[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5246 Introduced in House (IH)]

<DOC>






116th CONGRESS
  1st Session
                                H. R. 5246

  To direct the Secretary of Health and Human Services to carry out a 
 Health in All Policies Demonstration Project, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 21, 2019

 Mr. Pascrell (for himself, Mr. Lewis, Ms. Sanchez, Mr. Danny K. Davis 
   of Illinois, Mr. Suozzi, Mr. Panetta, and Ms. Sewell of Alabama) 
 introduced the following bill; which was referred to the Committee on 
   Energy and Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To direct the Secretary of Health and Human Services to carry out a 
 Health in All Policies Demonstration Project, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Researching and Ending Disparities 
by Understanding and Creating Equity Act of 2019'' or the ``REDUCE Act 
of 2019''.

SEC. 2. HEALTH IN ALL POLICIES DEMONSTRATION PROJECT.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') acting through the 
Director of the Centers for Disease Control and Prevention, and in 
coordination with relevant agencies including the Department of 
Education, the Department of Agriculture, the Department of Housing and 
Urban Development, the Department of Justice, the Department of Labor, 
the Environmental Protection Agency, and the Department of 
Transportation, shall implement a grant program, to be known as the 
Health in All Policies Demonstration Project.
    (b) Grants.--In carrying out subsection (a), the Secretary shall 
award grants to eligible entities to establish, implement, or enhance, 
in the jurisdiction of the respective entity, a collaborative, 
interdisciplinary, and community-focused approach to improve the health 
of all communities and people that--
            (1) integrates and articulates health considerations in 
        policymaking across sectors;
            (2) addresses--
                    (A) health;
                    (B) equity; and
                    (C) sustainability; and
            (3) targets a significant proportion of Medicare 
        beneficiaries, Medicare-Medicaid dual eligibles, or long-term 
        care Medicaid recipients.
    (c) Evaluation.--The Secretary shall identify metrics for 
evaluating the implementation of a grant under this section and, using 
such metrics, evaluate each grantee on the extent to which the approach 
implemented through the grant--
            (1) supports intersectoral collaboration;
            (2) benefits multiple partners;
            (3) engages stakeholders;
            (4) creates structural or procedural change;
            (5) impacts or relates to a model or demonstration project 
        administered by the Centers for Medicare & Medicaid Services, 
        such as an advanced payment model; and
            (6) provides cost savings, delivers efficiencies, and 
        improves overall health, including health disparity reduction 
        and health equity improvements.
    (d) Eligibility.--To be eligible to receive a grant under this 
section, an entity shall--
            (1) be a State, territory of the United States, Tribe, 
        city, or county; and
            (2) submit an application to the Secretary at such time, in 
        such manner, and containing such information as the Secretary 
        may require.
    (e) Prioritization; Geographical Diversity.--In awarding grants 
under this section, the Secretary shall--
            (1) give priority to eligible entities seeking to use a 
        grant to improve, as described in subsection (b), the health of 
        populations that--
                    (A) are target populations described in subsection 
                (b)(3); and
                    (B) have significant health inequities throughout 
                the populations; and
            (2) seek to ensure geographical diversity among grantees.
    (f) Reports by Grantees.--As a condition on receipt of a grant 
under this section, the Secretary shall require grantees--
            (1) to provide a report to the Secretary upon completion of 
        the Health in All Policies Demonstration Project; and
            (2) to include in such report the extent to which the 
        approach implemented achieved the goals listed in paragraphs 
        (1) through (6) of subsection (c).
    (g) Report to Congress.--
            (1) Submission.--The Secretary shall submit to the 
        Congress--
                    (A) not later than one year after the date of 
                enactment of this Act, an initial report on the Health 
                in All Policies Demonstration Project; and
                    (B) not later than one year after the completion of 
                the Demonstration Project, a final report on the 
                Demonstration Project.
            (2) Contents of initial report.--The report under paragraph 
        (1)(A) shall include--
                    (A) evaluation of the success of soliciting 
                applications;
                    (B) identification of the number of applications 
                received;
                    (C) specification of the timeline for awarding 
                funding; and
                    (D) identification of barriers to implementing the 
                Health in All Policies Demonstration Project, if any.
            (3) Contents of final report.--The report under paragraph 
        (1)(B) shall each include the following:
                    (A) An assessment of the Health in All Policies 
                Demonstration Project, including an evaluation of the 
                effectiveness of the Demonstration Project.
                    (B) Recommendations for Federal legislative 
                actions--
                            (i) to integrate, based on such assessment, 
                        a collaborative and interdisciplinary approach 
                        to improve the health of all communities; and
                            (ii) to support eligible entities in 
                        pursuing a comparable integration of such an 
                        approach across State programs.
    (h) Definitions.--In this section:
            (1) The term ``Medicare beneficiaries'' means individuals 
        entitled to part A of XVIII of the Social Security Act and 
        enrolled under part B of such title.
            (2) The term ``Medicare-Medicaid dual eligibles'' means 
        individuals who are dually eligible for benefits under title 
        XVIII of the Social Security Act and title XIX of such Act.
    (i) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $2,000,000 for the period of 
fiscal years 2021 through 2024.

SEC. 3. NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE 
              REPORT.

    (a) In General.--The Secretary of Health and Human Services shall 
seek to enter into an arrangement, not later than 60 days after the 
date of enactment of this Act, with the National Academies of Sciences, 
Engineering, and Medicine (or if the Academies decline to enter into 
such arrangement, another appropriate entity) under which the Academies 
(or other appropriate entity) agrees to prepare a report on eliminating 
health disparities to improve health equity.
    (b) Report.--
            (1) Contents.--The report prepared pursuant to subsection 
        (a) shall--
                    (A) review evidence on how social determinants of 
                health affect health outcomes among middle-income 
                Medicare beneficiaries and Medicare-Medicaid dual 
                eligibles;
                    (B) examine successful interventions, including 
                with respect to health outcomes, that address social 
                determinants of health (including transportation, 
                meals, housing, access to health care, personal care 
                assistance, and access to long-term services and 
                supports), reduce health disparities, and improve 
                health equity;
                    (C) make conclusions regarding--
                            (i) the effectiveness of existing programs 
                        and policies of the Centers for Medicare & 
                        Medicaid Services intended to reduce health 
                        disparities;
                            (ii) best practices and successful 
                        strategies that reduce health disparities; and
                            (iii) efforts needed to address health 
                        disparities related to health care workforce 
                        shortages; and
                    (D) make recommendations regarding--
                            (i) priorities for health disparities 
                        interventions within Federal health care 
                        programs; and
                            (ii) potential opportunities for expansion 
                        or replication of successful interventions and 
                        payment models to reduce health disparities and 
                        improve health equity.
            (2) Submission.--The arrangement under subsection (a) shall 
        require the National Academies of Sciences, Engineering, and 
        Medicine (or other appropriate entity), not later than 18 
        months after entering into such arrangement, to finalize the 
        report prepared pursuant to such arrangement and submit such 
        report to the Committees on Energy and Commerce and Ways and 
        Means of the House of Representatives and the Committees on 
        Finance and Health, Education, Labor, and Pensions of the 
        Senate.
    (c) Definitions.--In this section:
            (1) The term ``health equity'' means a state where all 
        people are able to attain their full health potential and no 
        one is hindered from achieving this potential due to social 
        position or another socially determined circumstance.
            (2) The term ``middle-income Medicare beneficiaries'' means 
        individuals entitled to part A of XVIII of the Social Security 
        Act and enrolled under part B of such title who have an income 
        that is not below 125 percent of the poverty line applicable to 
        a family of the size involved, but not more than 400 percent of 
        the poverty line so applicable.
            (3) The term ``Medicare-Medicaid dual eligibles'' means 
        individuals who are dually eligible for benefits under title 
        XVIII of the Social Security Act and title XIX of such Act.
            (4) The term ``social determinants of health'' refers to 
        the 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.
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