II 118th CONGRESS 1st Session S. 2259 IN THE SENATE OF THE UNITED STATES July 12, 2023 Mr. Sullivan (for himself and Ms. Hassan ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To require the Secretary of Veterans Affairs to carry out a pilot program to establish community integration network infrastructure for services for veterans, to require the collection from veterans of information related to social determinants of health, and for other purposes.

1. Short title This Act may be cited as the Leveraging Integrated Networks in Communities for Veterans Act or the LINC VA Act . 2. Pilot program on establishment of community integration network infrastructure for veterans (a) In general Beginning not later than one year after the date on which the report required under section 201(k)(1) of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019 ( Public Law 116–171 ; 38 U.S.C. 1720F note) is delivered to Congress, the Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment of the Department of Veterans Affairs, shall carry out a pilot program under which the Secretary shall establish community integration network infrastructure to provide services for veterans. (b) Elements of program In carrying out the pilot program under subsection (a), the Secretary shall— (1) establish a new or enhance an existing interoperable technology network that— (A) enables the coordination of public and private providers and payors of services for veterans, including services such as— (i) nutritional assistance; (ii) housing; (iii) health care, including preventive health intervention, chronic disease management, and behavioral health care; (iv) transportation; (v) job training; (vi) child development or care; (vii) caregiving and respite care; (viii) disability assistance; and (ix) other services, as determined by the Secretary; (B) prioritizes connectivity with appropriate existing technology networks developed by public or private organizations that comply with, as applicable, standards adopted by the Secretary of Health and Human Services under section 3004 of the Public Health Service Act ( 42 U.S.C. 300jj–14 ), for the purposes described in subparagraph (A); and (C) ensures that— (i) reasonable measures are taken to promote connectivity and interoperable exchange among covered entities; and (ii) appropriate privacy and security protections are in place, in accordance with applicable Federal and State privacy laws; (2) connect covered entities for purposes of communication, service coordination and consumer assistance, referral and capacity management, outcome tracking and reporting, and related services; (3) provide technical assistance and support covered entities in connecting and participating in the community integration network infrastructure; (4) collect information from veterans served under the pilot program regarding social determinants of health using a standardized risk assessment or screening tool, which shall include standardized definitions for identifying social determinants of health needs identified in the ICD–10 diagnostic codes Z55 through Z63, Z65, and Z75 (as in effect on the date of enactment of this Act) that incorporate measures for quantifying the relative severity of any such social determinant of health need identified in a veteran; and (5) incorporate screenings used to collect information under paragraph (4) into routine care provided to veterans under the laws administered by the Secretary. (c) Locations (1) In general The Secretary of Veterans Affairs shall carry out the pilot program under subsection (a) at not fewer than one facility of the Department of Veterans Affairs in each Veterans Integrated Service Network of the Department. (2) Variety of facilities In selecting facilities under paragraph (1), the Secretary shall ensure the selection of a variety of different types of facilities, including— (A) frontier facilities; (B) under-resourced facilities; and (C) facilities at which there are existing efforts to coordinate with community resources. (d) Coordination and integration of programs (1) Coordination with existing networks In carrying out the pilot program under subsection (a), the Secretary of Veterans Affairs shall coordinate with existing community networks. (2) Coordination and integration with State medicaid programs The Secretary of Health and Human Services, in consultation with the Secretary of Veterans Affairs, shall issue guidance to States that includes options for State Medicaid programs to coordinate and integrate medical assistance provided under a State plan or waiver under title XIX of the Social Security Act ( 42 U.S.C. 1396a et seq. ) with services for veterans provided under the pilot program under subsection (a), as well as a template for States to use to request or modify Medicaid waiver authority under section 1115 of the Social Security Act ( 42 U.S.C. 1315 ) for such purpose. (e) Tracking of referrals (1) In general The Secretary of Veterans Affairs shall track— (A) the accuracy of referrals of veterans to community networks under the pilot program under subsection (a); (B) the response time of providers to which such veterans are referred; and (C) the outcome of the initial meeting by a veteran and the provider to which the veteran is referred. (2) Form The Secretary may track the information required under paragraph (1) in any medium determined appropriate by the Secretary. (f) Report Not later than three years after amounts are first appropriated to carry out to carry out the pilot program under subsection (a), the Secretary of Veterans Affairs shall submit to Congress a report indicating the social service needs of veterans reflected by the use of services under the community integration network infrastructure established under the pilot program under subsection (a), including an assessment of— (1) the need for services that is being met through such infrastructure; and (2) the need for services that is not being met through such infrastructure. (g) Comptroller General evaluation, report, and recommendations (1) Evaluation The Comptroller General of the United States shall conduct an evaluation that measures the overall impact of the community integration network infrastructure established under the pilot program under subsection (a) with respect to— (A) changes in individual and population health outcomes among veterans; (B) changes in access to health care or social services among veterans; and (C) such other factors as the Comptroller General considers appropriate. (2) Report and recommendations (A) In general Not later than four years after the date of the enactment of this Act, the Comptroller General shall— (i) submit to Congress a report on the evaluation conducted under paragraph (1); (ii) make such report publicly available; and (iii) based on such evaluation, make recommendations to the Secretary of Veterans Affairs on how to improve and sustain community integration network infrastructure established under the pilot program under subsection (a). (B) Elements of report The report under subparagraph (A)(i) shall include data on— (i) what resources under the pilot program under subsection (a) are being utilized the most; (ii) what requests for services under the pilot program cannot be met; and (iii) the impact of the provision of services under the pilot program on health outcomes of veterans. (h) Definitions In this section: (1) Community integration network infrastructure The term community integration network infrastructure means infrastructure used to enable the coordination, alignment, and connection of covered entities for purposes of communication, service coordination, and referral management of services, with respect to services such as— (A) nutritional assistance; (B) housing; (C) health care, including preventive health intervention, chronic disease management, and behavioral health care; (D) transportation; (E) job training; (F) child development or care; (G) caregiving and respite care; (H) disability assistance; and (I) other services, as determined by the Secretary of Veterans Affairs. (2) Covered entity The term covered entity means any— (A) community-based organization that accepts referrals from health care organizations and that provides services such as— (i) nutritional assistance; (ii) housing; (iii) health care, including preventive health intervention, chronic disease management, and behavioral health care; (iv) transportation; (v) job training; (vi) child development or care; (vii) caregiving and respite care; and (viii) disability assistance; (B) public or private health care provider organization; (C) public or private funded payor of health care services, including home- or community-based services; (D) State, local, territorial, or Tribal health and social services agency; (E) State public housing authority or housing finance agency; (F) public health information exchange or public health information network, as defined by the Secretary of Veterans Affairs; or (G) other similar entity, as determined by the Secretary. (3) State The term State means a State, territory, or the District of Columbia. 3. Collection of information from veterans related to social determinants of health (a) In general The Secretary of Veterans Affairs shall collect from veterans enrolled in the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code, as part of routine screenings of such veterans under the laws administered by the Secretary, information related to social determinants that may factor into the health of such veterans. (b) Social determinants of health The information collected under subsection (a) shall include standardized definitions for identifying social determinants of health needs identified in the ICD–10 diagnostic codes Z55 through Z63, Z65, and Z75 (as in effect on the date of enactment of this Act). Such definitions shall incorporate measures for quantifying the relative severity of any such social determinant of health need identified in an individual. 4. Implementation In implementing this Act, the Secretary of Veterans Affairs shall consider data privacy and how to prevent data blocking and promote interoperability.