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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-HEY23787-TJ3-FN-YR1"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>116 S2259 IS: Leveraging Integrated Networks in Communities for Veterans Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2023-07-12</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>1st Session</session><legis-num>S. 2259</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20230712">July 12, 2023</action-date><action-desc><sponsor name-id="S383">Mr. Sullivan</sponsor> (for himself and <cosponsor name-id="S388">Ms. Hassan</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSVA00">Committee on Veterans' Affairs</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>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. </official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Leveraging Integrated Networks in Communities for Veterans Act</short-title></quote> or the <quote><short-title>LINC VA Act</short-title></quote>.</text></section><section id="id7A30227C5B55400895CCB6EBE426668F"><enum>2.</enum><header>Pilot program on establishment of community integration network infrastructure for veterans</header><subsection commented="no" display-inline="no-display-inline" id="id2b24b3dcdfb24ece897f32c6b8522174"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/116/171">Public Law 116–171</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1720F">38 U.S.C. 1720F</external-xref> 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. </text></subsection><subsection id="idA1C1073DA11B42D0A717F7BCF6D27A35"><enum>(b)</enum><header>Elements of program</header><text display-inline="yes-display-inline">In carrying out the pilot program under subsection (a), the Secretary shall—</text><paragraph id="id9db7e897ab934e539f0f7c133664c739"><enum>(1)</enum><text>establish a new or enhance an existing interoperable technology network that—</text><subparagraph id="id2ad37bc1b6264907aab16b6f931e01b0"><enum>(A)</enum><text>enables the coordination of public and private providers and payors of services for veterans, including services such as—</text><clause id="id1B174ADEB44B4B66BDC471331970BDA7"><enum>(i)</enum><text>nutritional assistance; </text></clause><clause id="id951D911235634951BB3CD1A4C8F69635"><enum>(ii)</enum><text>housing;</text></clause><clause id="id8ACF61AD49B04F958ED16B21BF81DD2C"><enum>(iii)</enum><text>health care, including preventive health intervention, chronic disease management, and behavioral health care; </text></clause><clause id="id1D545B6E6C034D73BD48914D8AE29C41"><enum>(iv)</enum><text>transportation; </text></clause><clause id="id47CD4991486648E59AD8E0C21988DC64"><enum>(v)</enum><text>job training; </text></clause><clause id="id2E587B12A75A408D826206CBB1C15EE5"><enum>(vi)</enum><text>child development or care;</text></clause><clause id="id65E549F8D87B46CC92D0FB9AF4A4A2C0"><enum>(vii)</enum><text>caregiving and respite care;</text></clause><clause id="id1EAC84CEF21A4129AEC5B09C63A79162"><enum>(viii)</enum><text>disability assistance; and</text></clause><clause id="idA583D937460A495A88CE6F0FC07BE953"><enum>(ix)</enum><text>other services, as determined by the Secretary;</text></clause></subparagraph><subparagraph id="id25c834d00dfb4e559769b52ed9ac6f69"><enum>(B)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300jj-14">42 U.S.C. 300jj–14</external-xref>), for the purposes described in subparagraph (A); and</text></subparagraph><subparagraph id="ide46e8b3bba9b4411b5d5800064a6e247"><enum>(C)</enum><text>ensures that—</text><clause id="id33299c452e194b04ba5e5f3234022d96"><enum>(i)</enum><text>reasonable measures are taken to promote connectivity and interoperable exchange among covered entities; and</text></clause><clause id="id82425ed3945547bb9d0a4db735fd3414"><enum>(ii)</enum><text>appropriate privacy and security protections are in place, in accordance with applicable Federal and State privacy laws;</text></clause></subparagraph></paragraph><paragraph id="idab92d8ed6c214cbd93f459347409dcfb"><enum>(2)</enum><text>connect covered entities for purposes of communication, service coordination and consumer assistance, referral and capacity management, outcome tracking and reporting, and related services;</text></paragraph><paragraph id="idb1a4c2ba86854bcab623c2ef86f4ed1a"><enum>(3)</enum><text>provide technical assistance and support covered entities in connecting and participating in the community integration network infrastructure;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id27BFAA14BE474E9F890E94A228D01654"><enum>(4)</enum><text>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</text></paragraph><paragraph id="id16442cac28fc424c8f83a4221eeaed92"><enum>(5)</enum><text>incorporate screenings used to collect information under paragraph (4) into routine care provided to veterans under the laws administered by the Secretary. </text></paragraph></subsection><subsection display-inline="no-display-inline" commented="no" id="id358E479AAE554A3C85A2629898463366"><enum>(c)</enum><header>Locations</header><paragraph display-inline="no-display-inline" commented="no" id="id2F2CB68888364BD288AA72550F499527"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph><paragraph display-inline="no-display-inline" commented="no" id="id02930FEDF25541269530FCFD8E2FE1E5"><enum>(2)</enum><header>Variety of facilities</header><text>In selecting facilities under paragraph (1), the Secretary shall ensure the selection of a variety of different types of facilities, including—</text><subparagraph display-inline="no-display-inline" commented="no" id="id13ECDF821A5E461291F0474F0E476887"><enum>(A)</enum><text>frontier facilities;</text></subparagraph><subparagraph display-inline="no-display-inline" commented="no" id="idF78EF66ADF0F43B193C641961A3BD950"><enum>(B)</enum><text>under-resourced facilities; and</text></subparagraph><subparagraph display-inline="no-display-inline" commented="no" id="id4F43F2D178C64D93A4D9781BFBCC27E6"><enum>(C)</enum><text>facilities at which there are existing efforts to coordinate with community resources.</text></subparagraph></paragraph></subsection><subsection id="id400a21962a1447fba074982da7d375fd"><enum>(d)</enum><header>Coordination and integration of programs</header><paragraph id="idB2FAF619ECAB4712BC3C1CCF0AB7BC2A"><enum>(1)</enum><header>Coordination with existing networks</header><text>In carrying out the pilot program under subsection (a), the Secretary of Veterans Affairs shall coordinate with existing community networks. </text></paragraph><paragraph id="id1DA3179357CE4A2BBCABCE7676EDE9C7"><enum>(2)</enum><header>Coordination and integration with State medicaid programs</header><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1396a">42 U.S.C. 1396a et seq.</external-xref>) 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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1315">42 U.S.C. 1315</external-xref>) for such purpose.</text></paragraph></subsection><subsection id="id68DC58D20A9B4201A71F935688B94261"><enum>(e)</enum><header>Tracking of referrals</header><paragraph id="id5F7990462DD6424B919F3D0A0A6FFD9D"><enum>(1)</enum><header>In general</header><text>The Secretary of Veterans Affairs shall track—</text><subparagraph id="idE78E19EE8F8542079FD55A50E1DC48C0"><enum>(A)</enum><text>the accuracy of referrals of veterans to community networks under the pilot program under subsection (a);</text></subparagraph><subparagraph id="id3F9892B45D774EEB843DFF7CCABA50C1"><enum>(B)</enum><text>the response time of providers to which such veterans are referred; and</text></subparagraph><subparagraph id="idC24C60A228DB43EA863133778B3110C8"><enum>(C)</enum><text>the outcome of the initial meeting by a veteran and the provider to which the veteran is referred.</text></subparagraph></paragraph><paragraph id="idF10F1186C36E4FA5BF4AA4D24EF067BD"><enum>(2)</enum><header>Form</header><text>The Secretary may track the information required under paragraph (1) in any medium determined appropriate by the Secretary. </text></paragraph></subsection><subsection id="idfcf01b10c5204ae387a00e83ad6a83d9"><enum>(f)</enum><header>Report</header><text>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— </text><paragraph commented="no" display-inline="no-display-inline" id="id4414896f39294c80b31b9ac8a36fb0c1"><enum>(1)</enum><text display-inline="yes-display-inline">the need for services that is being met through such infrastructure; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id44ed4806a1504b84a606d1650b439726"><enum>(2)</enum><text display-inline="yes-display-inline">the need for services that is not being met through such infrastructure.</text></paragraph></subsection><subsection id="id6004AEFD660C4A02AB888D069CA8B8BB"><enum>(g)</enum><header>Comptroller General evaluation, report, and recommendations</header><paragraph id="idB6278CA915B34191A223403693E33A18"><enum>(1)</enum><header>Evaluation</header><text display-inline="yes-display-inline">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—</text><subparagraph id="id844989CE03594ED880E689FE8F0A4FCB"><enum>(A)</enum><text>changes in individual and population health outcomes among veterans;</text></subparagraph><subparagraph id="idFEF0771AA1AC49829BE12F43BE7AE717"><enum>(B)</enum><text>changes in access to health care or social services among veterans; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idF4D5FE4F643642B79BE03FB8B66D0189"><enum>(C)</enum><text>such other factors as the Comptroller General considers appropriate.</text></subparagraph></paragraph><paragraph id="idDE74E8E5DBD94D089932566B7E7CD8F6"><enum>(2)</enum><header>Report and recommendations</header><subparagraph id="id045C0D53F82E4440BFB49197360BED7A"><enum>(A)</enum><header>In general</header><text>Not later than four years after the date of the enactment of this Act, the Comptroller General shall—</text><clause id="id796EC10582FA4DD29E6EB7619789283A"><enum>(i)</enum><text>submit to Congress a report on the evaluation conducted under paragraph (1);</text></clause><clause commented="no" display-inline="no-display-inline" id="id1af2ea0ca3004f4cb97ff9fdca9c640d"><enum>(ii)</enum><text display-inline="yes-display-inline">make such report publicly available; and</text></clause><clause id="idB3D3BFC255604F2FAB3A92A4FF19BBC8" commented="no" display-inline="no-display-inline"><enum>(iii)</enum><text>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).</text></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idDD301F459A9B498BABF39C74DCC59034"><enum>(B)</enum><header>Elements of report</header><text>The report under subparagraph (A)(i) shall include data on—</text><clause commented="no" display-inline="no-display-inline" id="idE71A52D2D0FF4F5EB0F6EC897307B484"><enum>(i)</enum><text>what resources under the pilot program under subsection (a) are being utilized the most;</text></clause><clause commented="no" display-inline="no-display-inline" id="idE6AEFAD76B7D408E8C9F7C03271BB7FF"><enum>(ii)</enum><text>what requests for services under the pilot program cannot be met; and</text></clause><clause commented="no" display-inline="no-display-inline" id="id11848370DCD444498BA3410EA7FE3DC8"><enum>(iii)</enum><text>the impact of the provision of services under the pilot program on health outcomes of veterans. </text></clause></subparagraph></paragraph></subsection><subsection id="id3624F39A35AE4D63BC47734592238852"><enum>(h)</enum><header>Definitions</header><text>In this section:</text><paragraph id="idB84B9AAC25084F88A14774FAC474AA69"><enum>(1)</enum><header>Community integration network infrastructure</header><text>The term <term>community integration network infrastructure</term> 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—</text><subparagraph id="id40435c2178574c6f90456191a9eefd7d"><enum>(A)</enum><text>nutritional assistance; </text></subparagraph><subparagraph id="idf184c583ed38457d915196c8d3c2a683"><enum>(B)</enum><text>housing;</text></subparagraph><subparagraph id="id187f0ae0a50a4810b0b50eb060213701"><enum>(C)</enum><text>health care, including preventive health intervention, chronic disease management, and behavioral health care; </text></subparagraph><subparagraph id="id3b387cd78f8d405bacaa839eb3663cc3"><enum>(D)</enum><text>transportation; </text></subparagraph><subparagraph id="id18f792b267b34ea7995afd46bf922091"><enum>(E)</enum><text>job training; </text></subparagraph><subparagraph id="id8e2a8aae5eab47b5b8d67ab91c66182d"><enum>(F)</enum><text>child development or care;</text></subparagraph><subparagraph id="idaa130f28d9eb4619bb8967d11ce79e80"><enum>(G)</enum><text>caregiving and respite care;</text></subparagraph><subparagraph id="id39eb3bbae4a8457ba244c845cd2931be"><enum>(H)</enum><text>disability assistance; and</text></subparagraph><subparagraph id="id7AC25A865E7E44E9A447FF0DF04DF7CA" commented="no" display-inline="no-display-inline"><enum>(I)</enum><text>other services, as determined by the Secretary of Veterans Affairs. </text></subparagraph></paragraph><paragraph id="idDB59DC69A61C45FBBD76627ACA9C2ECB"><enum>(2)</enum><header>Covered entity</header><text>The term <term>covered entity</term> means any—</text><subparagraph id="idaa8cfe5f417f4574b7bbb783df087ffc"><enum>(A)</enum><text>community-based organization that accepts referrals from health care organizations and that provides services such as—</text><clause id="id631d1829203841dfb95687bdc05a8fa1"><enum>(i)</enum><text>nutritional assistance; </text></clause><clause id="idded8cdad2f3440cfa3f80d8a28e4f0f0"><enum>(ii)</enum><text>housing;</text></clause><clause id="id6e06357b14544f839a2b8f08a3a49242"><enum>(iii)</enum><text>health care, including preventive health intervention, chronic disease management, and behavioral health care; </text></clause><clause id="id83cfc9211a5c4e07b0f9737e397e3537"><enum>(iv)</enum><text>transportation; </text></clause><clause id="id65bf3ceafa594255bfc5acc6ebf865f8"><enum>(v)</enum><text>job training; </text></clause><clause id="id1e890faddde14901b138475d5321e33a"><enum>(vi)</enum><text>child development or care;</text></clause><clause id="id5a4f9df2c707464aa5f4f95d749b723d"><enum>(vii)</enum><text>caregiving and respite care; and</text></clause><clause id="idf6b335a6ef1f4eacb01ab2d3158aef42"><enum>(viii)</enum><text>disability assistance;</text></clause></subparagraph><subparagraph id="id2efc227cffc34782b3e93c70c7245be8"><enum>(B)</enum><text>public or private health care provider organization;</text></subparagraph><subparagraph id="idd4304e873baa46acb5b03deb0f0f9cfc"><enum>(C)</enum><text>public or private funded payor of health care services, including home- or community-based services;</text></subparagraph><subparagraph id="id2d43980ececd4ee6b27aa8380afb34c9"><enum>(D)</enum><text>State, local, territorial, or Tribal health and social services agency;</text></subparagraph><subparagraph id="id3b3a6c43448a46c0872ae15b1d3c4373"><enum>(E)</enum><text>State public housing authority or housing finance agency;</text></subparagraph><subparagraph id="id7A3FE57EB8704EAA8F27D4FD6AE64EF8"><enum>(F)</enum><text>public health information exchange or public health information network, as defined by the Secretary of Veterans Affairs; or</text></subparagraph><subparagraph id="id4f2fa39bab6f480bafc09b1bae11aeff"><enum>(G)</enum><text>other similar entity, as determined by the Secretary.</text></subparagraph></paragraph><paragraph id="idD35300697C3B406DAEDA2641B1832981"><enum>(3)</enum><header>State</header><text>The term <term>State</term> means a State, territory, or the District of Columbia.</text></paragraph></subsection></section><section id="id5f6f95215ba441c494d45aec5bece02d"><enum>3.</enum><header>Collection of information from veterans related to social determinants of health</header><subsection commented="no" display-inline="no-display-inline" id="id2e396ae8309e48d599ea2389c77c52ba"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text>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.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id218A3422171445449F329157E50A5D44"><enum>(b)</enum><header>Social determinants of health</header><text>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.</text></subsection></section><section commented="no" display-inline="no-display-inline" id="id575c8965ef734906801de5e0c3c3ec6c"><enum>4.</enum><header>Implementation</header><text display-inline="no-display-inline">In implementing this Act, the Secretary of Veterans Affairs shall consider data privacy and how to prevent data blocking and promote interoperability. </text></section></legis-body></bill> 

