I 
116TH CONGRESS 
1ST SESSION H. R. 4004 
To direct the Secretary of Health and Human Services to establish an 
interagency council on social determinants of health, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 25, 2019 
Mrs. BUSTOS (for herself, Mr. COLE, Mr. MCGOVERN, Mrs. RODGERS of 
Washington, Mr. RUSH, Ms. BARRAGA´N, Mr. ENGEL, Mr. BUTTERFIELD, 
Mr. CA´RDENAS, Mr. MORELLE, Mr. FITZPATRICK, Mr. SCHRADER, Mr. 
SOTO, Mr. MICHAEL F. DOYLE of Pennsylvania, and Ms. BLUNT ROCH-
ESTER) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To direct the Secretary of Health and Human Services to 
establish an interagency council on social determinants 
of health, 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 ‘‘Social Determinants 
Accelerator Act of 2019’’. 
SEC. 2. FINDINGS; PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
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(1) There is a significant body of evidence 
showing that economic and social conditions have a 
powerful impact on individual and population health 
outcomes and well-being, as well as medical costs. 
(2) State, local, and Tribal governments and 
the service delivery partners of such governments 
face significant challenges in coordinating benefits 
and services delivered through the Medicaid program 
and other social services programs because of the 
fragmented and complex nature of Federal and 
State funding and administrative requirements. 
(3) The Federal Government should prioritize 
and proactively assist State and local governments 
to strengthen the capacity of State and local govern-
ments to improve health and social outcomes for in-
dividuals, thereby improving cost-effectiveness and 
return on investment. 
(b) PURPOSES.—The purposes of this Act are as fol-
lows: 
(1) To establish effective, coordinated Federal 
technical assistance to help State and local govern-
ments to improve outcomes and cost-effectiveness of, 
and return on investment from, health and social 
services programs. 
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(2) To build a pipeline of State and locally de-
signed, cross-sector interventions and strategies that 
generate rigorous evidence about how to improve 
health and social outcomes, and increase the cost-ef-
fectiveness of, and return on investment from, Fed-
eral, State, local, and Tribal health and social serv-
ices programs. 
(3) To enlist State and local governments and 
the service providers of such governments as part-
ners in identifying Federal statutory, regulatory, and 
administrative challenges in improving the health 
and social outcomes of, cost-effectiveness of, and re-
turn on investment from, Federal spending on indi-
viduals enrolled in Medicaid. 
(4) To develop strategies to improve health and 
social outcomes without denying services to, or re-
stricting the eligibility of, vulnerable populations. 
SEC. 3. SOCIAL DETERMINANTS ACCELERATOR COUNCIL. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services (referred to in this Act as the ‘‘Sec-
retary’’), in coordination with the Administrator of the 
Centers for Medicare & Medicaid Services (referred to in 
this Act as the ‘‘Administrator’’), shall establish an inter-
agency council, to be known as the Social Determinants 
Accelerator Interagency Council (referred to in this Act 
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as the ‘‘Council’’) to achieve the purposes listed in section 
2(b). 
(b) MEMBERSHIP.— 
(1) FEDERAL COMPOSITION.—The Council shall 
be composed of at least one designee from each of 
the following Federal agencies: 
(A) The Office of Management and Budg-
et. 
(B) The Department of Agriculture. 
(C) The Department of Education. 
(D) The Indian Health Service. 
(E) The Department of Housing and 
Urban Development. 
(F) The Department of Labor. 
(G) The Department of Transportation. 
(H) Any other Federal agency the Chair of 
the Council determines necessary. 
(2) DESIGNATION.— 
(A) IN GENERAL.—The head of each agen-
cy specified in paragraph (1) shall designate at 
least one employee described in subparagraph 
(B) to serve as a member of the Council. 
(B) RESPONSIBILITIES.—An employee de-
scribed in this subparagraph shall be a senior 
employee of the agency— 
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(i) whose responsibilities relate to au-
thorities, policies, and procedures with re-
spect to the health and well-being of indi-
viduals 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 implement 
and evaluate transformative initiatives that 
harness data or conducts rigorous evalua-
tion to improve the impact and cost-effec-
tiveness of federally funded services and 
benefits. 
(3) HHS REPRESENTATION.—In addition to 
the designees under paragraph (1), the Council shall 
include designees from at least three agencies within 
the Department of Health and Human Services, in-
cluding the Centers for Medicare & Medicaid Serv-
ices, at least one of whom shall meet the criteria 
under paragraph (2)(B). 
(4) OMB ROLE.—The Director of the Office of 
Management and Budget shall facilitate the timely 
resolution of Governmentwide and multiagency 
issues to help the Council achieve consensus rec-
ommendations described under subsection (c)(1). 
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