health inequities. Walmart will employ community health workers to conduct risk and social needs assessments at stores and provide life skills and health literacy education, while CareSource will use the information it gathers to coordinate nonclinical services for Medicare, Medicaid, and health insurance exchange members. The companies will cultivate innovative and evidence-based solutions to improve health outcomes in under-resourced and underserved communities.

PR Newswire: Unite Us Partners with Metro Mommy Agency to Advance Maternal Healthcare for Expecting Mothers in South Florida (2/28) – Unite Us has partnered with Metro Mommy Agency, a full-spectrum doula service provider, to accelerate the electronic referrals from health care providers to community providers serving expecting mothers. Doula care providers will be able to implement the Making Optimal Maternal and Child Health Accessible (MOMCHA) program within Unite Us' technology platform.

In Forum: Blue Cross Blue Shield of North Dakota holds conference on SDOH in the state (2/22) – Blue Cross Blue Shield of North Dakota, a health plan of the Blue Cross Blue Shield Association, brought local stakeholders together to discuss health across the state. Blue Cross Blue Shield’s Caring Foundation and NDSU’s Center for Social Research recently conducted a study into social determinants. Findings were at the center of the discussion, including around disparities between age, income and racial background.

Legislative Roundup 

Digital Equity Foundation Act: (3/1) – Sen. Lujan (D-NM) and seven cosponsors introduced the Digital Equity Foundation Act (S. 599), which would establish a nonprofit foundation that would channel public and private investments into making progress in closing the divide on digital equity, digital inclusion, and digital literacy.

Rep. Lee: Congresswoman Lee and Secretary Becerra Hold Roundtable on Food as Medicine, IRA Health Wins in Alameda (2/24) – Congresswoman Barbara Lee (D-CA) and HHS Secretary Becerra held a roundtable discussion on ways food can serve as medicine in Alameda, CA. The discussion recognized the success of the Alameda County Recipe4Health program and strategized ways to prevent and address chronic disease through the implementation of a similar food as medicine program at the national level.

Advancing Safe Medications for Moms and Babies Act (2/21) - Reps. Castor (D-FL), Fitzpatrick (R-PA), and Underwood (D-IL) introduced the Advancing Safe Medications for Moms and Babies Act of 2023 (H.R. 1117), which would implement certain recommendations to promote the inclusion of pregnant and lactating women in clinical research. Section-by-section

CARING for Social Determinants Act (2/17) – Reps. Blunt Rochester (D-DE) and Bilirakis (R-FL) introduced the Collecting and Analyzing Resources Integral and Necessary for Guidance (CARING) for Social Determinants Act (H.R. 1066), which would require the Secretary of HHS to issue and disseminate guidance to states to clarify strategies to address social determinants of health under Medicaid and CHIP.

Senate Committee on Agriculture, Nutrition & Forestry: Chairwoman Stabenow Opening Statement at Hearing on Nutrition Programs in the Next Farm Bill (2/16) – The Senate Committee on Agriculture, Nutrition and Forestry held a hearing titled “Farm Bill 2023: Nutrition Programs,” where the Committee heard from USDA Food and Nutrition Service officials on nutrition programs. Deputy Under Secretary for Food, Nutrition, and Consumer Services Stacy Dean submitted testimony prior to the hearing, outlining the importance of SNAP and its ability to address hunger, USDA food distribution programs, and USDA’s work to advance food and nutrition security, among other topics.

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. A final list of all SDOH-related bills from the 117^th Congress can be found here.

Administration Updates

ONC: FHIRed-SHIP – An Approach to Health Equity by Design for 21st Century Healthcare (3/2) – The Office of the National Coordinator for Health IT (ONC) published a blog on the closed loop system know as Fast Healthcare Interoperability Resources-enabled Social and Health Information Platform (FHIRed-SHIP) and its ability to help clinical providers identify patient’s social service needs, make referrals to social service organizations to address those needs, and receive information back from the social service organization to close the loop on the referral. This model helps to address SDOH by emphasizing a person-centric approach and coordinated medical and social services, interoperable systems, and access to and use of appropriate information at each point of care.

USDA: USDA Receives Equity Commission Interim Recommendations (2/28) – The U.S. Department of Agriculture (USDA) Equity Commission presented its 2023 Interim Report to Agriculture Secretary Vilsack. The Equity Commission has worked to identify how changes to USDA programs, policies, systems and practices can help lift barriers to inclusion or access and address systemic discrimination or racial, economic, health and social disparities. The report identifies recommendations for ways USDA can make changes to better serve the unique needs of the Department’s many and diverse stakeholders.

USDA: Implementation Guidance – Summer 2023 Non-Congregate Meal Service in Rural Areas (2/28) – USDA’s Food and Nutrition Service released implementation guidance which serves as instructions for state agencies and program operators on how to implement Summer Food Service Program (SFSP) and Seamless Summer Option (SSO) rural non-congregate meal service during summer 2023. SFSP and SSO rely on innovative and collaborative efforts to provide summer meals to children in need.

HUD: HUD Awards $5.6B in Annual Grants For Affordable Housing, Community Development, and Homeless Assistance (2/27) – The U.S. Department of Housing and Urban Development (HUD) announced $5.6 billion in funding for 1,200 communities through more than 2,400 grants to States, urban counties, insular areas, DC, Puerto Rico, and local organizations across the country. The grants provide for a wide range of activities including affordable housing, homeless assistance, and connecting individuals with HIV/AIDS to housing and support.

HHS: Health Equity DataJam Challenge (2/23) - HHS published the 2023 Health Equity DataJam challenge and webpage, which invites teams to leverage data from healthdata.gov and other publicly available datasets to propose solutions at the juncture of health equity and the social determinants of health. The purpose of the challenge is to transform HHS data into actionable insights and digital tools to help bridge health disparities, including those exacerbated by COVID-19. Submissions are due by April 30, 2023.

USDA: WIC Online Ordering and Transactions and Food Delivery Revisions to Meet the Needs of a Modern, Data-Driven Program (2/23) – USDA issued a proposed rule to remove barriers to online ordering and internet-based transactions in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program. These proposals are expected to improve the WIC shopping experience while increasing equity and access to nutritious foods for WIC participants to improve nutrition security. Comments are due by May 24, 2023.

ONC: SDOH Toolkit and Learning Forum Sessions for the Health IT Community (2/22) – ONC announced a new Social Determinants of Health (SDOH) Information Exchange Toolkit. This resource is designed to aid the health IT community in the implementation of initiatives that recognize the importance of using SDOH information. The Toolkit can serve as a resource for initiatives that support the collection and use of SDOH information in communities across the country, and includes considerations related to community engagement, health IT standards, infrastructure, interoperability, and governance.

USDA: WIC 2023/2024 Income Eligibility Guidelines (2/21) - The USDA announced adjusted income eligibility guidelines to be used by State agencies in determining the income eligibility of persons applying to participate in WIC.

SDoH & Health Equity in the News

Fierce Healthcare: As SNAP benefits wane, food-as-medicine companies carve out a niche in healthcare (2/27) – With states bracing for an approaching cliff to emergency SNAP benefits with the end of the public health emergency, digital food as medicine programs are bringing resources to the table. Food as medicine programs have long been seen as a niche corner of health care, however, as value-based care gains traction and addressing social determinants becomes more engrained in the health care system, companies like Instacart, FarmboxRx, and About Fresh are expanding their reach.

Patient Engagement HIT: Adding Social Determinants to CMS’ Universal Foundation a Key Step Forward (2/27) – CMS recently proposed a Universal Foundation to use a standard set of quality measures to streamline quality reporting across different value-based care contracts. Notably, CMS included social determinants of health screening and the ability to quantify health disparities as measures for inclusion in the Universal Foundation. This article highlights conversations with the Physicians Foundation on why CMS’ intention to include measures around social drivers of health is groundbreaking.

Axios: Medicaid for food draws mixed reviews (2/24) – Advocates, analysts and policymakers are giving mixed reviews to the Biden Administration’s move to allow states to leverage Medicaid funds for food and groceries. Some say that Medicaid can be used as an additional tool to address food insecurity and diet-related health conditions, while others see expanding programs like SNAP as the priority given the impending cliff in emergency benefits at the end of the PHE.

Health Affairs: Developing National Social Care Standards (2/22) – Social care innovations to date have largely been catalyzed by CMS and select state Medicaid programs that grant flexibilities and incentives for health plans, accountable care organizations, and delivery systems to experiment around social care integration. This is now pivoting to become more the norm within the health care sector itself. This article summarizes five of the emerging national social care accountability initiatives, highlight similarities and differences in design, and considers the advantages and disadvantages of norming in a still rapidly evolving field.

Kaiser Family Foundation: A Look at Recent Medicaid Guidance to Address SDOH and Health-Related Social Needs (2/22) – States can use Medicaid, with some limitations, to address social determinants of health or associated health-related social needs. CMS has recently issued new guidance to expand opportunities for states to use Medicaid in this way, building on guidance released in 2021. This policy watch discusses the new opportunities available to states to address health-related social needs through managed care and through Section 1115 demonstration waivers.

 Maternal Health

New York Times: Rural Hospitals Are Shuttering Their Maternity Units (2/26) – Citing costs, many hospitals in rural areas are closing their labor and delivery wards, expanding so-called maternity care deserts. Women in rural areas face a higher risk of pregnancy-related complications, and those living in maternity care deserts are three times as likely to die during pregnancy and the critical year afterward as those who are closer to care.

U.S. Breastfeeding Committee: State & Territory Breastfeeding Reports (February 2023) – The U.S. Breastfeeding Committee released its State & Territory Breastfeeding Reports, which each describe how breastfeeding rates in the state/territory and other measures compare to national levels. The reports also list the coalitions serving communities in the state and highlights state and community-based lactation projects made possible through federal funding in 2021 and 2022.

 New Research and Reports

Social Science & Medicine: Between health care and social services – Boundary objects and cross-sector collaboration (March 2023) – Cross-sector collaborations between health care and social services are spreading, however the high-risk, high-cost patient works as a boundary object in these collaborations. This paper examines how the “high-risk” patient with both medical and social needs is constructed as a shared object of intervention across sectors. Using the concept of boundary object, authors illustrate how the high-risk patient category aggregates and represents multiple types of information—medical, social, service utilization, and cost—in ways that facilitate its use across sectors.

Fierce Healthcare: JAMA Study reveals housing instability, financial strain not accurately flagged by EHR screeners (2/22) – A recent study published in JAMA found that electronic health records (EHRs) do not accurately reflect some social determinants of health. Screenings of food insecurity, housing instability and financial strain in adult primary care were found to reach varying levels of accuracy. The results of 826 patient self-reports revealed that EHR questionnaires were successful at highlighting patients battling food insecurity while those experiencing housing instability or financial strain were less likely to be flagged.

ATI Advisory: New, Non-Medical Supplemental Benefits in Medicare Advantage in 2023 (2/21) – ATI Advisory released a new chartbook with data on new, non-medical supplemental benefits in Medicare Advantage in 2023, to include meals, food and produce, social needs benefits, transportation for nonmedical needs, and more. In 2023, the most commonly offered benefit under Special Supplemental Benefits for the Chronically Ill (SSBCI) was food and produce, with 929 plans offering this benefit in 2023 (22 percent increase from 2022). The second most common was general supports for living, followed by transportation for non-medical needs.

Center for American Progress: Nonprofit Hospitals Can Improve Community Health Through Housing Investments (2/21) - Growing gaps in affordable, quality housing options can have harmful health consequences and deepen health disparities. Given housing’s integral role as a social determinant of health and nonprofit hospitals’ obligation to provide community benefit in exchange for significant tax exemptions, hospitals should address housing needs within their communities. This report provides policy recommendations for the strategies nonprofit hospitals can consider for investing in housing, as well as for state and federal policymakers to encourage nonprofit hospitals to invest in expanding access to quality, affordable housing by making changes to the community benefit requirement.

Journal of Allergy and Clinical Immunology: Food Insecurity in the Pediatric Food Allergy Population (February 2023) – Food insecurity affects approximately 15 percent of children in the U.S. and has increased due to the COVID-19 pandemic and rising food costs. Previous studies have shown higher rates of food insecurity in food allergic children, though data is limited. This study aims to investigate food insecurity trends in an urban, children’s hospital-based, Allergy/Immunology outpatient clinic.

Upcoming Events

• March 7 – CMS, “The Path Forward: Improving Data to Advance Health Equity Solutions.” Virtual.

• March 8 – CMS, “From Data to Action: How CMS and its Stakeholders Are Addressing Inequities in Healthcare.” Virtual.

• March 8 – Systems for Action, “Integrating Health and Social Services through a Novel Independent Practice Association.” Virtual.

• March 8 – University of Michigan Center for Value-Based Insurance Design, “VBID Summit 2023: Accelerating Health Equity.” Virtual.

• March 9 – NEJM Catalyst, “Social Needs and SDOH: Impact on Patients & Communities.” Virtual.

• March 9 – National Academy of Medicine, “Culture of Health Program Meeting: Impact of Systems on Health Equity.” Virtual.

• March 13 – Long-Term Quality Alliance, “A Deep Dive on In-Home Support Services, Caregiver Supports, and Social Needs Benefits: How Medicare Advantage Plans are Using These Benefits to Meaningfully Meet Members’ Needs.” Virtual.

• March 14 – Bipartisan Policy Center, “Fireside Chat with USDA Under Secretary Xochitl Torres Small.” Virtual.

• March 14, 17 and 18 – OMB Interagency Technical Working Group on Race and Ethnicity Standards, “Town Hall on OMB’s Race and Ethnicity Statistical Standards.” Virtual.

• March 16 – CMS, “CMS Health Equity Conference Proposal Submission Webinar.” Virtual.

• March 16 – Bureau of Primary Health Care Behavioral Health Technical Assistance, “Approaches to Address Social Determinants of Health.” Virtual.

• March 22-24 – 20/20 mom, “2023 Maternal Mental Health Forum.” Virtual.

• March 24 – Root Cause Coalition, “Come to the Table: Ending Hunger in America by 2030 Midwest Region Summit.” Ann Arbor, MI.

• March 28 – ONC, “SDOH Information Exchange Learning Forum – Values, Principles, and Privacy.” Virtual.

• March 29 – 30 – HRSA, “2023 PCMH Health Equity Technical Assistance Symposium.” Virtual.

• April 2-4 – RISE, “The Rise Summit on Social Determinants of Health.” Chicago, IL.

• April 19 – Systems for Action, “Social Bonds as a Pooled Financing Mechanism to Address Social Drivers of Health Equity.” Virtual.

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

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

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

• 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.

SDoH Opportunities

March - October

• Deadline: March 8 – CMS, Request for Comments: List of Screening Instruments for Housing Stability, Food Security, and Transportation Questions on Health Risk Assessments

• Deadline: March 12 – U.S. Breastfeeding Committee, Request for Applications: 2023 National Breastfeeding Conference & Convening Awards

• Deadline: March 13 – NIMHD, Request for Applications: Health Disparities Research Institute

• Deadline: March 13 – CMS, Request for Information: Accelerating the Adoption of Standards Related to Social Risk Factor Data (within the Interoperability & Prior Authorization proposed rule)

• Deadline: March 13 – CDC, Proposed Data Collection Submitted for Public Comment and Recommendations: Maternal Mortality Review Information Application

• Deadline: March 13 – NIMHD, Call for Applications: Health Disparities Research Institute

• Deadline: March 13 – HHS, Request for Information: Promising Practices for Advancing Health Equity for Intersex Individuals

• Deadline: March 15 – Institute for Medicaid Innovation, Survey: 2023 Annual Medicaid MCO Survey

• Deadline: March 16 – CMS, Call for Proposals: CMS Health Equity Conference Presentation Proposals

• Deadline: March 17 - NIH National Institute of Diabetes and Digestive and Kidney Diseases, Request for Information: Report of the NIDDK Advisory Council Working Group on Health Disparities and Health Equity Research

• Deadline: March 23 – CDC, Funding Opportunity: BOLD Public Health Programs

• Deadline: March 23 – Food Research and Action Center, Request for Applications: WIC Community Innovation and Outreach Project Team

• Deadline: March 24 – NIH, Funding Opportunity: Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities

• Deadline: March 24 – NIH, Funding Opportunity: Technologies for Improving Minority Health and Eliminating Health Disparities

• Deadline: March 24 – NIH, Funding Opportunity: Innovations for Healthy Living – Improving Minority Health and Eliminating Health Disparities

• Deadline: March 29 – Robert Wood Johnson Foundation, Request for Applications: 2023 Culture of Health Prize

• Deadline: April 5 – Robert Wood Johnson Foundation, Call for Proposals: Healthy Eating Research

• Deadline: April 11 – CDC, Funding Opportunity: Racial and Ethnic Approaches to Community Health (REACH 2023)

• Deadline: April 12 – Office of Management and Budget, Request for Comments: Initial Proposals for Updating OMB’s Race and Ethnicity Statistical Standards

• Deadline: April 30 – AcademyHealth, Request for Applications: 2023 Health Equity DataJam Challenge

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

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

• 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 – 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