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SDoH Legislation and Funding Needle Moves to Address Populations Impacted by Trauma

 

A version of this article first appeared in RACMonitor News on 7/22/21 and is published with explicit permission

Several recent key events have occurred to leverage the necessary legislation funding, and reimbursement required to implement sustainable SDoH programs. All directly enhance interventions and programs that target populations which have potentially endured profound trauma.

Legislative focus is on the Social Determinants Accelerator Act, HR 2503. This bi-partisan sponsored bill is geared to get over $25M in planning grants and technical assistance directly to state, local, and tribal governments and communities, for the purpose of addressing social determinants of health. Associations and organizations are stepping up to endorse the act with considerable advocacy to advance the legislation; the massive list  of entities is viewable on the Aligning for Health website. The bill was a major focus of the recent House Committee on Energy & Commerce hearing. Other social risk legislation received attention, including:

  • HR 666: The Anti-Racism in Public Health Act
  • HR 925: The Data to Save Moms Act
  • HR 943: The Social Determinants for Moms Act and
  • HR 3894: The CARING for Social Determinants of Health Act

In addition, a bill to amend title XXVII (27) of the Public Health Service Act was discussed, which include SDoH interventions in medical loss ratio calculations. Links to each bill, and the  Accelerator Act endorsement pageappear in my article this week for RACmonitor.

The Gravity Project continues their success. The project advanced a multi-domain submission to the ICD-10-CM Coordination and Maintenance Virtual Meeting in March. We have lift off! The codes have been approved and will be implemented October 1, 2021. This is exciting news for those who have been longing to expand the Z-code and subcategories that encompass education, food insecurity, and housing; the literature is clear about the relationship between each these factors and trauma. The list of enhancements is exciting to review; it includes, but is not limited to:

  • Z55.5 Less than a high school diploma
  • Z58.6 Inadequate drinking water supply
  • Z 59.00 Homelessness unspecified, has some new subcategories:
  • Z 59.01 Sheltered homelessness
  • Z 59.02 Unsheltered homelessness
  • Z 59.41 Food insecurity
  • Z 59.81 Housing instability, housed and subcategories of:
  • Z59.811 Housing instability, housed with risk of homelessness
  • Z59.812 Housing instability, housed, homelessness in past 12 months
  • Z59.819 Housing instability, housed unspecified

More recommendations are on the Gravity Project’s wish list. Additional codes are being refined and submitted for 2022 approval that address domains of veteran status, transportation insecurity, financial insecurity and material hardship. I’ll continue to provide updates as they become available on this topic and the project’s important work. The full set of released terms can be viewed at the CDC’s National Center for Health Statistics, ICD-10-CM page, under section heading, “2022 release of ICD-10-CM”.

Our  Monitor Monday survey focused on, Which potential ICD-10-CM-Z code submission listeners would want to see approved for 2022. Time will tell what priorities will be on the reimbursement horizon, though you can view the survey responses here.

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