II 

117TH CONGRESS 

2D SESSION S. 5011 

To amend title XIX of the Social Security Act to establish a demonstration 

project testing Whole Child Health Models, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2022 

Mr. CARPER (for himself and Mr. SULLIVAN) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to establish 

a demonstration project testing Whole Child Health Models, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Kickstarting Innova5 tive Demonstrations Supporting Kids Health Act of 2022’’ 

6 or the ‘‘KIDS Health Act of 2022’’. 


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1 SEC. 2. ESTABLISHMENT OF WHOLE CHILD HEALTH MOD2 ELS. 

3 Section 1903 of the Social Security Act (42 U.S.C. 

4 1396b) is amended by adding at the end the following new 

5 subsection: 

6 ‘‘(cc) WHOLE CHILD HEALTH DEMONSTRATION

7 PROJECT.— 

8 ‘‘(1) IN GENERAL.—The Secretary, acting 

9 through the Deputy Administrator and Director of 

10 the Center for Medicaid and CHIP Services, shall 

11 conduct a demonstration project (referred to in this 

12 subsection as the ‘demonstration project’) under 

13 which participating States shall design and imple14 ment whole child health models in 1 or more target 

15 communities in accordance with the requirements of 

16 this subsection. The requirements of section 

17 1902(a)(1) (relating to statewideness) shall not 

18 apply to the demonstration project. 

19 ‘‘(2) DESIGN PHASE.— 

20 ‘‘(A) GRANTS.—Not later than 12 months 

21 after the date of the enactment of this sub22 section, the Secretary shall award up to 15 

23 grants to States that submit complete applica24 tions for such grants which meet the require25 ments of subparagraph (C). 


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1 ‘‘(B) SELECTION OF GRANTEES.—In 

2 awarding grants under this paragraph, the Sec3 retary shall, to the extent possible, prioritize 

4 awarding grants to a geographically diverse se5 lection of States and target communities of dif6 ferent sizes and with varying experience with 

7 value-based payment, including rural and urban 

8 communities. 

9 ‘‘(C) GRANT APPLICATION.—A State shall 

10 include in an application for a grant awarded 

11 under this paragraph the following: 

12 ‘‘(i) A description of each proposed 

13 target community in which the State pro14 poses to implement a whole child health 

15 model. 

16 ‘‘(ii) For each target community de17 scribed in clause (i), a statement of the 

18 proposed objectives of the State in imple19 menting a whole child health model in that 

20 community. 

21 ‘‘(iii) Such other information as the 

22 Secretary may require. 

23 ‘‘(D) USE OF GRANT FUNDS.— 


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1 ‘‘(i) IN GENERAL.—A State awarded a 

2 grant under this paragraph shall use the 

3 grant funds to— 

4 ‘‘(I) conduct or use an existing 

5 needs assessment that is not more 

6 than two years old and meets the re7 quirements of clause (ii) for each pro8 posed target community; 

9 ‘‘(II) not later than 12 months 

10 after being awarded the grant, design 

11 and submit for approval by the Sec12 retary a proposed whole child health 

13 model that meets the requirements of 

14 subparagraph (E) for each target 

15 community based on the results of the 

16 needs assessment and other assess17 ments or surveys conducted for that 

18 community; and 

19 ‘‘(III) implement the whole child 

20 health model during the implementa21 tion phase described in paragraph (3). 

22 ‘‘(ii) NEEDS ASSESSMENT REQUIRE23 MENTS.—A needs assessment conducted 

24 for a proposed target community with 


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1 grant funds awarded to a State shall in2 clude the following: 

3 ‘‘(I) An evaluation of the physical 

4 health, mental, emotional and behav5 ioral health, developmental, social, re6 lational and substance use disorder 

7 service needs of eligible individuals in 

8 the target community, including needs 

9 that could be addressed through popu10 lation-based or community-based 

11 interventions. 

12 ‘‘(II) A review of the resources 

13 available to meet the physical health, 

14 mental health, and substance use dis15 order service needs of eligible individ16 uals in the target community. 

17 ‘‘(III) A description of the bar18 riers identified in the target commu19 nity to eligible individuals accessing 

20 resources and services to address their 

21 physical health, mental health, and 

22 substance use disorder service needs. 

23 ‘‘(IV) A description of health dis24 parities identified in the target com25 munity, including input from commuVerDate Sep 11 2014 22:21 Oct 13, 2022 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S5011.IS S5011

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1 nity residents in the target commu2 nity. 

3 ‘‘(E) WHOLE CHILD HEALTH MODEL RE4 QUIREMENTS.— 

5 ‘‘(i) IN GENERAL.—A proposed whole 

6 child health model shall include descrip7 tions of the following: 

8 ‘‘(I) How the State and its multi9 sector partners will address the phys10 ical health, mental, emotional and be11 havioral health, developmental, social, 

12 relational and substance use disorder 

13 service needs of eligible individuals in 

14 the target community identified in the 

15 needs assessment of that community 

16 through implementation of the whole 

17 child health model and provision of 

18 whole child health services. 

19 ‘‘(II) How the State Medicaid, 

20 human services, and child welfare 

21 agencies will coordinate with commu22 nity partners to ensure the successful 

23 implementation of the whole child 

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1 nities and the provision of whole child 

2 health services. 

3 ‘‘(III) The lead agency or other 

4 entity the State proposes to designate 

5 to coordinate activities carried out to 

6 implement the whole child health 

7 model in the target communities. 

8 ‘‘(ii) REQUIREMENTS.—A proposed 

9 whole child health model shall meet the fol10 lowing requirements: 

11 ‘‘(I) Align with an existing or 

12 planned delivery and payment system 

13 of the State plan under this title or 

14 under a waiver of such plan, includ15 ing, as applicable, a managed care de16 livery system. 

17 ‘‘(II) Include partnerships with 

18 child and family serving organizations 

19 and agencies such as health care pro20 viders, payers, school districts, public 

21 health and child care. 

22 ‘‘(III) Promote the delivery of 

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1 ing workforce shortages, in the target 

2 community and an assessment of the 

3 potential impact of the model on 

4 health equity, disparities, and safety 

5 net providers in the target commu6 nity. 

7 ‘‘(IV) Coordinate funding sources 

8 under the State plan under this title 

9 (or under a waiver of plan), the State 

10 plans under parts B and E of title IV, 

11 and other applicable funding sources, 

12 for the whole child health services pro13 vided under the model. 

14 ‘‘(V) Include— 

15 ‘‘(aa) the design and imple16 mentation or adaptation of a 

17 value-based payment arrange18 ment for providing whole child 

19 health services under the State 

20 plan under this title (or under a 

21 waiver of such plan) that pro22 motes pediatric health; or 

23 ‘‘(bb) in the case of a State 

24 that faces significant barriers to 

25 implementing or adapting such a 


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1 value-based payment arrange2 ment, a proposal for steps that 

3 the State will take towards ad4 vancing value-based care with re5 spect to whole child health serv6 ices provided under the State 

7 plan under this title (or under a 

8 waiver of such plan). 

9 ‘‘(VI) Include strategies to co10 ordinate referrals to whole child 

11 health services, including using tele12 health, referral networks and/or other 

13 technologies to facilitate access to 

14 whole child health services. 

15 ‘‘(VII) Include strategies to pro16 mote the integration of primary care 

17 with whole child health services and 

18 substance use disorder services. 

19 ‘‘(VIII) Include strategies to inte20 grate and streamline eligibility, enroll21 ment, and renewal processes to facili22 tate enrollment in health coverage and 

23 other benefit programs. 


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1 ‘‘(IX) Include strategies to pro2 mote school-based health and 

3 wellness. 

4 ‘‘(X) Describe how the State will 

5 leverage or enhance existing health in6 formation technology infrastructure 

7 and cross-sector data-sharing capabili8 ties to support the provision of en9 hanced care coordination services, in10 cluding with respect to claiming ad11 ministrative matching funds for the 

12 design, development, and installation 

13 of data systems to allow or enhance 

14 coordination among State agencies 

15 and other entities. 

16 ‘‘(XI) Describe how the State will 

17 evaluate the impact of the model on 

18 child health and disparities in health 

19 outcomes, according to requirements 

20 outlined by Secretary. 

21 ‘‘(XII) Include other such popu22 lation health strategies or core serv23 ices as the State determines appro24 priate. 


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1 ‘‘(iii) PARTICIPATION BY INDIAN

2 TRIBES IN WHOLE CHILD HEALTH MOD3 ELS.—The Secretary may waive or other4 wise modify the requirements for a whole 

5 child health model described in clause (ii) 

6 to the extent necessary to permit Indian 

7 tribes to participate in such a model. 

8 ‘‘(3) IMPLEMENTATION PHASE.—After the de9 sign period, the implementation phase of the dem10 onstration project shall be conducted for a period of 

11 not less than 48 months and not more than 72 

12 months. 

13 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

14 ‘‘(A) IN GENERAL.—There are authorized 

15 to be appropriated to the Secretary for the pur16 pose of carrying out this subsection, out of any 

17 funds in the Treasury not otherwise appro18 priated, $125,000,000, to remain available until 

19 expended. 

20 ‘‘(B) LIMITATION ON USE OF FUNDS.— 

21 From any amounts appropriated pursuant to 

22 this paragraph, the Secretary shall use— 

23 ‘‘(i) not more than $2,000,000 for ad24 ministrative costs, staffing, and reporting 

25 requirements; 


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1 ‘‘(ii) not more than $10,000,000 for 

2 learning platforms, staffing, and technical 

3 assistance related directly to the design 

4 and implementation of whole child health 

5 models, and to carry out activities under 

6 this subsection; and 

7 ‘‘(iii) not more than $3,000,0000 may 

8 be used for carrying out evaluations de9 scribed in paragraph (5). 

10 ‘‘(C) PAYMENT FOR WHOLE CHILD

11 HEALTH SERVICES.— 

12 ‘‘(i) IN GENERAL.—For each fiscal 

13 quarter occurring during the implementa14 tion phase of the demonstration project, 

15 subject to clause (ii), the Secretary shall 

16 pay each State selected to participate in 

17 that phase of the project, an amount equal 

18 to 80 percent of the amounts expended by 

19 the State during such quarter for pro20 viding whole child health services to eligible 

21 individuals in the target communities net 

22 of any Federal payments made to the 

23 State for such expenditures, under this 

24 title or otherwise. 


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1 ‘‘(ii) REQUIREMENT.—The additional 

2 Federal funds paid to a State under this 

3 subparagraph shall be used to supplement, 

4 not supplant, the level of State funds ex5 pended for services that are treated as 

6 whole child health services under the dem7 onstration project. 

8 ‘‘(5) REPORTS AND EVALUATION.— 

9 ‘‘(A) IN GENERAL.—A State that is se10 lected to participate in the demonstration 

11 project shall report on the outcomes under the 

12 entity’s whole child health model pursuant to 

13 periodic reporting requirements established by 

14 the Secretary. 

15 ‘‘(B) STATE REPORTS.—Each State 

16 awarded a grant under this subsection shall 

17 submit the following reports to the Secretary: 

18 ‘‘(i) INTERIM REPORT.—An interim 

19 report at the end of the first 24 months of 

20 the implementation phase of the project 

21 that describes— 

22 ‘‘(I) the progress of the State’s 

23 implementation of the whole child 

24 health model in the target commu25 nities; 


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1 ‘‘(II) the organizations and pro2 viders that are participating in the 

3 implementation of the model in the 

4 target communities; 

5 ‘‘(III) the number of eligible indi6 viduals in the target communities re7 ceiving enhanced care coordination 

8 services; and 

9 ‘‘(IV) such other information as 

10 the Secretary may require. 

11 ‘‘(ii) FINAL REPORT.—A final report 

12 not later than 1 year after the end of the 

13 implementation phase of the demonstration 

14 project that describes— 

15 ‘‘(I) best practices and challenges 

16 in implementing the whole child 

17 health model in the target commu18 nities; 

19 ‘‘(II) the impact of the model on 

20 child well-being, health care outcomes 

21 and health disparities in the target 

22 communities; and 

23 ‘‘(III) such other information as 

24 the Secretary may require. 


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1 ‘‘(C) GAO REPORT.—Not later than 3 

2 years after the first grant is awarded under this 

3 subsection, the Comptroller General of the 

4 United States shall submit a report to Congress 

5 evaluating the individual, financial, and sys6 tems-level impacts associated with whole child 

7 health models implemented under the dem8 onstration project. 

9 ‘‘(6) CONSULTATION.—A State awarded a 

10 grant under paragraph (2) shall consult with stake11 holders, such as eligible individuals and their pri12 mary caregivers, schools, health care, mental health, 

13 and substance use disorder treatment organizations, 

14 pediatric providers, public health departments, child 

15 care providers, juvenile justice programs, child wel16 fare programs, and community-based organizations, 

17 in designing and carrying out the activities required 

18 under paragraph (2), and with respect to the imple19 mentation and evaluation of the whole child health 

20 models implemented by the State. Such consultation 

21 may include establishment of a Community Advisory 

22 Board as defined by the Secretary. 

23 ‘‘(7) RESPONSIBILITIES OF THE SECRETARY.— 

24 ‘‘(A) TECHNICAL ASSISTANCE.— 


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1 ‘‘(i) IN GENERAL.—The Secretary 

2 shall provide States awarded a grant under 

3 paragraph (2) with technical assistance 

4 with respect to the design of whole child 

5 health models. Such assistance may include 

6 assisting States with moving along a whole 

7 child health model and utilizing innovative 

8 financing strategies, such as braiding pub9 lic and private funds. As feasible, the Sec10 retary may partner with other Federal 

11 agencies, including the Office of Manage12 ment and Budget, when providing tech13 nical assistance to promote a whole child 

14 health approach. The Secretary shall also 

15 provide such States with technical assist16 ance with respect to implementation of 

17 such models. 

18 ‘‘(ii) SHARED LEARNING.—The Sec19 retary shall facilitate shared learning, such 

20 as a learning collaborative, among the 

21 States participating in the demonstration 

22 project. 

23 ‘‘(iii) REPORTS TO CONGRESS.—The 

24 Secretary shall submit to the Committee 

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1 mittee on Energy and Commerce of the 

2 House of Representatives the following re3 ports: 

4 ‘‘(I) DESIGN PHASE.—Not later 

5 than 36 months after the date on 

6 which design grant funds are first 

7 awarded under paragraph (2), a re8 port that describes the whole child 

9 health models proposed by States. 

10 ‘‘(II) IMPLEMENTATION

11 PHASE.— 

12 ‘‘(aa) INTERIM REPORT.— 

13 Not later than 3 years after the 

14 date on which the implementa15 tion phase of the demonstration 

16 project begins, an interim report. 

17 ‘‘(bb) FINAL REPORT.—Not 

18 later than 2 years after the date 

19 on which the demonstration 

20 project ends, a final report. 

21 ‘‘(cc) CONTENT.—The in22 terim and final reports required 

23 under this clause shall include 

24 the following: 


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1 ‘‘(AA) A summary of 

2 the whole child health mod3 els being implemented under 

4 the demonstration project. 

5 ‘‘(BB) An assessment 

6 of the impacts of such mod7 els on the physical and men8 tal health and well-being of 

9 eligible individuals in the 

10 target communities. 

11 ‘‘(CC) A description of 

12 the most effective strategies 

13 of such models in promoting 

14 the physical and mental 

15 health of eligible individuals, 

16 including the effectiveness of 

17 such strategies in reducing 

18 health disparities and im19 proving health equity. 

20 ‘‘(DD) A summary of 

21 the information reported to 

22 the Secretary by States. 

23 ‘‘(dd) LEGISLATIVE REC24 OMMENDATIONS.—In addition to 

25 the information required under 


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1 item (cc), the final report sub2 mitted under item (bb) shall in3 clude recommendations for such 

4 Federal legislative changes, if 

5 any, as the Secretary rec6 ommends to implement positive 

7 outcomes identified by the use of 

8 whole child health models under 

9 the demonstration project. 

10 ‘‘(8) DEFINITIONS.—In this subsection: 

11 ‘‘(A) ELIGIBLE INDIVIDUAL.—The term 

12 ‘eligible individual’ means an individual who has 

13 not attained age 21 and who is eligible for med14 ical assistance under a State plan under this 

15 title or under a waiver of such plan, or for as16 sistance under a State child health plan under 

17 title XXI or under a waiver of such plan. 

18 ‘‘(B) INDIAN TRIBE.—The term ‘Indian 

19 Tribe’ has the meaning given that term in sec20 tion 4(e) of the Indian Self-Determination and 

21 Education Assistance Act (25 U.S.C. 5304(e)). 

22 ‘‘(C) TARGET COMMUNITY.—The term 

23 ‘target community’ means, with respect to a 

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1 in the State in which the State proposes to im2 plement a whole child health model. 

3 ‘‘(D) WHOLE CHILD HEALTH SERVICES.— 

4 The term ‘whole child health services’ means 

5 the following: 

6 ‘‘(i) Comprehensive care management. 

7 ‘‘(ii) Enhanced care coordination serv8 ices and referrals to health, developmental 

9 and social supports that include strategies 

10 to— 

11 ‘‘(I) identify and address the 

12 physical, mental, emotional, and be13 havioral health, developmental, rela14 tional and social needs of eligible indi15 viduals; 

16 ‘‘(II) coordinate referrals, as 

17 needed, to health care, mental, emo18 tional, and behavioral health, sub19 stance use disorder treatment, child 

20 development, and social service pro21 viders; 

22 ‘‘(III) ensure that eligible individ23 uals follow up with service providers 

24 to whom they are referred; and 


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1 ‘‘(IV) facilitate the ability of eli2 gible individuals to access needed 

3 services by centralizing, coordinating 

4 with, or co-locating resources. 

5 ‘‘(9) REQUIREMENT TO ISSUE GUIDANCE ON

6 COMBINING FEDERAL AND NON-FEDERAL FUNDS TO

7 ADDRESS SOCIAL DETERMINANTS OF HEALTH IN

8 LOW-INCOME POPULATIONS.—Not later than 365 

9 days after the selection of eligible entities under this 

10 subsection, the Secretary shall issue and disseminate 

11 guidance and technical assistance to grant awardees 

12 to clarify strategies and best practices to combine 

13 funds, including Medicaid, in the context of a child 

14 health and wellness fund, consistent with Federal 

15 law, and shall make such guidance publicly avail16 able.’’. 

Æ 


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