1751 
maps and environmental justice scores 
with relevant regional, State, local, 
and Tribal data; 
(v) identify a methodology to account 
for the cumulative impacts of all indicators 
selected by the Committee under clause (i), 
in addition to other indicators as the Com-
mittee determines to be necessary, to pro-
vide relative environmental justice scores 
for regions that are— 
(I) as small as practicable to 
identify communities; and 
(II) not larger than a census 
tract; 
(vi) ensure that the tool is capable of 
providing maps of environmental justice 
communities based on environmental jus-
tice scores described in clause (v); 
(vii) ensure that users of the tool are 
able to map available layers together or 
independently as desired; 
(viii) implement a method for users of 
the tool to generate a map and environ-
mental justice score based on a subset of 
indicators, particularly for the purpose of 
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using the tool in addressing various policy 
needs, permitting processes, and invest-
ment goals; 
(ix) make the tool customizable to ad-
dress specific policy needs, permitting 
processes, and investment goals; 
(x) account for conditions that are not 
captured by the quantitative data used to 
develop the 1 or more maps and environ-
mental justice scores comprising the tool, 
by— 
(I) developing and executing a 
plan to perform outreach to relevant 
communities; and 
(II) establishing a mechanism by 
which communities can self-identify as 
environmental justice communities to 
be included in the tool, which may in-
clude citing qualitative data on condi-
tions for which quantitative data are 
lacking, such as cultural loss in Tribal 
communities; 
(xi) consider that the tool— 
(I) will be used across the Fed-
eral Government in screening Federal 
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1753 
policies, permitting processes, and in-
vestments for environmental and cli-
mate justice impacts; and 
(II) may be used to assess com-
munities for pollution reduction pro-
grams; and 
(xii) carry out such other activities as 
the Committee determines to be appro-
priate. 
(3) TRANSPARENCY AND UPDATES.— 
(A) IN GENERAL.— 
(i) NOTICE
AND
COMMENT.—The 
Committee shall establish the tool de-
scribed in paragraph (2) after providing 
notice and an opportunity for public com-
ment. 
(ii) 
HEARINGS.—In 
carrying 
out 
clause (i), the Committee shall hold hear-
ings, which shall be time- and language-ap-
propriate, in communities affected by envi-
ronmental justice issues in geographically 
disparate States and Tribal areas. 
(B) UPDATES.— 
(i) ANNUAL
UPDATES.—The Com-
mittee shall update the tool described in 
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1754 
paragraph (2) not less frequently than an-
nually to account for data sets that are up-
dated annually. 
(ii) OTHER UPDATES.—Not less fre-
quently than once every 3 years, the Com-
mittee shall— 
(I) update the indicators, meth-
odology, or both for the tool described 
in paragraph (2); and 
(II) reevaluate data submitted by 
Federal departments and agencies 
that is used for the tool. 
(iii) REPORTS.—After the initial es-
tablishment of the tool described in para-
graph (2) and each update under clause (i) 
or (ii), the Committee shall publish a re-
port describing— 
(I) the process for identifying in-
dicators relating to environmental jus-
tice in the development of the tool; 
(II) the methodology described in 
paragraph (2)(B)(v); and 
(III) the use of public input and 
community engagement in that proc-
ess. 
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1755 
(C) 
TRAINING
TUTORIALS
AND
SES-
SIONS.— 
(i) IN
GENERAL.—The Committee 
shall— 
(I) develop virtual training tuto-
rials and sessions for environmental 
justice communities for the use of the 
tool described in paragraph (2); and 
(II) where practicable, provide in- 
person training sessions for environ-
mental justice communities for the 
use of that tool. 
(ii) LANGUAGES.—The tutorials and 
sessions under clause (i) shall be made 
available in each language commonly used 
in the applicable environmental justice 
community. 
(D) PUBLIC AVAILABILITY.— 
(i) IN
GENERAL.—The Committee 
shall make available to the public on an 
internet website of the Environmental Pro-
tection Agency— 
(I) the tool described in para-
graph (2); 
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1756 
(II) each update under clauses (i) 
and (ii) of subparagraph (B); 
(III) each report under subpara-
graph (B)(iii); and 
(IV) the training tutorials and 
sessions developed under subpara-
graph (C)(i)(I). 
(ii) ACCESSIBILITY.—The Committee 
shall make the tool, updates, and reports 
described in clause (i) accessible to the 
public by publication in relevant languages 
and with accessibility functions, as appro-
priate. 
(iii) REQUIREMENT.—In carrying out 
clause (i)(I), the Committee shall take 
measures to prevent the tool from being 
misused to discriminate against environ-
mental justice communities, such as by 
providing safeguards against the use of 
downscaled data that may enable the iden-
tification of individuals. 
(4) DATA GAP AUDIT.— 
(A) IN GENERAL.—In establishing the tool 
described in paragraph (2), the Committee shall 
direct relevant Federal departments and agen-
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1757 
cies to conduct an audit of data collected by the 
department or agency to identify any data that 
are relevant to environmental justice concerns, 
including data relating to— 
(i) public health metrics; 
(ii) toxic chemicals; 
(iii) socioeconomic demographics; 
(iv) air quality; 
(v) water quality; and 
(vi) killings of individuals by law en-
forcement officers. 
(B) REQUIREMENTS.—An audit described 
in subparagraph (A) shall— 
(i) examine the granularity and acces-
sibility of the data; 
(ii) address the need for improved air 
quality monitoring; and 
(iii) include recommendations to other 
Federal departments and agencies on 
means to improve the quality, granularity, 
and transparency of, and public involve-
ment in, data collection and dissemination. 
(C) 
IMPROVEMENTS.—The 
Committee 
shall direct a Federal department or agency, in 
conducting an audit under subparagraph (A), to 
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1758 
address gaps in existing data collection that will 
assist the Committee in establishing and oper-
ating the tool described in paragraph (2), in-
cluding by providing to the department or agen-
cy— 
(i) benchmarks to meet in addressing 
the gaps; 
(ii) instructions for consistency in 
data formatting that will allow for inclu-
sion of data in the environmental justice 
data repository described in subsection (e); 
and 
(iii) best practices for collecting data 
in collaboration with local organizations 
and partners, such as engaging in ground- 
truthing. 
(D) REPORTS.—Not later than 180 days 
after a Federal department or agency has con-
ducted an audit under subparagraph (A), the 
Committee shall— 
(i) make available to the public on an 
internet website of the Environmental Pro-
tection Agency a report describing the 
findings and conclusions of the audit, in-
cluding the progress made by the Federal 
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1759 
department or agency in addressing envi-
ronmental justice data gaps; and 
(ii) submit the report described in 
clause (i) to— 
(I) the Committee on Environ-
ment and Public Works of the Senate; 
(II) the Committee on Health, 
Education, Labor, and Pensions of 
the Senate; 
(III) the Committee on Energy 
and Commerce of the House of Rep-
resentatives; and 
(IV) the Committee on Education 
and Labor of the House of Represent-
atives. 
(e) ENVIRONMENTAL JUSTICE DATA REPOSITORY.— 
(1) IN GENERAL.—The Administrator shall es-
tablish an environmental justice data repository to 
maintain— 
(A) the data collected by the Committee 
through the establishment of the tool described 
in subsection (d)(2) and the audits conducted 
under subsection (d)(4)(A); and 
(B) any subnational data collected under 
paragraph (3)(B). 
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(2) UPDATES.—The Administrator shall update 
the data in the data repository described in para-
graph (1) as frequently as practicable, including 
every year if practicable, but not less frequently than 
once every 3 years. 
(3) AVAILABILITY; INCLUSION OF SUBNATIONAL 
DATA.—The Administrator— 
(A) shall make the data repository de-
scribed in paragraph (1) available to regional, 
State, local, and Tribal governments; and 
(B) may collaborate with the governments 
described in subparagraph (A) to include within 
that data repository subnational data in exist-
ence before the establishment of the tool de-
scribed in subsection (e)(2) and the completion 
of the audits under subsection (e)(4)(A). 
(4) REQUIREMENT.—The Administrator shall 
take measures to prevent the data in the data repos-
itory described in paragraph (1) from being misused 
to discriminate against environmental justice com-
munities, such as by providing safeguards against 
the use of downscaled data that may enable the 
identification of individuals. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to the Administrator to 
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carry out this section, including any necessary administra-
tive costs of the Committee— 
(1) $20,000,000 for each of fiscal years 2023 
and 2024; and 
(2) $18,000,000 for each of fiscal years 2025 
through 2027. 
(g) EFFECT.—Nothing in any provision of this sec-
tion relating to the tool described in subsection (d)(2) pro-
hibits a State from developing a map relating to environ-
mental justice or pollution burden that relies on different 
data, or analyzes data differently, than that tool. 
SEC. 10013. ANTIRACISM IN PUBLIC HEALTH. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) For centuries, structural racism, defined by 
the National Museum of African American History 
and Culture as an ‘‘overarching system of racial bias 
across institutions and society,’’ in the United States 
has negatively affected communities of color, espe-
cially Black, Latinx, Asian American, Pacific Is-
lander, and American Indian and Alaska Native peo-
ple, to expand and reinforce White supremacy. 
(2) Structural racism determines the conditions 
in which people are born, grow, work, live, and age 
and determine people’s access to quality housing, 
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1762 
education, food, transportation, and political power, 
and other social determinants of health. 
(3) Structural racism serves as a major barrier 
to achieving health equity and eliminating racial and 
ethnic inequities in health outcomes that exist at 
alarming rates and are determined by a wider set of 
forces and systems. 
(4) Due to structural racism in the United 
States, people of color are more likely to suffer from 
chronic health conditions (such as heart disease, dia-
betes, asthma, hepatitis, and hypertension) and in-
fectious diseases (such as HIV/AIDS, and COVID– 
19) compared to their White counterparts. 
(5) Due to structural racism in maternal health 
care in the United States, Black and American In-
dian and Alaska Native infants are more than twice 
as likely to die than White infants, Black women are 
3 to 4 times more likely to die from pregnancy-re-
lated causes than White women, and American In-
dian and Alaska Native women are 5 times more 
likely to die from pregnancy-related causes than 
White women. This trend persists even when adjust-
ing for income and education. 
(6) Due to structural racism in the United 
States, Non-Hispanic Black women have the highest 
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1763 
rates for 22 of 25 severe morbidity indicators used 
by the Center for Disease Control and Prevention 
(CDC). 
(7) Due to structural racism in the United 
States, people of color comprise a disproportionate 
percentage of persons with disabilities in the United 
States. 
(8) Due to structural racism in the United 
States, Black men are up to three and a half times 
as likely to be killed by police as White men, and 1 
in every 1,000 Black men will die as a result of po-
lice violence. Policing has adverse effects on mental 
health in Black communities. 
(9) Due to the confluence of structural racism 
and factors such as gender, class, and sexual ori-
entation or gender identity, commonly referred to as 
intersectionality, Black and Latinx transgender 
women are more likely to die due to violence and 
homicide than their White counterparts. 
(10) Due to structural racism, inequitable ac-
cess to quality health care and long-term services 
and supports also disproportionately burdens com-
munities of color; people of color and immigrants are 
less likely to be insured and are more likely to live 
in medically underserved areas. 
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1764 
(11) Due to structural racism, older adults of 
color are also more likely to be admitted to nursing 
homes and assisted living facilities and to reside in 
those of poor quality, and when older adults of color 
do receive home and community based services, Med-
icaid spends less money on their services and they 
are more likely to be hospitalized than older White 
adults. 
(12) In addition, the Federal Government’s fail-
ure to honor the unique political status of American 
Indian and Alaska Native people, to respect the in-
herent sovereignty of Tribal Nations, and to uphold 
its trust and treaty obligations to Tribal Nations 
and American Indian and Alaska Native people, is 
an ongoing and unjust manifestation of centuries of 
oppression, with the consequence of adverse health 
outcomes for Native peoples. 
(13) The COVID–19 pandemic has exposed the 
devastating impact of structural racism on the 
United States ability to ensure equitable health out-
comes for people of color, and made these commu-
nities more likely to suffer from severe outcomes due 
to the coronavirus infection. 
(14) Racial and ethnic inequity in public health 
is a result of systematic, personally mediated, and 
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1765 
internalized racism and racist public and private 
policies and practices, and dismantling structural 
racism is integral to addressing public health. 
(b) DEFINITIONS.—In this section: 
(1) ANTIRACISM.—The term ‘‘antiracism’’ is a 
collection of antiracist policies that lead to racial eq-
uity, and are substantiated by antiracist ideas. 
(2) ANTIRACIST.—The term ‘‘antiracist’’ is any 
measure that produces or sustains racial equity be-
tween racial groups. 
(c) PUBLIC HEALTH RESEARCH AND INVESTMENT 
IN DISMANTLING STRUCTURAL RACISM.—Part B of title 
III of the Public Health Service Act (42 U.S.C. 243 et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 320B. NATIONAL CENTER ON ANTIRACISM AND 
HEALTH. 
‘‘(a) IN GENERAL.— 
‘‘(1) NATIONAL CENTER.—There is established 
within the Centers for Disease Control and Preven-
tion a center to be known as the ‘National Center 
on Antiracism and Health’ (referred to in this sec-
tion as the ‘Center’). The Director of the Centers for 
Disease Control and Prevention shall appoint a di-
rector to head the Center who has experience living 
in and working with racial and ethnic minority com-
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munities. The Center shall promote public health 
by— 
‘‘(A) declaring racism a public health crisis 
and naming racism as an historical and present 
threat to the physical and mental health and 
well-being of the United States and world; 
‘‘(B) aiming to develop new knowledge in 
the science and practice of antiracism, including 
by identifying the mechanisms by which racism 
operates in the provision of health care and in 
systems that impact health and well-being; 
‘‘(C) transferring that knowledge into 
practice, including by developing interventions 
that dismantle the mechanisms of racism and 
replace such mechanisms with equitable struc-
tures, policies, practices, norms, and values so 
that a healthy society can be realized; and 
‘‘(D) contributing to a national and global 
conversation regarding the impacts of racism on 
the health and well-being of the United States 
and world. 
‘‘(2) GENERAL DUTIES.—The Secretary, acting 
through the Center, shall undertake activities to 
carry out the mission of the Center as described in 
paragraph (1), such as the following: 
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1767 
‘‘(A) Conduct research into, collect, ana-
lyze and make publicly available data on, and 
provide leadership and coordination for the 
science and practice of antiracism, the public 
health impacts of structural racism, and the ef-
fectiveness of intervention strategies to address 
these impacts. Topics of research and data col-
lection under this subparagraph may include 
identifying and understanding— 
‘‘(i) policies and practices that have a 
disparate impact on the health and well- 
being of communities of color; 
‘‘(ii) the public health impacts of im-
plicit racial bias, White supremacy, weath-
ering, 
xenophobia, 
discrimination, 
and 
prejudice; 
‘‘(iii) the social determinants of health 
resulting from structural racism, including 
poverty, housing, employment, political 
participation, and environmental factors; 
and 
‘‘(iv) the intersection of racism and 
other systems of oppression, including as 
related to age, sexual orientation, gender 
identity, and disability status. 
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1768 
‘‘(B) Award noncompetitive grants and co-
operative agreements to eligible public and non-
profit private entities, including State, local, 
territorial, and Tribal health agencies and orga-
nizations, for the research and collection, anal-
ysis, and reporting of data on the topics de-
scribed in subparagraph (A). 
‘‘(C) Establish, through grants or coopera-
tive agreements, at least 3 regional centers of 
excellence, located in racial and ethnic minority 
communities, in antiracism for the purpose of 
developing new knowledge in the science and 
practice of antiracism in health by researching, 
understanding, and identifying the mechanisms 
by which racism operates in the health space, 
racial and ethnic inequities in health care ac-
cess and outcomes, the history of successful 
antiracist movements in health, and other 
antiracist public health work. 
‘‘(D) Establish a clearinghouse within the 
Centers for Disease Control and Prevention for 
the collection and storage of data generated 
under the programs implemented under this 
section for which there is not an otherwise ex-
isting surveillance system at the Centers for 
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1769 
Disease Control and Prevention. Such data 
shall— 
‘‘(i) 
be 
comprehensive 
and 
disaggregated, to the extent practicable, by 
including racial, ethnic, primary language, 
sex, gender identity, sexual orientation, 
age, socioeconomic status, and disability 
disparities; 
‘‘(ii) be made publicly available; 
‘‘(iii) protect the privacy of individuals 
whose information is included in such data; 
and 
‘‘(iv) comply with privacy protections 
under the regulations promulgated under 
section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996. 
‘‘(E) Provide information and education to 
the public on the public health impacts of struc-
tural racism and on antiracist public health 
interventions. 
‘‘(F) Consult with other Centers and Na-
tional Institutes within the Centers for Disease 
Control and Prevention, including the Office of 
Minority Health and Health Equity and the 
Center for State, Tribal, Local, and Territorial 
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1770 
Support, to ensure that scientific and pro-
grammatic activities initiated by the agency 
consider structural racism in their designs, 
conceptualizations, and executions, which shall 
include— 
‘‘(i) putting measures of racism in 
population-based surveys; 
‘‘(ii) establishing a Federal Advisory 
Committee on racism and health for the 
Centers for Disease Control and Preven-
tion; 
‘‘(iii) developing training programs, 
curricula, and seminars for the purposes of 
training public health professionals and re-
searchers around issues of race, racism, 
and antiracism; 
‘‘(iv) providing standards and best 
practices for programming and grant re-
cipient compliance with Federal data col-
lection standards, including section 4302 
of the Patient Protection and Affordable 
Care Act; and 
‘‘(v) establishing leadership and stake-
holder councils with experts and leaders in 
racism and public health disparities. 
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‘‘(G) Coordinate with the Indian Health 
Service and with the Centers for Disease Con-
trol and Prevention’s Tribal Advisory Com-
mittee to ensure meaningful Tribal consulta-
tion, the gathering of information from Tribal 
authorities, and respect for Tribal data sov-
ereignty. 
‘‘(H) Engage in government to government 
consultation with Indian Tribes and Tribal or-
ganizations. 
‘‘(I) At least every 2 years, produce and 
publicly post on the Centers for Disease Control 
and Prevention’s website a report on antiracist 
activities completed by the Center, which may 
include newly identified antiracist public health 
practices. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated such sums as may be nec-
essary to carry out this section.’’. 
(d) PUBLIC HEALTH RESEARCH AND INVESTMENT 
IN POLICE VIOLENCE.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall establish within the National 
Center for Injury Prevention and Control of the 
Centers for Disease Control and Prevention (re-
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ferred to in this subsection as the ‘‘Center’’) a law 
enforcement violence prevention program. 
(2) GENERAL
DUTIES.—In implementing the 
program under paragraph (1), the Center shall con-
duct research into, and provide leadership and co-
ordination for— 
(A) the understanding and promotion of 
knowledge about the public health impacts of 
uses of force by law enforcement, including po-
lice brutality and violence; 
(B) developing public health interventions 
and perspectives for eliminating deaths, injury, 
trauma, and negative mental health effects 
from police presence and interactions, including 
police brutality and violence; and 
(C) ensuring comprehensive data collection, 
analysis, and reporting regarding police violence 
and misconduct in consultation with the De-
partment of Justice and independent research-
ers. 
(3) FUNCTIONS.—Under the program under 
paragraph (1), the Center shall— 
(A) summarize and enhance the knowledge 
of the distribution, status, and characteristics 
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of law enforcement-related death, trauma, and 
injury; 
(B) conduct research and prepare, with the 
assistance of State public health departments— 
(i) statistics on law enforcement-re-
lated death, injury, and brutality; 
(ii) studies of the factors, including 
legal, socioeconomic, discrimination, and 
other factors that correlate with or influ-
ence police brutality; 
(iii) public information about uses of 
force by law enforcement, including police 
brutality and violence, for the practical use 
of the public health community, including 
publications that synthesize information 
relevant to the national goal of under-
standing police violence and methods for 
its control; 
(iv) information to identify socio-
economic groups, communities, and geo-
graphic areas in need of study, and a stra-
tegic plan for research necessary to com-
prehend the extent and nature of police 
uses of force by law enforcement, including 
police brutality and violence, and deter-
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mine what options exist to reduce or eradi-
cate death and injury that result; and 
(v) best practices in police violence 
prevention in other countries; 
(C) award grants, contracts, and coopera-
tive agreements to provide for the conduct of 
epidemiologic research on uses of force by law 
enforcement, including police brutality and vio-
lence, by Federal, State, local, and private 
agencies, institutions, organizations, and indi-
viduals; 
(D) award grants, contracts, and coopera-
tive agreements to community groups, inde-
pendent research organizations, academic insti-
tutions, and other entities to support, execute, 
or conduct research on interventions to reduce 
or eliminate uses of force by law enforcement, 
including police brutality and violence; 
(E) coordinate with the Department of 
Justice, and other Federal, State, and local 
agencies on the standardization of data collec-
tion, storage, and retrieval necessary to collect, 
evaluate, analyze, and disseminate information 
about the extent and nature of uses of force by 
law enforcement, including police brutality and 
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violence, as well as options for the eradication 
of such practices; 
(F) submit an annual report to Congress 
on research findings with recommendations to 
improve data collection and standardization and 
to disrupt processes in policing that preserve 
and reinforce racism and racial disparities in 
public health; 
(G) conduct primary research and explore 
uses of force by law enforcement, including po-
lice brutality and violence, and options for its 
control; and 
(H) study alternatives to law enforcement 
response as a method of reducing police vio-
lence. 
(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated, such sums 
as may be necessary to carry out this subsection. 
SEC. 10014. LGBTQ ESSENTIAL DATA. 
(a) IMPROVING DATA COLLECTION ON THE SEXUAL 
ORIENTATION AND GENDER IDENTITY OF DECEASED IN-
DIVIDUALS THROUGH THE NATIONAL VIOLENT DEATH 
REPORTING SYSTEM.— 
(1) COLLECTION OF SEXUAL ORIENTATION AND 
GENDER IDENTITY DATA.— 
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(A) IN
GENERAL.—Not later than 120 
days after the date of enactment of this Act, 
the Director of the Centers for Disease Control 
and Prevention shall take measures to improve 
the incidence of the collection of information on 
the sexual orientation and gender identity of de-
ceased individuals through the National Violent 
Death Reporting System or any successor pro-
grams. 
(B) CONFIDENTIALITY.—Any information 
collected relating to the sexual orientation or 
gender identity of a decedent shall be main-
tained in accordance with the confidentiality 
and privacy standards and policies for the pro-
tection of individuals applicable to all other 
data collected for purposes of the National Vio-
lent Death Reporting System. 
(2) DEFINITIONS.—In this subsection: 
(A) GENDER IDENTITY.—The term ‘‘gen-
der identity’’ means an individual’s sense of 
being male, female, transgender, or another 
gender, as distinct from the individual’s sex as-
signed at birth. 
(B) SEXUAL
ORIENTATION.—The term 
‘‘sexual orientation’’ means how a person iden-
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tifies in terms of their emotional, romantic, or 
sexual attractions, and includes identification as 
straight, heterosexual, gay, lesbian, or bisexual, 
among other terms. 
(3) AUTHORIZATION.—There is authorized to 
be appropriated $25,000,000 for fiscal year 2023 to 
carry out this subsection. 
(b) SENSE OF CONGRESS.—It is the sense of the 
Congress that— 
(1) the Centers for Disease Control and Preven-
tion has made significant efforts to encourage States 
and other jurisdictions to collect data on sexual ori-
entation and gender identity through the National 
Violent Death Reporting System; and 
(2) jurisdictions that participate in the collec-
tion of such data through the National Violent 
Death Reporting System should be commended for 
their participation. 
SEC. 10015. SOCIAL DETERMINANTS ACCELERATOR. 
(a) FINDINGS; PURPOSES.— 
(1) FINDINGS.—Congress finds the following: 
(A) There is a significant body of evidence 
showing that economic and social conditions 
have a powerful impact on individual and popu-
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1778 
lation health outcomes and well-being, as well 
as medical costs. 
(B) State, local, and Tribal governments 
and the service delivery partners of such gov-
ernments face significant challenges in coordi-
nating benefits and services delivered through 
the Medicaid program and other social services 
programs because of the fragmented and com-
plex nature of Federal and State funding and 
administrative requirements. 
(C) 
The 
Federal 
Government 
should 
prioritize and proactively assist State and local 
governments to strengthen the capacity of State 
and local governments to improve health and 
social outcomes for individuals, thereby improv-
ing cost-effectiveness and return on investment. 
(2) PURPOSES.—The purposes of this section 
are as follows: 
(A) To establish effective, coordinated Fed-
eral technical assistance to help State and local 
governments to improve outcomes and cost-ef-
fectiveness of, and return on investment from, 
health and social services programs. 
(B) To build a pipeline of State and locally 
designed, cross-sector interventions and strate-
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gies that generate rigorous evidence about how 
to improve health and social outcomes, and in-
crease the cost-effectiveness of, and return on 
investment from, Federal, State, local, and 
Tribal health and social services programs. 
(C) To enlist State and local governments 
and the service providers of such governments 
as partners in identifying Federal statutory, 
regulatory, and administrative challenges in im-
proving the health and social outcomes of, cost- 
effectiveness of, and return on investment from, 
Federal spending on individuals enrolled in 
Medicaid. 
(D) To develop strategies to improve 
health and social outcomes without denying 
services to, or restricting the eligibility of, vul-
nerable populations. 
(b) SOCIAL DETERMINANTS ACCELERATOR COUN-
CIL.— 
(1) ESTABLISHMENT.—The Secretary of Health 
and Human Services (referred to in this section as 
the ‘‘Secretary’’), in coordination with the Adminis-
trator of the Centers for Medicare & Medicaid Serv-
ices (referred to in this section as the ‘‘Adminis-
trator’’), shall establish an interagency council, to be 
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known as the Social Determinants Accelerator Inter-
agency Council (referred to in this section as the 
‘‘Council’’) to achieve the purposes listed in sub-
section (a)(2). 
(2) MEMBERSHIP.— 
(A) FEDERAL COMPOSITION.—The Council 
shall be composed of at least one designee from 
each of the following Federal agencies: 
(i) The Office of Management and 
Budget. 
(ii) The Department of Agriculture. 
(iii) The Department of Education. 
(iv) The Indian Health Service. 
(v) The Department of Housing and 
Urban Development. 
(vi) The Department of Labor. 
(vii) The Department of Transpor-
tation. 
(viii) Any other Federal agency the 
Chair of the Council determines necessary. 
(B) DESIGNATION.— 
(i) IN GENERAL.—The head of each 
agency specified in subparagraph (A) shall 
designate at least one employee described 
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1781 
in clause (ii) to serve as a member of the 
Council. 
(ii) RESPONSIBILITIES.—An employee 
described in this subparagraph shall be a 
senior employee of the agency— 
(I) whose responsibilities relate 
to authorities, policies, and procedures 
with respect to the health and well- 
being of individuals receiving medical 
assistance under a State plan (or a 
waiver of such plan) under title XIX 
of the Social Security Act (42 U.S.C. 
1396 et seq.); or 
(II) who has authority to imple-
ment and evaluate transformative ini-
tiatives that harness data or conducts 
rigorous evaluation to improve the im-
pact and cost-effectiveness of federally 
funded services and benefits. 
(C) HHS REPRESENTATION.—In addition 
to the designees under subparagraph (A), the 
Council shall include designees from at least 
three agencies within the Department of Health 
and Human Services, including the Centers for 
Medicare & Medicaid Services, at least one of 
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whom shall meet the criteria under subpara-
graph (B)(ii). 
(D) OMB ROLE.—The Director of the Of-
fice of Management and Budget shall facilitate 
the timely resolution of Governmentwide and 
multiagency issues to help the Council achieve 
consensus recommendations described under 
paragraph (3)(A). 
(E) NON-FEDERAL
COMPOSITION.—The 
Comptroller General of the United States may 
designate up to 6 Council designees— 
(i) who have relevant subject matter 
expertise, including expertise implementing 
and evaluating transformative initiatives 
that harness data and conduct evaluations 
to improve the impact and cost-effective-
ness of Federal Government services; and 
(ii) that each represent— 
(I) State, local, and Tribal health 
and human services agencies; 
(II) public housing authorities or 
State housing finance agencies; 
(III) State and local government 
budget offices; 
(IV) State Medicaid agencies; or 
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1783 
(V) national consumer advocacy 
organizations. 
(F) CHAIR.— 
(i) IN GENERAL.—The Secretary shall 
select the Chair of the Council from among 
the members of the Council. 
(ii) 
INITIATING
GUIDANCE.—The 
Chair, on behalf of the Council, shall iden-
tify and invite individuals from diverse en-
tities to provide the Council with advice 
and information pertaining to addressing 
social determinants of health, including— 
(I) individuals from State and 
local government health and human 
services agencies; 
(II) individuals from State Med-
icaid agencies; 
(III) individuals from State and 
local government budget offices; 
(IV) 
individuals 
from 
public 
housing authorities or State housing 
finance agencies; 
(V) individuals from nonprofit or-
ganizations, small businesses, and 
philanthropic organizations; 
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(VI) advocates; 
(VII) researchers; and 
(VIII) any other individuals the 
Chair determines to be appropriate. 
(3) DUTIES.—The duties of the Council are— 
(A) to make recommendations to the Sec-
retary and the Administrator regarding the cri-
teria for making awards under subsection (c); 
(B) to identify Federal authorities and op-
portunities for use by States or local govern-
ments to improve coordination of funding and 
administration of Federal programs, the bene-
ficiaries of whom include individuals described 
in subsection (a), and which may be unknown 
or underutilized and to make information on 
such authorities and opportunities publicly 
available; 
(C) to provide targeted technical assistance 
to States developing a social determinants ac-
celerator plan under subsection (c), including 
identifying potential statutory or regulatory 
pathways for implementation of the plan and 
assisting in identifying potential sources of 
funding to implement the plan; 
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(D) to report to Congress annually on the 
subjects set forth in paragraph (4); 
(E) to develop and disseminate evaluation 
guidelines and standards that can be used to 
reliably assess the impact of an intervention or 
approach that may be implemented pursuant to 
this section on outcomes, cost-effectiveness of, 
and return on investment from Federal, State, 
local, and Tribal governments, and to facilitate 
technical assistance, where needed, to help to 
improve State and local evaluation designs and 
implementation; 
(F) to seek feedback from State, local, and 
Tribal governments, including through an an-
nual survey by an independent third party, on 
how to improve the technical assistance the 
Council provides to better equip State, local, 
and Tribal governments to coordinate health 
and social service programs; 
(G) to solicit applications for grants under 
subsection (c); and 
(H) to coordinate with other cross-agency 
initiatives focused on improving the health and 
well-being of low-income and at-risk populations 
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in order to prevent unnecessary duplication be-
tween agency initiatives. 
(4) SCHEDULE.—Not later than 60 days after 
the date of the enactment of this Act, the Council 
shall convene to develop a schedule and plan for car-
rying out the duties described in paragraph (3), in-
cluding solicitation of applications for the grants 
under subsection (c). 
(5) REPORT TO CONGRESS.—The Council shall 
submit an annual report to Congress, which shall in-
clude— 
(A) a list of the Council members; 
(B) activities and expenditures of the 
Council; 
(C) summaries of the interventions and ap-
proaches that will be supported by State, local, 
and Tribal governments that received a grant 
under subsection (c), including— 
(i) the best practices and evidence- 
based approaches such governments plan 
to employ to achieve the purposes listed in 
subsection (a)(2); and 
(ii) a description of how the practices 
and approaches will impact the outcomes, 
cost-effectiveness of, and return on invest-
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1787 
ment from, Federal, State, local, and Trib-
al governments with respect to such pur-
poses; 
(D) the feedback received from State and 
local governments on ways to improve the tech-
nical assistance of the Council, including find-
ings from a third-party survey and actions the 
Council plans to take in response to such feed-
back; and 
(E) the major statutory, regulatory, and 
administrative challenges identified by State, 
local, and Tribal governments that received a 
grant under subsection (c), and the actions that 
Federal agencies are taking to address such 
challenges. 
(6) FACA APPLICABILITY.—The Federal Advi-
sory Committee Act (5 U.S.C. App.) shall not apply 
to the Council. 
(7) COUNCIL PROCEDURES.—The Secretary, in 
consultation with the Comptroller General of the 
United States and the Director of the Office of Man-
agement and Budget, shall establish procedures for 
the Council to— 
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(A) ensure that adequate resources are 
available to effectively execute the responsibil-
ities of the Council; 
(B) effectively coordinate with other rel-
evant advisory bodies and working groups to 
avoid unnecessary duplication; 
(C) create transparency to the public and 
Congress with regard to Council membership, 
costs, and activities, including through use of 
modern technology and social media to dissemi-
nate information; and 
(D) avoid conflicts of interest that would 
jeopardize the ability of the Council to make de-
cisions and provide recommendations. 
(c) SOCIAL DETERMINANTS ACCELERATOR GRANTS 
TO STATES OR LOCAL GOVERNMENTS.— 
(1) GRANTS TO STATES, LOCAL GOVERNMENTS, 
AND TRIBES.—Not later than 180 days after the 
date of the enactment of this Act, the Administrator, 
in consultation with the Secretary and the Council, 
shall award on a competitive basis not more than 25 
grants to eligible applicants described in paragraph 
(2), for the development of social determinants ac-
celerator plans, as described in paragraph (6). 
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(2) ELIGIBLE
APPLICANT.—An eligible appli-
cant described in this subsection is a State, local, or 
Tribal health or human services agency that— 
(A) demonstrates the support of relevant 
parties across relevant State, local, or Tribal ju-
risdictions; and 
(B) in the case of an applicant that is a 
local government agency, provides to the Sec-
retary a letter of support from the lead State 
health or human services agency for the State 
in which the local government is located. 
(3) AMOUNT OF GRANT.—The Administrator, 
in coordination with the Council, shall determine the 
total amount that the Administrator will make avail-
able to each grantee under this subsection. 
(4) APPLICATION.—An eligible applicant seek-
ing a grant under this subsection shall include in the 
application the following information: 
(A) The target population (or populations) 
that would benefit from implementation of the 
social determinants accelerator plan proposed to 
be developed by the applicant. 
(B) A description of the objective or objec-
tives and outcome goals of such proposed plan, 
which shall include at least one health outcome 
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and at least one other important social out-
come. 
(C) The sources and scope of inefficiencies 
that, if addressed by the plan, could result in 
improved cost-effectiveness of or return on in-
vestment from Federal, State, local, and Tribal 
governments. 
(D) A description of potential interventions 
that could be designed or enabled using such 
proposed plan. 
(E) The State, local, Tribal, academic, 
nonprofit, community-based organizations, and 
other private sector partners that would partici-
pate in the development of the proposed plan 
and subsequent implementation of programs or 
initiatives included in such proposed plan. 
(F) Such other information as the Admin-
istrator, in consultation with the Secretary and 
the Council, determines necessary to achieve the 
purposes of this section. 
(5) USE OF FUNDS.—A recipient of a grant 
under this subsection may use funds received 
through the grant for the following purposes: 
(A) To convene and coordinate with rel-
evant government entities and other stake-
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1791 
holders across sectors to assist in the develop-
ment of a social determinant accelerator plan. 
(B) To identify populations of individuals 
receiving medical assistance under a State plan 
(or a waiver of such plan) under title XIX of 
the Social Security Act (42 U.S.C. 1396 et 
seq.) who may benefit from the proposed ap-
proaches to improving the health and well-being 
of such individuals through the implementation 
of the proposed social determinants accelerator 
plan. 
(C) To engage qualified research experts to 
advise on relevant research and to design a pro-
posed evaluation plan, in accordance with the 
standards and guidelines issued by the Admin-
istrator. 
(D) To collaborate with the Council to sup-
port the development of social determinants ac-
celerator plans. 
(E) To prepare and submit a final social 
determinants accelerator plan to the Council. 
(6) CONTENTS
OF
PLANS.—A social deter-
minant accelerator plan developed under this sub-
section shall include the following: 
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(A) A description of the target population 
(or populations) that would benefit from imple-
mentation of the social determinants accelerator 
plan, including an analysis describing the pro-
jected impact on the well-being of individuals 
described in paragraph (5)(B). 
(B) A description of the interventions or 
approaches designed under the social deter-
minants accelerator plan and the evidence for 
selecting such interventions or approaches. 
(C) The objectives and outcome goals of 
such interventions or approaches, including at 
least one health outcome and at least one other 
important social outcome. 
(D) A plan for accessing and linking rel-
evant data to enable coordinated benefits and 
services for the jurisdictions described in para-
graph (2)(A) and an evaluation of the proposed 
interventions and approaches. 
(E) A description of the State, local, Trib-
al, academic, nonprofit, or community-based or-
ganizations, or any other private sector organi-
zations that would participate in implementing 
the proposed interventions or approaches, and 
the role each would play to contribute to the 
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ure the impact of the proposed interventions or 
approaches on the outcomes of, cost-effective-
ness of, and return on investment from, Fed-
eral, State, local, and Tribal governments. 
(K) Precautions for ensuring that vulner-
able populations will not be denied access to 
Medicaid or other essential services as a result 
of implementing the proposed plan. 
(d) FUNDING.— 
(1) IN GENERAL.—Out of any money in the 
Treasury not otherwise appropriated, there is appro-
priated to carry out this section $25,000,000, of 
which up to $5,000,000 may be used to carry out 
this section, to remain available for obligation until 
the date that is 5 years after the date of enactment 
of this Act. 
(2) RESERVATION OF FUNDS.— 
(A) IN
GENERAL.—Of the funds made 
available under paragraph (1), the Secretary 
shall reserve not less than 20 percent to award 
grants to eligible applicants for the development 
of social determinants accelerator plans under 
subsection (c) intended to serve rural popu-
lations. 
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(B) EXCEPTION.—In the case of a fiscal 
year for which the Secretary determines that 
there are not sufficient eligible applicants to 
award up to 25 grants under subsection (c) 
that are intended to serve rural populations and 
the Secretary cannot satisfy the 20-percent re-
quirement, the Secretary may reserve an 
amount that is less than 20 percent of amounts 
made available under paragraph (1) to award 
grants for such purpose. 
(3) RULE OF CONSTRUCTION.—Nothing in this 
section shall prevent Federal agencies represented 
on the Council from contributing additional funding 
from other sources to support activities to improve 
the effectiveness of the Council. 
SEC. 
10016. 
IMPROVING 
SOCIAL 
DETERMINANTS 
OF 
HEALTH. 
(a) FINDINGS.—Congress finds the following: 
(1) Healthy People 2030 defines social deter-
minants of health as conditions in the environments 
where people are born, live, learn, work, play, wor-
ship, and age that affect a wide range of health, 
functioning, and quality-of-life outcomes and risks. 
(2) One of the overarching goals of Healthy 
People 2030 is to ‘‘create social, physical, and eco-
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nomic environments that promote attaining the full 
potential for health and well-being for all’’. 
(3) Healthy People 2030 developed a ‘‘place- 
based’’ organizing framework, reflecting five key 
areas of social determinants of health namely— 
(A) economic stability; 
(B) education access and quality; 
(C) social and community context; 
(D) health care access and quality; and 
(E) neighborhood and built environment. 
(4) It is estimated that medical care accounts 
for only 10 to 20 percent of the modifiable contribu-
tors to healthy outcomes for a population. 
(5) The Centers for Medicare & Medicaid Serv-
ices has indicated the importance of the social deter-
minants in its work stating that, ‘‘As we seek to fos-
ter innovation, rethink rural health, find solutions to 
the opioid epidemic, and continue to put patients 
first, we need to take into account social deter-
minants of health and recognize their importance.’’. 
(6) The Department of Health and Human 
Services’ Public Health 3.0 initiative recognizes the 
role of public health in working across sectors on so-
cial determinants of health, as well as the role of 
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public health as chief health strategist in commu-
nities. 
(7) Through its Health Impact in 5 Years ini-
tiative, the Centers for Disease Control and Preven-
tion has highlighted nonclinical, community-wide ap-
proaches that show positive health impacts, results 
within five years, and cost-effectiveness or cost-sav-
ings over the lifetime of the population or earlier. 
(8) Health departments and the Centers for 
Disease Control and Prevention are not funded for 
such cross-cutting work. 
(b) SOCIAL
DETERMINANTS
OF
HEALTH
PRO-
GRAM.— 
(1) PROGRAM.—To the extent and in the 
amounts made available in advance in appropriations 
Acts, the Director of the Centers for Disease Control 
and Prevention (in this section referred to as the 
‘‘Director’’) shall carry out a program, to be known 
as the Social Determinants of Health Program (in 
this section referred to as the ‘‘Program’’), to 
achieve the following goals: 
(A) Improve health outcomes and reduce 
health inequities by coordinating social deter-
minants of health activities across the Centers 
for Disease Control and Prevention. 
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(B) Improve the capacity of public health 
agencies and community organizations to ad-
dress social determinants of health in commu-
nities. 
(2) ACTIVITIES.—To achieve the goals listed in 
paragraph (1), the Director shall carry out activities 
including the following: 
(A) Coordinating across the Centers for 
Disease Control and Prevention to ensure that 
relevant programs consider and incorporate so-
cial determinants of health in grant awards and 
other activities. 
(B) Awarding grants under subsection (c) 
to State, local, territorial, and Tribal health 
agencies and organizations, and to other eligible 
entities, to address social determinants of 
health in target communities. 
(C) Awarding grants under subsection (d) 
to nonprofit organizations and public or other 
nonprofit institutions of higher education— 
(i) to conduct research on best prac-
tices to improve social determinants of 
health; 
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