[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2259 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 2259

   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.


_______________________________________________________________________


                   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.

    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 ``Leveraging Integrated Networks in 
Communities for Veterans Act'' or the ``LINC VA Act''.

SEC. 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.

SEC. 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.

SEC. 4. IMPLEMENTATION.

    In implementing this Act, the Secretary of Veterans Affairs shall 
consider data privacy and how to prevent data blocking and promote 
interoperability.
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