I 
116TH CONGRESS 
2D SESSION 
H. R. 6561 
To authorize the Director of the Centers for Disease Control and Prevention 
to carry out a Social Determinants of Health Program, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 21, 2020 
Ms. BARRAGA´N (for herself, Mr. BUTTERFIELD, Ms. BLUNT ROCHESTER, Mr. 
LUJA´N, Mr. CA´RDENAS, Mr. SOTO, Ms. JACKSON LEE, Ms. VELA´ZQUEZ, 
Ms. NORTON, Ms. MOORE, Mr. COHEN, Ms. GARCIA of Texas, Mrs. 
NAPOLITANO, Mr. GRIJALVA, Ms. TLAIB, Mr. KILDEE, Mr. MORELLE, 
Mr. DANNY K. DAVIS of Illinois, and Mr. HIGGINS of New York) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce 
A BILL 
To authorize the Director of the Centers for Disease Control 
and Prevention to carry out a Social Determinants of 
Health Program, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Improving Social De-
terminants of Health Act of 2020’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) Healthy People 2020 defines social deter-
minants of health as conditions in the environments 
in which people live, learn, work, play, worship, 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 2020 is to ‘‘create social and physical envi-
ronments that promote good health for all’’. 
(3) Healthy People 2020 developed a ‘‘place- 
based’’ organizing framework, reflecting five key 
areas of social determinants of health namely— 
(A) economic stability; 
(B) education; 
(C) social and community context; 
(D) health and health care; 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 
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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 
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. 
(9) Providing grants to public health depart-
ments and other eligible entities to coordinate cross- 
sector collaboration will allow a community-wide, evi-
dence-based approach to address underlying social 
determinants of health. 
SEC. 3. SOCIAL DETERMINANTS OF HEALTH PROGRAM. 
(a) PROGRAM.—To the extent and in the amounts 
made available in advance in appropriations Acts, the Di-
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(3) Awarding grants under section 5 to non-
profit organizations and public or other nonprofit in-
stitutions of higher education— 
(A) to conduct research on best practices 
to improve social determinants of health; 
(B) to provide technical assistance, train-
ing, and evaluation assistance to grantees under 
section 4; and 
(C) to disseminate best practices to grant-
ees under section 4. 
(4) Coordinating, supporting, and aligning ac-
tivities of the Centers for Disease Control and Pre-
vention related to social determinants of health with 
activities of other Federal agencies related to social 
determinants of health, including such activities of 
agencies in the Department of Health and Human 
Services such as the Centers for Medicare & Med-
icaid Services. 
(5) Collecting and analyzing data related to the 
social determinants of health. 
SEC. 4. GRANTS TO ADDRESS SOCIAL DETERMINANTS OF 
HEALTH. 
(a) IN GENERAL.—The Director, as part of the Pro-
gram, shall award grants to eligible entities to address so-
cial determinants of health in their communities. 
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(b) ELIGIBILITY.—To be eligible to apply for a grant 
under this section, an entity shall be— 
(1) a State, local, territorial, or Tribal health 
agency or organization; 
(2) a qualified nongovernmental entity, as de-
fined by the Director; or 
(3) a consortium of entities that includes a 
State, local, territorial, or Tribal health agency or 
organization. 
(c) USE OF FUNDS.— 
(1) IN GENERAL.—A grant under this section 
shall be used to address social determinants of 
health in a target community by designing and im-
plementing innovative, evidence-based, cross-sector 
strategies. 
(2) TARGET COMMUNITY.—For purposes of this 
section, a target community shall be a State, county, 
city, or other municipality. 
(d) PRIORITY.—In awarding grants under this sec-
tion, the Director shall prioritize applicants proposing to 
serve target communities with significant unmet health 
and social needs, as defined by the Director. 
(e) APPLICATION.—To seek a grant under this sec-
tion, an eligible entity shall— 
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(1) submit an application at such time, in such 
manner, and containing such information as the Di-
rector may require; 
(2) propose a set of activities to address social 
determinants of health through evidence-based, 
cross-sector strategies, which activities may in-
clude— 
(A) collecting quantifiable data from health 
care, social services, and other entities regard-
ing the most significant gaps in health-pro-
moting social, economic, and environmental 
needs; 
(B) identifying evidence-based approaches 
to meeting the nonmedical, social needs of pop-
ulations identified by data collection described 
in subparagraph (A), such as unstable housing 
or inadequate food; 
(C) developing scalable methods to meet 
patients’ social needs identified in clinical set-
tings or other sites; 
(D) convening entities such as local and 
State governmental and nongovernmental orga-
nizations, health systems, payors, and commu-
nity-based organizations to review, plan, and 
implement community-wide interventions and 
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strategies to advance health-promoting social 
conditions; 
(E) monitoring and evaluating the impact 
of activities funded through the grant on the 
health and well-being of the residents of the 
target community and on the cost of health 
care; and 
(F) such other activities as may be speci-
fied by the Director; 
(3) demonstrate how the eligible entity will col-
laborate with— 
(A) health systems; 
(B) payors, including, as appropriate, med-
icaid managed care organizations (as defined in 
section 1903(m)(1)(A) of the Social Security 
Act (42 U.S.C. 1396b(m)(1)(A))), Medicare 
Advantage plans under part C of title XVIII of 
such Act (42 U.S.C. 1395w–21 et seq.), and 
health insurance issuers and group health plans 
(as such terms are defined in section 2791 of 
the Public Health Service Act); 
(C) other relevant stakeholders and initia-
tives in areas of need, such as the Accountable 
Health Communities Model of the Centers for 
Medicare & Medicaid Services, health homes 
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under the Medicaid program under title XIX of 
the Social Security Act (42 U.S.C. 1396 et 
seq.), 
community-based 
organizations, 
and 
human services organizations; 
(D) other non-health care sector organiza-
tions, including organizations focusing on trans-
portation, housing, or food access; and 
(E) local employers; and 
(4) identify key health inequities in the target 
community and demonstrate how the proposed ef-
forts of the eligible entity would address such inequi-
ties. 
(f) MONITORING AND EVALUATION.—As a condition 
of receipt of a grant under this section, a grantee shall 
agree to submit an annual report to the Director describ-
ing the activities carried out through the grant and the 
outcomes of such activities. 
(g) INDEPENDENT NATIONAL EVALUATION.— 
(1) IN GENERAL.—Not later than 5 years after 
the first grants are awarded under this section, the 
Director shall provide for the commencement of an 
independent national evaluation of the Program 
under this section. 
(2) REPORT TO CONGRESS.—Not later than 60 
days after receiving the results of such independent 
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national evaluation, the Director shall report such 
results to the Congress. 
SEC. 5. RESEARCH AND TRAINING. 
The Director, as part of the Program— 
(1) shall award grants to nonprofit organiza-
tions and public or other nonprofit institutions of 
higher education— 
(A) to conduct research on best practices 
to improve social determinants of health; 
(B) to provide technical assistance, train-
ing, and evaluation assistance to grantees under 
section 4; and 
(C) to disseminate best practices to grant-
ees under section 4; and 
(2) may require a grantee under paragraph (1) 
to provide technical assistance and capacity building 
to entities that are eligible entities under section 4 
but not receiving funds through such section. 
SEC. 6. FUNDING. 
(a) IN GENERAL.—There is authorized to be appro-
priated to carry out this Act, $50,000,000 for each of fis-
cal years 2021 through 2026. 
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