PRINTER'S NO. 1355
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
1039
Session of
2022
INTRODUCED BY SCHWANK, FONTANA, COMITTA, HUGHES, CAPPELLETTI,
COSTA AND KEARNEY, JANUARY 26, 2022
REFERRED TO HEALTH AND HUMAN SERVICES, JANUARY 26, 2022
AN ACT
Establishing the Health In All Policies Task Force; and
providing for duties of task force.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Health In All
Policies Task Force Act.
Section 2. Findings and declarations.
The General Assembly finds and declares as follows:
(1) Advancing the health of all Pennsylvanians is
critical to sustaining a strong and economically vibrant
Commonwealth.
(2) Health outcomes can be largely attributed to a wide
range of external factors apart from an individual's health
care, which only accounts for 10% of an individual's health
and assumes 96% of health expenditures in the United States.
(3) An individual's zip code is often a predictor of
health, and many Pennsylvanians are not living or working in
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communities that were designed with health in mind.
(4) Health outcomes, such as differences in life
expectancy by race and ethnicity, are the result of a
confluence of social, environmental and behavioral factors
simultaneously operating at different scales.
(5) Primary care is critical to the health of
individuals, improves health outcomes and, when systems
prioritize primary health, is associated with a more
equitable distribution of positive health outcomes in
populations.
(6) Primary care spending, a measure of primary care
orientation, only amounts to approximately 5% to 8% of all
health spending, with states with higher investment in
primary care reporting better patient outcomes.
(7) These complex issues rarely have a singular solution
that can be implemented by one sector or State agency.
(8) The integration of health impacts into the
Commonwealth's public policies, including policies related to
health care and public health, air and water quality, natural
resources, housing, infrastructure, education and
transportation, can have a substantial impact on the health
and economic prosperity of communities of this Commonwealth.
(9) Improving health outcomes by reducing the chronic
disease burden and health inequities in this Commonwealth
requires State interagency collaboration to ensure that
health is considered when policies are developed.
Section 3. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
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"Health in All Policies." A collaborative approach that
integrates health considerations into policymaking across
sectors to improve community and population health that:
(1) Recognizes that health is influenced by social,
physical and economic environments, collectively referred to
as the social determinants of health.
(2) Incorporates social determinants of health that are
key drivers of health outcomes and health inequities into
policy considerations.
(3) Promotes equity and sustainability.
(4) Creates structural or procedural change to
interagency relations and decision-making.
(5) Builds on an international and historical body of
collaborative work.
"Primary care." The provision of integrated and accessible
health care services by clinicians in the fields of family
medicine, general internal medicine, general pediatrics and
general practice who are accountable for addressing a large
majority of personal health care needs, developing a sustained
partnership with patients and practicing in the context of
family and community.
"Primary care spending." Total medical expenditures,
including payments to reimburse the cost of physical and mental
health care to primary care, excluding prescription drugs,
vision care and dental care, whether paid on a fee for service
basis or as part of a capitated rate or other type of payment
mechanism.
"Secretary." The Secretary of Human Services of the
Commonwealth.
"Social determinants of health." Conditions under which
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people are born, grow, live, work and age.
"Task force." The Health In All Policies Task Force
established under section 4(a).
Section 4. Establishment and composition of task force.
(a) Establishment.--The Health in All Policies Task Force is
established to identify strategies to influence policy
development to ensure that health impacts are considered with
input from interagency collaboration, in accordance with the
following key elements of Health in All Policies initiatives:
(1) Promoting health, equity and sustainability through
incorporating these elements into policies, programs and
processes as well as embedding these elements into government
decision-making processes so that healthy public policy
becomes normal business.
(2) Breaking down silos to include agencies not
typically considered as health agencies that directly impact
health and building new partnerships to promote health and
equity and increase government efficiency.
(3) Benefiting multiple partners through addressing
goals of public health and other agencies and reducing
redundancy to ensure the more effective use of government
resources.
(4) Engaging a variety of stakeholders to ensure that
work is responsive to community needs.
(5) Embedding the Health in All Policies infrastructure
into existing or new structures and processes of government.
(b) Co-chairs.--The secretary and the Secretary of
Intergovernmental Affairs shall act as co-chairs of the task
force.
(c) Composition.--The task force shall consist of the
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following:
(1) A representative from each of the following:
(i) The Office of Attorney General.
(ii) The Department of Agriculture.
(iii) The Department of Community and Economic
Development.
(iv) The Department of Conservation and Natural
Resources.
(v) The Department of Corrections.
(vi) The Department of Drug and Alcohol Programs.
(vii) The Department of Education.
(viii) The Department of Environmental Protection.
(ix) The Department of General Services.
(x) The Department of Human Services.
(xi) The Department of Labor and Industry.
(xii) The Department of Revenue.
(xiii) The Department of State.
(xiv) The Department of Transportation.
(xv) The Pennsylvania Public Utilities Commission.
(2) A member from the majority caucus of the Senate,
appointed by the President pro tempore of the Senate.
(3) A member from the minority caucus of the Senate,
appointed by the Minority Leader of the Senate.
(4) A member from the majority caucus of the House of
Representatives, appointed by the Speaker of the House of
Representatives.
(5) A member from the minority caucus of the House of
Representatives, appointed by the Minority Leader of the
House of Representatives.
(6) A representative from each of the following
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organizations:
(i) The Pennsylvania Academy of Family Physicians.
(ii) The Pennsylvania Chapter of the American
Academy of Pediatrics.
(iii) The Pennsylvania Chapter of the American
College of Physicians.
(iv) The Pennsylvania Association of Community
Health Centers.
(v) The Pennsylvania Coalition of Nurse
Practitioners.
(vi) The United Way of Pennsylvania.
(vii) The Housing Alliance of Pennsylvania.
(viii) The Pennsylvania College of Emergency
Physicians.
(7) Any other representatives from sectors identified by
the task force, including, but not limited to, the medical
community, community advocacy groups, social services
organizations, redevelopment authorities or environmental
organizations, which are necessary to carry out the task
force's duties under section 5.
(d) Appointment.--An entity under subsection (b)(6) may
submit the name of a prospective representative to the secretary
for the purpose of appointment to the task force.
(e) Terms.--
(1) Each member of the task force shall serve for a
period of two years.
(2) Members may be reappointed by the secretary.
(f) Meetings.--The Department of Human Services shall
establish a meeting schedule and coordinate meetings of the task
force.
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(g) Expenses.--The members of the task force shall not
receive compensation for their services as members of the task
force but shall be reimbursed for reasonable expenses incurred
in the performance of their duties as members of the task force.
Section 5. Duties of task force.
(a) Work plan.--The task force shall develop a work plan for
integrating health into policy decisions that includes
strategies for all of the following:
(1) Developing and structuring cross-sector
relationships.
(2) Enhancing workforce capacity.
(3) Incorporating health into decision-making processes.
(4) Coordinating funding and investments.
(5) Integrating research, evaluation and data systems.
(6) Implementing accountability structures.
(7) Synchronizing communications and messaging.
(b) Development.--In developing the work plan under
subsection (a), the task force may do any of the following:
(1) Review existing efforts by State agencies.
(2) Consider best practices used by other state agencies
outside of this Commonwealth.
(3) Propose formal action plans for recommended
programs, policies and strategies, including, but not limited
to:
(i) Utilizing health impact assessments as a tool to
integrate health into current policy processes.
(ii) Quantifying primary care spending and efforts
to increase the level of investment.
(iii) Creating opportunities to utilize common data
or indicators across sectors.
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(iv) Generating cross-agency collaboration with
sufficient time and funding.
(4) Use an opportunistic approach, focusing on
identifying issues, policies or relationships that can
provide early successes.
(5) Use an issue approach, identifying a specific policy
that has a major impact on specific public health priorities.
(6) Use a sector approach, focusing on one specific
policy area that has a large health impact.
(c) Guidance.--The task force shall develop guidance,
criteria and tools to support State, judicial and legislative
agencies in assessing the potential impact on health when
proposing new agency rules, budgetary changes or major
programmatic changes.
Section 6. Report.
Within one year of the effective date of this section, the
task force shall issue a report to the Governor on the strategic
plan, goals and enabling strategies to integrate health into
policy decisions. After the issuance of the initial report under
this section, unless otherwise directed by the Governor, the
task force shall provide semiannual reports to the Governor on
the progress towards satisfying the objectives specified under
this act.
Section 7. Effective date.
This act shall take effect in 60 days.
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