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Green New Deal for Health Act
Introduced Jul 27, 2026 · Last action Jul 27, 2026 — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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Summary
This legislation is called the Green New Deal for Health Act. It is being reviewed by a committee.
Full bill text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 5134 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
2d Session
S. 5134
To establish a Green New Deal for Health to prepare and empower the
health care sector to protect the health and well-being of our workers,
our communities, and our planet in the face of the climate crisis, and
for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 27, 2026
Mr. Markey (for himself, Ms. Warren, Mr. Sanders, Mr. Merkley, and Mr.
Booker) introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To establish a Green New Deal for Health to prepare and empower the
health care sector to protect the health and well-being of our workers,
our communities, and our planet in the face of the climate crisis, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Green New Deal for
Health Act''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Findings and sense of Congress on health and climate change.
TITLE I--WHOLE-OF-GOVERNMENT APPROACH
Sec. 101. Definitions.
Sec. 102. Office of Climate Change and Health Equity; national
strategic action plan.
Sec. 103. Advisory board.
Sec. 104. Climate change health protection and promotion reports.
Sec. 105. Authorization of appropriations.
TITLE II--PROTECTING ESSENTIAL HEALTH CARE ACCESS
Sec. 201. Maintenance of health care access relating to hospital
discontinuation of services or closure.
Sec. 202. Empowering community health in environmental justice
communities.
TITLE III--GREEN AND RESILIENT HEALTH CARE INFRASTRUCTURE
Sec. 301. Green Hill-Burton funds for climate-ready medical facilities.
Sec. 302. Planning and Evaluation Grant Program.
TITLE IV--HEALTH CARE SECTOR DECARBONIZATION
Sec. 401. Office of Sustainability and Environmental Impact.
Sec. 402. Climate risk disclosure for medical supplies.
Sec. 403. Green health care manufacturing.
TITLE V--A HEALTH WORKFORCE TO TACKLE THE CLIMATE CRISIS
Sec. 501. Education and training relating to health risks associated
with climate change.
Sec. 502. Building a community health workforce for the climate crisis.
Sec. 503. Safeguarding essential health care workers.
TITLE VI--SAFE, STRONG, AND RESILIENT COMMUNITIES
Subtitle A--Empowering Resilient Community Mental Health
Sec. 601. Grants for resilient community mental health.
Subtitle B--Understanding and Preventing Heat Risk
Sec. 611. Definitions.
Sec. 612. Study on extreme heat information and response.
Sec. 613. Financial assistance for research and resilience in
addressing extreme heat risks.
Sec. 614. Authorization of appropriations.
Subtitle C--Home Resiliency for Medical Needs
Sec. 621. Medicare coverage of medically necessary home resiliency
services.
TITLE VII--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH
Sec. 701. Research and innovation for climate and health.
SEC. 2. DEFINITIONS.
In this Act:
(1) Environmental justice community.--The term
``environmental justice community'' means a community with
significant representation of communities of color, low-income
communities, or Tribal and Indigenous communities that
experiences, or is at risk of experiencing, higher or more
adverse human health or environmental effects.
(2) Individual disproportionately affected by climate
change.--The term ``individual disproportionately affected by
climate change'' means an individual that may face elevated
mental and physical health risks due to climate change based on
2 or more of the following factors:
(A) Age under 5 years old or over 65 years old.
(B) Race and ethnicity, and experience of racial
bias.
(C) Sex, gender, and gender minority status.
(D) Being of reproductive age.
(E) Exposure to environmental health risks due to
living conditions or location, including current or
past experience of homelessness.
(F) Occupation or exposure to occupational hazards.
(G) Household income.
(H) Disability.
(I) Co-morbidities.
(J) Current or past exposure to personal or
systemic trauma, including natural disasters.
(K) Immigration status.
(L) Language isolation.
(3) Medically underserved community.--The term ``medically
underserved community'' has the meaning given such term in
section 799B of the Public Health Service Act (42 U.S.C. 295p).
SEC. 3. FINDINGS AND SENSE OF CONGRESS ON HEALTH AND CLIMATE CHANGE.
(a) Findings.--Congress finds that, according to the assessment of
the United States Global Change Research Program entitled ``The Impacts
of Climate Change on Human Health in the United States: A Scientific
Assessment'' and dated 2016--
(1) the impacts of human-induced climate change are
increasing nationwide;
(2) rising greenhouse gas concentrations result in
increases in temperature, changes in precipitation, increases
in the frequency and intensity of some extreme weather events,
and rising sea levels;
(3) the climate change impacts described in paragraph (2)
endanger our health by affecting--
(A) our access to care, food, and water sources;
(B) the air we breathe;
(C) the weather we experience; and
(D) our interactions with the built and natural
environments; and
(4) as the climate continues to change, the risks to human
health continue to grow.
(b) Sense of Congress.--It is the sense of Congress that--
(1) climate change poses threats to the United States and
globally through its impacts on society, the economy, the
physical environment, and physical and mental health;
(2) climate change health threats are growing in scale and
severity;
(3) climate change disproportionately affects individuals
in the United States who are economically disadvantaged, belong
to communities of color, or have other social and health
vulnerabilities;
(4) the health care sector accounts for 8.5 percent of
United States emissions, further worsening the overall health
impacts of climate change; and
(5) the Federal Government, working with international,
State, Tribal, and local governments, nongovernmental
organizations, businesses, and individuals, should use all
practicable means and measures--
(A) to deploy a whole-of-government and whole-of-
health approach to protect our collective health from
the impacts of climate change and to mitigate
environmental health impacts from health sector
operations;
(B) to build a just health care ecosystem where all
Americans have access to dignified, high-quality care
in their communities;
(C) to ensure the health care system is resilient
to extreme weather and can continue to provide care
before, during, and after crises;
(D) to lead the health sector to decarbonize its
facilities and operations in an equitable and just
manner;
(E) to empower a thriving health workforce with
good, high-wage union jobs and to recognize the value
of all of the essential workers that enable high-
quality health care; and
(F) to invest in, empower, and build safe, strong,
and resilient communities.
TITLE I--WHOLE-OF-GOVERNMENT APPROACH
SEC. 101. DEFINITIONS.
In this title:
(1) Director.--The term ``Director'' means the Director of
the Office.
(2) National strategic action plan.--The term ``national
strategic action plan'' means the national strategic action
plan published pursuant to section 102(b)(1).
(3) Office.--The term ``Office'' means the Office of
Climate Change and Health Equity established by section
102(a)(1).
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 102. OFFICE OF CLIMATE CHANGE AND HEALTH EQUITY; NATIONAL
STRATEGIC ACTION PLAN.
(a) Office of Climate Change and Health Equity.--
(1) Establishment.--
(A) In general.--There is established within the
Department of Health and Human Services the Office of
Climate Change and Health Equity.
(B) Purpose.--The purpose of the Office shall be to
facilitate a robust, Federal response to the impact of
climate change on the health of the American people and
the health care system.
(C) Director.--There is established the position of
Director of the Office, who--
(i) shall be the head of the Office; and
(ii) may report to the Assistant Secretary
for Health.
(2) Activities.--The duties of the Office shall be to
address priority health actions relating to the health impacts
of climate change, including by doing each of the following:
(A) Contribute to assessments of how climate change
is affecting the health of individuals living in the
United States.
(B) Understand the needs of the populations most
disproportionately affected by climate-related health
threats.
(C) Serve as a credible source of information on
the physical, mental, and behavioral health
consequences of climate change.
(D) Align Federal efforts to deploy climate-
conscious human services and direct services to support
and protect populations composed of individuals
disproportionately affected by climate change.
(E) Create and distribute tools and resources to
support climate resilience for the health sector,
community-based organizations, and individuals.
(F) Create and distribute tools and resources to
support health sector efforts to track and decrease
greenhouse gas emissions.
(G) Lead efforts to reduce the carbon footprint and
environmental impacts of the health sector.
(H) Carry out other activities determined
appropriate by the Secretary.
(b) National Strategic Action Plan.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, the Secretary, on the basis of the best
available science, and in consultation pursuant to paragraph
(2), shall publish a national strategic action plan to
coordinate effective deployment of Federal efforts to ensure
that public health and health care systems are prepared for and
can respond to the impacts of climate change on health in the
United States.
(2) Consultation.--In developing or making any revision to
the national strategic action plan, the Secretary shall--
(A) consult with the Director, the Administrator of
the Environmental Protection Agency, the Under
Secretary of Commerce for Oceans and Atmosphere, the
Administrator of the National Aeronautics and Space
Administration, the Director of the Indian Health
Service, the Secretary of Labor, the Secretary of
Defense, the Secretary of State, the Secretary of
Veterans Affairs, the National Environmental Justice
Advisory Council, the heads of other appropriate
Federal agencies, Tribal governments, and State and
local government officials; and
(B) provide meaningful opportunity for engagement,
comment, and consultation with relevant public
stakeholders, particularly representatives of
populations composed of individuals disproportionately
affected by climate change, environmental justice
communities, Tribal communities, health care providers,
public health organizations, and scientists.
(3) National strategic action plan components.--The
national strategic action plan shall include an assessment of,
and strategies to improve, the health sector capacity of the
United States to address climate change, including--
(A) identifying, prioritizing, and engaging
communities and populations who are disproportionately
affected by exposures to climate hazards;
(B) addressing mental and physical health
disparities exacerbated by climate impacts to enhance
community health resilience;
(C) identifying the link between environmental
injustice and vulnerability to the impacts of climate
change and prioritizing those who have been harmed by
environmental and climate injustice;
(D) providing outreach and communication aimed at
public health and health care professionals and the
public to promote preparedness and response strategies;
(E) tracking and assessing programs across Federal
agencies to advance research related to the impacts of
climate change on health;
(F) identifying and assessing existing preparedness
and response strategies for the health impacts of
climate change;
(G) prioritizing critical public health and health
care infrastructure projects;
(H) providing modeling and forecasting tools of
climate change health impacts, including local impacts,
where feasible;
(I) establishing academic and regional centers of
excellence;
(J) recommending models for maintaining access to
health care during extreme weather;
(K) providing technical assistance and support for
preparedness and response plans for the health threats
of climate change in States, municipalities,
territories, Indian Tribes, and developing countries;
(L) addressing the impacts of fossil fuel pollution
and greenhouse gas emissions on the health of
individuals living in the United States;
(M) tracking health care sector contributions to
greenhouse gas emissions and identifying actions to
reduce those emissions;
(N) recommending new regulations or policies to
address identified gaps in the health system capacity
to effectively reduce emissions, reduce environmental
impact, and address climate change; and
(O) developing, improving, integrating, and
maintaining disease surveillance systems and monitoring
capacity to respond to health-related impacts of
climate change, including on topics addressing--
(i) water-, food-, and vector-borne
infectious diseases and climate change;
(ii) pulmonary effects, including responses
to aeroallergens, infectious agents, and toxic
exposures;
(iii) cardiovascular effects, including
impacts of temperature extremes;
(iv) air pollution health effects,
including heightened sensitivity to air
pollution such as wildfire smoke;
(v) reproductive health effects, including
access to reproductive health care;
(vi) harmful algal blooms;
(vii) mental and behavioral health impacts
of climate change;
(viii) the health of migrants, refugees,
displaced persons, and communities composed of
individuals disproportionately affected by
climate change;
(ix) the implications for communities and
populations vulnerable to the health effects of
climate change, as well as strategies for
responding to climate change within such
communities;
(x) Tribal, local, and community-based
health interventions for climate-related health
impacts;
(xi) extreme heat and weather events;
(xii) decreased nutritional value of crops;
and
(xiii) disruptions in access to routine and
acute medical care, public health programs, and
other supportive services for maintaining
health.
(c) Periodic Assessment and Revision.--Not later than 1 year after
the date of first publication of the national strategic action plan,
and annually thereafter, the Secretary shall periodically assess, and
revise as necessary, the national strategic action plan, to reflect new
information collected, including information on--
(1) the status of and trends in critical environmental
health indicators and related human health impacts;
(2) the trends in and impacts of climate change on public
health;
(3) advances in the development of strategies for preparing
for and responding to the impacts of climate change on public
health; and
(4) the effectiveness of the implementation of the national
strategic action plan in protecting against climate change
health threats.
(d) Implementation.--
(1) Implementation through hhs.--The Secretary shall
exercise the Secretary's authority under this title and other
Federal statutes to achieve the goals and measures of the
Office and the national strategic action plan.
(2) Other public health programs and initiatives.--The
Secretary and Federal officials of other relevant Federal
agencies shall administer public health programs and
initiatives authorized by laws other than this title, subject
to the requirements of such laws, in a manner designed to
achieve the goals of the Office and the national strategic
action plan.
(3) Health impact assessment.--
(A) In general.--Not later than 180 days after the
date of enactment of this Act, the Secretary shall
identify proposed and current laws, policies, and
programs that are of particular interest for their
impact in contributing to or alleviating health burdens
and the health impacts of climate change.
(B) Assessments.--Not later than 2 years after the
date of enactment of this Act, the head of each
relevant Federal agency shall--
(i) assess the impacts that the proposed
and current laws, policies, and programs
identified under subparagraph (A) under their
jurisdiction have or may have on protection
against the health threats of climate change;
and
(ii) assist State, Tribal, local, and
territorial governments in conducting such
assessments.
SEC. 103. ADVISORY BOARD.
(a) Establishment.--The Secretary shall, pursuant to chapter 10 of
title 5, United States Code, establish a permanent science advisory
board to be composed of not less than 10 and not more than 20 members.
(b) Appointment of Members.--
(1) In general.--The Secretary shall appoint the members of
the science advisory board from among individuals who--
(A) are recommended by the President of the
National Academy of Sciences or the President of the
National Academy of Medicine; and
(B) have expertise in essential public health and
health care services, including with respect to diverse
populations, climate change, environmental and climate
justice, and other relevant disciplines.
(2) Requirement.--The Secretary shall ensure that the
science advisory board includes members with practical or lived
experience with relevant issues described in paragraph (1)(B).
(c) Functions.--The science advisory board shall--
(1) provide scientific and technical advice and
recommendations to the Secretary on the domestic and
international impacts of climate change on public health and
populations and regions disproportionately affected by climate
change, and strategies and mechanisms to prepare for and
respond to the impacts of climate change on public health;
(2) advise the Secretary regarding the best science
available for purposes of issuing the national strategic action
plan and conducting the climate and health program; and
(3) submit a report to Congress on its activities and
recommendations not later than 1 year after the date of
enactment of this Act and not later than every year thereafter.
(d) Support.--The Secretary shall provide financial and
administrative support to the board.
SEC. 104. CLIMATE CHANGE HEALTH PROTECTION AND PROMOTION REPORTS.
(a) In General.--The Secretary shall offer to enter into an
agreement, including the provision of such funding as may be necessary,
with the National Academies of Sciences, Engineering, and Medicine,
under which such National Academies will prepare periodic reports to
aid public health and health care professionals in preparing for and
responding to the adverse health effects of climate change that--
(1) review scientific developments on health impacts and
health disparities of climate change;
(2) evaluate the measurable impacts of activities
undertaken at the directive of the national strategic action
plan; and
(3) recommend changes to the national strategic action plan
and climate and health program.
(b) Submission.--The agreement under subsection (a) shall require a
report to be submitted to Congress and the Secretary and made publicly
available not later than 1 year after the first publication of the
national strategic action plan, and every 4 years thereafter.
SEC. 105. AUTHORIZATION OF APPROPRIATIONS.
(a) Office of Climate Change and Health Equity.--There is
authorized to be appropriated to the Secretary to carry out section
102(a) $10,000,000 for each of fiscal years 2027 through 2033.
(b) National Strategic Action Plan.--There is authorized to be
appropriated to the Secretary to carry out section 102(b) $2,000,000
for fiscal year 2027, to remain available until expended.
(c) Advisory Board.--There is authorized to be appropriated to the
Secretary to carry out section 103(c) $500,000 for fiscal year 2027, to
remain available until expended.
TITLE II--PROTECTING ESSENTIAL HEALTH CARE ACCESS
SEC. 201. MAINTENANCE OF HEALTH CARE ACCESS RELATING TO HOSPITAL
DISCONTINUATION OF SERVICES OR CLOSURE.
Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is
amended--
(1) in subsection (a)(1)--
(A) in subparagraph (X), by striking ``and'' at the
end;
(B) in subparagraph (Y)(ii)(V), by striking the
period and inserting ``, and''; and
(C) by inserting after subparagraph (Y) the
following new subparagraph:
``(Z) beginning 60 days after the date of the enactment of
this subparagraph, in the case of a hospital, to comply with
the requirements of subsection (l) (relating to discontinuation
of services or closure).''; and
(2) by adding at the end the following new subsection:
``(l) Requirements for Hospitals Relating to Discontinuation of
Services or Closure.--
``(1) Requirements.--
``(A) In general.--For purposes of subsection
(a)(1)(Z), except as provided in subparagraph (B), the
requirements described in this subsection are that a
hospital--
``(i) notify the Secretary, in accordance
with paragraph (2), not less than 90 days prior
to the discontinuation of services or full
hospital closure;
``(ii) prohibit the discontinuation of
essential services (as defined in paragraph
(6)) during the notification period (as defined
in such paragraph) unless there is a clear harm
posed to patient or employee health or safety
in the hospital continuing to furnish such
services;
``(iii) respond to any inquiries by the
Secretary relating to the implementation of
this subsection, including the determination of
essential services under paragraph (6)(C); and
``(iv) if applicable--
``(I) submit a mitigation plan and
related information as described in
paragraph (3); and
``(II) participate in the public
comment and review process (including,
if applicable, the alternative
mitigation plan) described in paragraph
(4).
``(B) Application in case of catastrophic events.--
In the case where a discontinuation of services or
closure of a hospital is due to an unforeseen
catastrophic event (as defined by the Secretary), the
requirements described in subparagraph (A) shall apply,
except--
``(i) the hospital shall provide the
notification under clause (i) of such
subparagraph not later than 30 days after the
catastrophic event or as soon as feasible as
determined by the Secretary; and
``(ii) clause (ii) of such subparagraph
(relating to prohibiting the discontinuation of
services) shall not apply.
``(2) Notification information.--For purposes of paragraph
(1)(A)(i), the notification under such paragraph shall include
the following information with respect to a hospital:
``(A) Discontinuation of services.--In the case
where the hospital is discontinuing services (without
full hospital closure):
``(i) The services that will be
discontinued and number of hospital beds
impacted.
``(ii) The number of individuals furnished
such services annually and a breakdown of the
type of insurance used by such individuals for
such services.
``(iii) The number of impacted employees
and what labor organization represents them
(and the contact information for such
organization).
``(iv) The names and addresses of any
organized health care coalitions and community
groups that represent the communities impacted
by the discontinuation of such services.
``(v) Alternative providers of such
services, including provider type, contact
information, and distance and transportation
time by car and public transit from the
hospital.
``(B) Full hospital closure.--In the case of full
hospital closure:
``(i) Hospital ownership entities.
``(ii) The full extent of services that
will no longer be furnished by the hospital.
``(iii) The number of individuals furnished
services annually by the hospital, a
description of the services furnished, and a
breakdown of the type of insurance type used by
such individuals for such services.
``(iv) The number of impacted employees
and, if applicable, what labor organizations
represent them (and the contact information for
each such organization).
``(v) The names and addresses of any
organized health care coalitions and community
groups that represent the communities impacted
by the closure.
``(vi) Alternative providers, including
provider type, contact information, and
distance and transportation time by car and
public transit from the hospital.
``(vii) Steps taken prior to the decision
to close in order to avoid closure.
``(viii) Distribution of liquidation
proceeds (cash or assets) or any payments (cash
or assets) made to employees, owners, or
contractors related to the closure.
``(3) Submission of mitigation plan and related information
for essential services.--
``(A) Notification by secretary.--If the Secretary
determines that the discontinuation of services or
closure of an applicable hospital would negatively
impact access to essential services, the Secretary
shall notify the applicable hospital of such
determination.
``(B) Submission of mitigation plan and related
information.--If an applicable hospital receives a
notification under subparagraph (A), the applicable
hospital shall, not later than 15 days after receiving
such notification, submit to the Secretary--
``(i) a plan to--
``(I) preserve access to essential
services for impacted communities
through partnerships, commitments from
surrounding facilities, transportation
plan access, and preparation for surge
response; and
``(II) support employees in
transitioning to new positions within
health care;
``(ii) information on workforce and public
engagement to ensure awareness of the
discontinuation of services or closure; and
``(iii) a description of potential
alternatives to the discontinuation of services
or closure that the hospital considered and an
explanation of why those alternatives are not a
viable option.
``(C) Public availability.--The Secretary shall
make a mitigation plan and related information
submitted by an applicable hospital under this
paragraph available to the public on the internet
website of the Centers for Medicare & Medicaid
Services.
``(4) Public comment and review process; alternative
mitigation plan.--
``(A) Public comment period.--
``(i) In general.--The Secretary shall
provide a public comment period of not less
than 45 days with the opportunity to submit
written comments regarding the impact of the
potential discontinuation of services or
closure of an applicable hospital.
``(ii) Notice.--Notice of the opportunity
to submit comments shall be published in the
Federal Register and distributed to--
``(I) providers of services and
suppliers that may be impacted by the
discontinuation of services or closure
of the applicable hospital;
``(II) any labor organization that
represents any subdivision of employees
of the applicable hospital;
``(III) organized health care
coalitions and community groups that
represent the communities impacted by
the discontinuation of services or
closure;
``(IV) the State health agency; and
``(V) the local department of
public health.
``(B) Alternative mitigation plan.--
``(i) In general.--If, after reviewing the
mitigation plan submitted by an applicable
hospital under paragraph (3) and the comments
submitted during the public comment period
under subparagraph (A) with respect to the
discontinuation of services or closure of the
applicable hospital, the Secretary finds that
the discontinuation of services or closure of
the applicable hospital would have a
significant impact on access to essential
services, the Secretary shall work with the
applicable hospital or other providers of
services and suppliers in the area, as
appropriate, to develop and implement an
alternative plan to the plan submitted by the
applicable hospital under paragraph (3)
(referred to in this subsection as the
`alternative mitigation plan') in order to
ensure continued access to essential services,
which may include an agreement to delay the
discontinuation of services or closure of the
applicable hospital until the alternative
mitigation plan is complete.
``(ii) Technical assistance.--An
alternative mitigation plan under clause (i)
may include technical assistance or information
on available funding mechanisms to support the
furnishing of essential services.
``(iii) Collaboration.--The Secretary
should, to the extent practicable, collaborate
with State and municipal government officials
in the development of an alternative mitigation
plan under clause (i).
``(iv) Public availability.--The Secretary
shall make any information submitted and the
alternative mitigation plan developed under
this paragraph available to the public on the
internet website of the Centers for Medicare &
Medicaid Services.
``(C) Implementation.--The Secretary shall
promulgate regulations to detail the required response
time by an applicable hospital and the speed of the
review process under this paragraph in order to ensure
that such process can be completed with respect to an
applicable hospital prior to the proposed service
discontinuation date or closure date of the applicable
hospital.
``(D) Prohibition.--In the case where the Secretary
finds that a hospital has violated the requirements of
this subsection, the Secretary may prohibit the
hospital and any hospital under the same hospital
ownership entity from being eligible to enroll or
reenroll under the program under this title under
section 1866(j) until the earlier of--
``(i) the date that is 3 years after the
date on which the hospital discontinues
services or closes;
``(ii) the date on which the Secretary
determines essential health services that were
negatively impacted by the discontinuation or
closure have been restored; or
``(iii) such time as the Secretary is
satisfied with the mitigation plan submitted by
the hospital under paragraph (3) or the
alternative mitigation plan under this
paragraph.
``(5) Annual reports.--The Secretary shall submit an annual
report to Congress on the discontinuation of services and full
closure of hospitals. Each report submitted under the preceding
sentence shall include--
``(A) a description of trends in the
discontinuation of services and closures of hospitals,
including hospital ownership type, geographic location,
types of services furnished, demographic served, and
insurance type;
``(B) an analysis of the impact of the
discontinuation of services and closures on health care
access and ability to meet surge demand due to
emergency (such as a pandemic or climate disaster);
``(C) recommendations for such administrative or
legislative changes as the Secretary determines
appropriate to preserve access to essential services
nationwide.
``(6) Definitions.--In this subsection:
``(A) Applicable hospital.--The term `applicable
hospital' means a hospital that submits a notification
under paragraph (1)(A)(i) of a discontinuation of
services or full hospital closure.
``(B) Discontinuation.--The term `discontinuation'
may include any reduction or discontinuation of
services furnished by an applicable hospital, including
those that occur as part of a merger or acquisition
agreement.
``(C) Essential services.--The term `essential
services' means, with respect to an applicable
hospital, services that are necessary for preserving
health care access (as determined by the Secretary),
including services for which the Secretary determines--
``(i) there are no equivalent services
available within the same travel time;
``(ii) that loss of the services would
result in meaningful reductions in surge
capacity that will negatively impact access to
services;
``(iii) that loss of the services would
limit health care access for specific
demographics of individuals based on sex,
sexuality, race, nationality, age, or
disability status;
``(iv) that loss of the services would have
a meaningful impact on the ability of health
systems to respond to impacts of climate
change; or
``(v) there is a health or health care-
related emergency declaration status applicable
to the surrounding geographical area of the
hospital on the date on which the hospital
submits notification under paragraph (1)(A)(i)
of a discontinuation of services or full
hospital closure.
``(D) Notification period.--The term `notification
period' means, with respect to an applicable hospital,
the period beginning on the date on which the hospital
submits notification under paragraph (1)(A)(i) of a
discontinuation of services or full hospital closure
and ending on the date of such discontinuation of
services or closure.
``(7) No preemption of state law.--Nothing in subsection
(a)(1)(Z) or this subsection shall be construed to limit any
rights or remedies under State or local law relating to
protecting access to essential services or reviewing proposed
hospital closures or reduction of services.''.
SEC. 202. EMPOWERING COMMUNITY HEALTH IN ENVIRONMENTAL JUSTICE
COMMUNITIES.
Section 10503 of the Patient Protection and Affordable Care Act (42
U.S.C. 254b-2) is amended--
(1) in subsection (b)--
(A) in paragraph (1)--
(i) in subparagraph (J), by striking
``and'' at the end; and
(ii) by adding at the end the following:
``(L) $130,000,000,000 for the period of fiscal
years 2027 through 2031; and''; and
(B) in paragraph (2)--
(i) in subparagraph (K), by striking
``and'' at the end;
(ii) in subparagraph (L), by striking the
period and inserting ``; and''; and
(iii) by adding at the end the following:
``(M) $2,000,000,000 for each of
fiscals years 2027 through 2031.''; and
(2) by adding at the end the following:
``(f) Environmental Justice Communities.--The Secretary shall
ensure that not less than 50 percent of the amounts appropriated under
subsection (b) on or after 2027 are awarded to entities for use with
respect to projects or sites located in or serving environmental
justice communities (as defined in section 2 of the Green New Deal for
Health Act).
``(g) Prohibition.--No amounts made available under this section
may be used for any activity that is subject to the reporting
requirements set forth in section 203(a) of the Labor-Management
Reporting and Disclosure Act of 1959 (29 U.S.C. 433(a)).''.
TITLE III--GREEN AND RESILIENT HEALTH CARE INFRASTRUCTURE
SEC. 301. GREEN HILL-BURTON FUNDS FOR CLIMATE-READY MEDICAL FACILITIES.
(a) Grants for Construction or Modernization Projects.--
(1) In general.--Section 1610(a) of the Public Health
Service Act (42 U.S.C. 300r(a)) is amended--
(A) in paragraph (1)(A)--
(i) in clause (i), by striking ``, or'' and
inserting a semicolon;
(ii) in clause (ii), by striking the period
at the end and inserting ``; or''; and
(iii) by adding at the end the following:
``(iii) increase capacity to provide
essential health care and update medical
facilities to become more resilient to climate
disasters and public health crises to ensure
access and availability of quality health care
for communities in need.''; and
(B) by striking paragraph (3) and inserting the
following:
``(3) Priority.--In awarding grants under this subsection,
the Secretary shall give priority to applicants whose projects
will include, by design, resilience against natural disasters,
climate change mitigation, or other necessary predisaster
adaptations to ensure continuous health care access and combat
health risks due to climate change, such as--
``(A) installation of onsite distributed generation
that combines energy-efficient devices, energy storage,
and renewable energy in accordance with modern
electrical safety standards for medical facilities to
allow the medical facility to access essential energy
during power outages and optimize use of onsite and
offsite energy sources for emissions reductions;
``(B) improving air conditioning, monitoring, and
purifying through installation of high-efficiency heat
pumps that provide both cooling and heating, air
purifiers, air filtration systems, and air quality
monitoring systems integrated with energy systems and
energy efficiency considerations in preparation for
future natural hazards and public health crises, such
as wildfire, smog, extreme heat events, and pandemics;
``(C) installation and maintenance of wetlands,
drainage ponds, and any other green infrastructure to
protect the medical facility from projected severe
effects with respect to extreme weather, natural
disasters, or climate-change-related events, including
sea-level rise, flooding, and increased risk of
wildfire;
``(D) green rooftops, walls, and indoor plantings,
particularly those that can provide publicly accessible
temperature management and air quality improvements;
``(E) tree planting and other green infrastructure
to create publicly accessible cool space to address
urban heat islands;
``(F) infrastructure upgrades that protect access
routes to the medical facility, such as long-term
flood, wildfire, and other disaster mitigation for the
roads, sidewalks, and public transit infrastructure
that service the medical facility;
``(G) the long-term maintenance of decarbonization
and zero-emissions infrastructure; and
``(H) any other type of plan or project the
Secretary determines will increase the sustainability
and resiliency of a medical facility, protect patient
health and community access during extreme weather, and
advance environmental justice.
``(4) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection
$100,000,000,000 for fiscal year 2027, to remain available
until expended.''.
(2) Technical amendment.--Section 1610(b) of the Public
Health Service Act (42 U.S.C. 300r(b)) is amended by striking
paragraph (3).
(b) Medical Facility Project Applications.--
(1) In general.--Section 1621(b)(1) of the Public Health
Service Act (42 U.S.C. 300s-1(b)(1)) is amended--
(A) in subparagraph (J), by striking ``and'' at the
end;
(B) in subparagraph (K), by striking the period at
the end and inserting a semicolon; and
(C) by adding at the end the following:
``(L) reasonable assurance that the facility will
have adequate staffing to fulfill the community service
obligation; and
``(M) reasonable assurance that the facility--
``(i) has a collective bargaining agreement
with 1 or more labor organizations representing
employees at the facility; or
``(ii) has an explicit policy not to
interfere with the rights of employees of the
facility under section 7 of the National Labor
Relations Act.''.
(2) Application for planning grants.--Section 1621 of the
Public Health Service Act (42 U.S.C. 300s-1) is amended by
adding at the end the following:
``(c) Application for Planning Grants.--An application for a
project submitted under part A or B shall deemed to be complete for
purposes of section 302(d)(2) of the Green New Deal for Health Act, and
the application shall be deemed to have been submitted for purposes of
consideration for a planning grant under that section.''.
SEC. 302. PLANNING AND EVALUATION GRANT PROGRAM.
(a) Definitions.--In this section:
(1) Medical facility.--The term ``medical facility'' means
a hospital, public health center, outpatient medical facility,
rehabilitation facility, facility for long-term care, or other
facility (as may be designated by the Secretary) for the
provision of health care to ambulatory patients.
(2) Proposed project.--The term ``proposed project'' means
a construction or modernization project proposed by an eligible
entity in a sustainability and resiliency plan.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(4) Sustainability and resiliency plan.--The term
``sustainability and resiliency plan'' means a plan, including
comprehensive preproject evaluation, for a construction or
modernization project that would, in order to protect patient
health and community access, enhance--
(A) the sustainability of a medical facility and
infrastructure surrounding the medical facility; and
(B) the resiliency of that medical facility and
infrastructure surrounding the medical facility to
climate change and public health crises.
(b) Establishment.--The Secretary shall establish a grant program,
to be known as the ``Planning and Evaluation Grant Program'', under
which the Secretary shall make planning grants to eligible entities to
develop sustainability and resiliency plans for medical facilities
owned or operated by the eligible entity and infrastructure surrounding
the medical facilities.
(c) Eligible Entities.--To be eligible to receive a planning grant
under subsection (b), an applicant shall be--
(1) a State, Tribal government, or political subdivision of
a State or Tribal government, including any city, town, county,
borough, hospital district authority, or public or quasi-public
corporation; or
(2) a nonprofit private entity.
(d) Applications.--
(1) In general.--Except as provided in paragraph (2), an
eligible entity seeking a planning grant under subsection (b)
shall submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary
may by regulation prescribe, including--
(A) a description of the proposed project;
(B) a summary and breakdown of the demographics of
the patient population served or potentially served by
the medical facility under the proposed project,
including information on--
(i) whether the medical facility is a
facility for which a majority of the revenue
the facility receives for patient care is from
reimbursements for medical care furnished to
Medicare and Medicaid beneficiaries under
titles XVIII and XIX of the Social Security Act
(42 U.S.C. 1395 et seq. and 1396 et seq.); and
(ii) other indications that individuals
vulnerable to climate change are served or
potentially served by the medical facility;
(C) a description of the ways in which the proposed
project--
(i) will carry out 1 or more activities
described in subsection (g);
(ii) meet the needs of the community the
medical facility serves, especially the needs
of vulnerable populations; and
(iii) meet the sustainability and
resiliency needs of the medical facility due to
climate risks and hazards;
(D) a description of whether the community served
by the medical facility is an environmental justice
community;
(E) a description of the ways in which the planning
grant would be used to carry out 1 or more planning and
evaluation activities described in subsection (f);
(F) reasonable assurance that all laborers and
mechanics employed by contractors or subcontractors in
the performance of work on a project will be paid wages
at rates not less than those prevailing on similar work
in the locality as determined by the Secretary of Labor
in accordance with subchapter IV of chapter 31 of part
A of subtitle II of title 40, United States Code
(commonly referred to as the ``Davis-Bacon Act''), and
the Secretary of Labor shall have with respect to such
labor standards the authority and functions set forth
in Reorganization Plan Numbered 14 of 1950 (64 Stat.
1267; 5 U.S.C. App.) and section 3145 of title 40,
United States Code; and
(G) reasonable assurance that the facility--
(i) has a collective bargaining agreement
with 1 or more labor organizations representing
employees at the facility; or
(ii) has an explicit policy not to
interfere with the rights of employees at the
facility under section 7 of the National Labor
Relations Act (29 U.S.C. 157).
(2) Additional applications.--An application submitted
under part A or B of title XVI of the Public Health Service Act
(42 U.S.C. 300q et seq. and 42 U.S.C. 300r) shall be deemed to
be a complete application submitted for purposes of
consideration for a planning grant under subsection (b).
(e) Selection.--The Secretary shall--
(1) in coordination with the Secretary of Energy and the
Administrator of the Environmental Protection Agency, if
necessary, develop metrics to evaluate applications for
planning grants under subsection (b); and
(2) give priority to applications that focus on improving a
medical facility--
(A) for which--
(i) a majority of the revenue the facility
receives for patient care is from
reimbursements for medical care furnished to
Medicare and Medicaid beneficiaries under
titles XVIII and XIX of the Social Security Act
(42 U.S.C. 1395 et seq. and 1396 et seq.); or
(ii) a high proportion of patients is
uninsured, as determined by the Secretary; and
(B) that is located in a neighborhood or serves a
patient population that--
(i) experiences low air quality;
(ii) lacks green space;
(iii) bears higher cumulative pollution
burdens; or
(iv) is at disproportionate risk of
experiencing the adverse effects of climate
change.
(f) Planning Activities.--Planning and evaluation activities
carried out by an eligible entity using grant funds received under
subsection (b) shall include 1 or more of the following:
(1) Performing project planning, community outreach and
engagement, feasibility studies, and needs assessments of the
local community and patient populations.
(2) Performing engineering and climate-risk assessments of
the medical facility infrastructure and the access routes to
the medical facility.
(3) Providing management and operational assistance for
developing and receiving funding for the proposed project.
(4) Other planning and evaluation activities and
assessments as the Secretary determines appropriate.
(g) Proposed Projects.--Construction and modernization activities
carried out by a proposed project under a sustainability and resiliency
plan developed pursuant to a planning grant received under subsection
(b) may include--
(1) improvements to the infrastructure, buildings, and
grounds of the medical facility, including--
(A) installation of onsite distributed generation
that combines energy-efficient devices, energy storage,
and renewable energy in accordance with modern
electrical safety standards for medical facilities to
allow the medical facility to access essential energy
during power outages and optimize use of onsite and
offsite energy sources for emissions reductions; and
(B) improving air conditioning, monitoring, and
purifying through installation of high-efficiency heat
pumps that provide both cooling and heating, air
purifiers, air filtration systems, and air quality
monitoring systems integrated with energy systems and
energy efficiency considerations in preparation for
future natural hazards and public health crises such as
wildfire, smog, extreme heat events, and pandemics;
(2) green infrastructure projects, such as--
(A) installation and maintenance of wetlands,
drainage ponds, and any other green infrastructure that
would protect the medical facility from projected
severe effects with respect to extreme weather, natural
disasters, or climate-change-related events, including
sea-level rise, flooding, and increased risk of
wildfire; and
(B) green rooftops, walls, and indoor plantings,
particularly those that can provide publicly accessible
temperature management and air quality improvements;
(3) resiliency projects to secure local accessibility to
the medical facility by protecting the access routes to the
medical facility, such as--
(A) infrastructure upgrades that protect access
routes to the medical facility, such as long-term
flood, wildfire, and other disaster mitigation for the
roads, sidewalks, and public transit infrastructure
that service the medical facility; and
(B) the long-term maintenance of decarbonization
and zero-emissions infrastructure; and
(4) any other type of activity the Secretary determines
will increase the sustainability and resiliency of a medical
facility and protect patient health and community access during
extreme weather.
(h) Amount of Grant.--The total amount of a grant under subsection
(b) shall not exceed $500,000.
(i) Technical Assistance.--The Secretary, in coordination with the
Secretary of Energy, the Administrator of the Environmental Protection
Agency, and the Secretary of Transportation, if necessary, directly or
through partnerships with States, Tribal governments, and nonprofit
organizations, shall provide technical assistance to eligible entities
interested in carrying out proposed projects that--
(1) serve environmental justice communities or medically
underserved communities;
(2) demonstrate a commitment to provide job training,
apprenticeship programs, and contracting opportunities to
residents and small businesses owned by residents of the
community that the medical facility serves;
(3) identify and further community priority actions and
conduct robust community engagement; and
(4) employ nature-based solutions that focus on protection,
restoration, or management of ecological systems to safeguard
public health, provide clean air and water, increase natural
hazard resilience, and sequester carbon.
(j) Prohibition on Training Repayment.--As a condition of receiving
a grant or technical assistance under this section, an eligible entity
shall certify that the eligible entity does not use, and if the
eligible entity contracts with any staffing agency or training
provider, that such agency or provider does not use, any provision in
employment agreements, job training agreements, or apprenticeship
program agreements that would require an employee or training or
apprenticeship program participant to pay a debt if the employee or
training or apprenticeship program participant's employment or work
relationship or training period with a specified employer or business
entity is terminated.
(k) Environmental Justice Communities.--The Secretary shall ensure
that not less than 50 percent of grant funds awarded under subsection
(b) are used for sustainability and resiliency plans for proposed
projects located in environmental justice communities.
(l) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary to carry out this section $5,000,000,000
for fiscal year 2027, to remain available until expended.
TITLE IV--HEALTH CARE SECTOR DECARBONIZATION
SEC. 401. OFFICE OF SUSTAINABILITY AND ENVIRONMENTAL IMPACT.
(a) Establishment.--There is hereby established in the Centers for
Medicare & Medicaid Services an Office of Sustainability and
Environmental Impact (in this section referred to as the ``Office'') to
prepare the health care system for the impacts of climate change by
supporting health care decarbonization, sustainability, and
environmental efforts and to ensure that the health care system
minimizes and mitigates its climate harm while advancing patient health
and safety.
(b) Priority Goals.--The Office shall--
(1) collaborate with the Office of Climate Change and
Health Equity, the Environmental Protection Agency, and other
interagency committees to support a whole-of-government and
whole-of-health approach to addressing the climate crisis;
(2) develop and promulgate regulations that support
climate-informed care, support health care decarbonization and
sustainability, and mitigate the environmental impacts of the
health care system upon patients, communities, and health care
workers;
(3) develop and promulgate regulations that support patient
access to, and coverage of, climate-informed health care
services to prevent and address the health impacts of climate
change;
(4) conduct oversight of health care systems, their climate
emissions, and environmental harms and provide interagency
technical assistance in remediating such emissions and
environmental harms; and
(5) issue ``Climate-Friendly'' health system designations
and accreditations that identify health systems that
demonstrate commitment to, and substantial evidence of,
reducing emissions and environmental harm while advancing
health care quality and patient and worker safety.
(c) Director.--
(1) In general.--The Office shall be headed by a Director,
to be known as the Director of Sustainability and Environmental
Impact, who shall be appointed by the Secretary of Health and
Human Services (in this section referred to as the
``Secretary'').
(2) Functions.--The Director shall--
(A) convene stakeholders (including key health care
stakeholders) for strategic planning towards the
priority goals of the Office;
(B) advise the Secretary and the Administrator of
the Centers for Medicare & Medicaid Services in matters
of sustainability and environmental impact and the role
of the Centers for Medicare & Medicaid Services in
sustainability and environmental impact;
(C) collaborate with academic experts and community
leaders to understand and establish best practices for
decarbonizing health care operations; and
(D) develop and evaluate the Office's strategy to
tackle health care decarbonization and sustainability
and mitigating environmental impacts within the Centers
for Medicare & Medicaid Services.
(d) Report to Congress.--Not later than 2 years after the date of
the enactment of this Act, and every 2 years thereafter, the Secretary
shall submit to Congress a Health Care Sustainability and Environmental
Impact Report, which shall be prepared by the Director of
Sustainability and Environmental Impact, with appropriate assistance
from other agencies in the executive branch of the Federal Government.
Each such report shall include the following:
(1) A summary of interagency collaboration.
(2) A methodology to designate and accredit health systems
that achieve substantial reductions in emissions and
environmental harm as ``Climate-Friendly'' health systems.
(3) An inventory of ``Climate-Friendly'' designated health
systems, their strategies, challenges, and best practices for
sustainability and mitigating environmental impact, and any
significant effects of these efforts on--
(A) quality of care;
(B) patient safety;
(C) safety of health care workers and health care
facility workers;
(D) health care costs; and
(E) environmental health and overall health of the
community served.
(4) An analysis of the demographics and climate
vulnerability of patients and types of communities served by
``Climate-Friendly'' health systems.
(5) Recommendations for actions by health systems and for
Federal technical assistance and supportive resources for the
health system to achieve substantial reductions in emissions
and environmental harm in order to attain ``Climate-Friendly''
designation.
(6) A summary of oversight efforts of the Centers for
Medicare & Medicaid Services regarding emissions and
environmental impacts and payment and coverage impacts on
climate change preparedness, mitigation, and response.
(7) Recommendations for such legislation and administration
action as the Secretary determines appropriate to regulate and
promote health care sustainability, decarbonization, and
mitigate environmental impact within the health care system.
(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $2,000,000 for each of fiscal
years 2027 through 2036.
SEC. 402. CLIMATE RISK DISCLOSURE FOR MEDICAL SUPPLIES.
Subchapter A of chapter V of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 351 et seq.) is amended by adding at the end the
following:
``SEC. 524C. CLIMATE RISK DISCLOSURE FOR MEDICAL SUPPLIES.
``(a) Task Force.--
``(1) In general.--The Secretary, in coordination with the
Commissioner and the Administrator of the Environmental
Protection Agency, shall establish a task force for purposes of
developing a strategy to establish climate risk disclosure
policies for manufacturers of drugs (including biological
products) and devices.
``(2) Duties.--The task force established under paragraph
(1) shall--
``(A) recommend a methodology for drug and device
manufacturers to calculate the emissions and climate
risk due to clinical use of the drug or device,
factoring in emissions from the manufacture, transport,
use, processing, reprocessing, and waste relating to
the drug or device;
``(B) recommend a policy and process for mandatory
public disclosure of emissions and climate risk
relating to drugs and devices;
``(C) recommend a policy for oversight of
disclosures to ensure accuracy and transparency of
emissions reporting as described in subparagraph (B),
and to ensure that patient safety and necessary access
is maintained;
``(D) develop methods to disseminate information to
clinicians for low environmental impact options for
clinically equivalent treatment options;
``(E) develop suggestions for the reduction of
emissions by drug and device manufacturers without
harming or risking patient safety; and
``(F) provide technical assistance and establish
partnerships to facilitate lower emissions design and
manufacture of comparable drugs and comparable devices.
``(3) Membership.--The task force established under
paragraph (1) shall be composed of the following:
``(A) 3 representatives of the Food and Drug
Administration, appointed by the Commissioner.
``(B) 3 representatives of the Environmental
Protection Agency, appointed by the Administrator of
the Environmental Protection Agency.
``(C) 3 representatives of the Office of Climate
Change and Health Equity of the Department of Health
and Human Services, appointed by the Secretary.
``(b) Regulations.--Not later than 1 year after the date of
enactment of the Green New Deal for Health Act, the Secretary shall
promulgate regulations to--
``(1) establish mandatory climate risk disclosure and
transparency policies for drugs and devices approved, licensed,
or cleared under section 505, 510(k), 513(f)(2), or 515 of this
Act or section 351 of the Public Health Service Act; and
``(2) incorporate climate risk into policies related to
transparency, labeling, and other regulatory policies related
to drugs and devices, based on the recommendations of the task
force described in subsection (a).
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $4,000,000 for fiscal year 2027,
to remain available until expended.''.
SEC. 403. GREEN HEALTH CARE MANUFACTURING.
(a) In General.--There is established a Federal interagency working
group, to be known as the ``Council on Green Health Care
Manufacturing'' (referred to in this section as the ``Council'').
(b) Membership.--The membership of the Council shall consist of--
(1) the Secretary of Health and Human Services (referred to
in this section as the ``Secretary''), who shall serve as the
Chair;
(2) the Secretary of Energy;
(3) the Secretary of Transportation;
(4) the Secretary of Labor;
(5) the Administrator of the Environmental Protection
Agency;
(6) the Director of the Office of Climate Change and Health
Equity;
(7) the Director of Sustainability and Environmental
Impact;
(8) the Chair of the Council on Environmental Quality;
(9) the United States Trade Representative; and
(10) the heads of other Federal agencies, as determined
necessary by the Chair.
(c) Duties.--
(1) Assessment and report.--
(A) In general.--Not later than 1 year after the
date of enactment of this Act, the Council shall
conduct an assessment of global and domestic medical
supply chains, including an assessment of--
(i) the environmental and climate impacts
of medical supply chains, including--
(I) emissions from the production,
transportation, and packaging of
medical and pharmaceutical products;
(II) chemical and other
environmental pollution;
(III) excessive energy consumption;
(IV) negative externalities
relating to waste; and
(V) any other environmental or
climate impacts the Council determines
relevant;
(ii) labor conditions for workers in the
United States and globally who produce medical
and pharmaceutical products consumed by
individuals residing in the United States,
including the degree to which such workers--
(I) are ensured a protected right
to organize;
(II) are provided adequate
workplace safety protections; and
(III) are adequately compensated;
(iii) efficiency and resiliency of
processes under medical supply chains,
including the ability of medical supply chains
to adapt to sudden shifts in demand, including
shifts in demand within discrete geographic
regions;
(iv) the reliance of the United States on
international supply chains for medical
products, including information about which
types of medical products are primarily
manufactured outside of the United States, and
where such products are manufactured; and
(v) human rights abuses in manufacturing of
medical and pharmaceutical products and
sourcing of those products, including abuses of
indigenous rights and traditions.
(B) Report.--On completion of the assessment
conducted under subparagraph (A), the Council shall
submit to Congress and make publicly available a
report, to be known as the ``Green Health Care
Manufacturing Report'', that describes the findings of
the assessment.
(2) Recommendations.--
(A) In general.--Based on the findings of the
assessment conducted under paragraph (1)(A), the
Council shall develop recommendations for regulations
that would support a medical supply chain that is--
(i) sustainable;
(ii) free of greenhouse gas emissions; and
(iii) based in the United States.
(B) Inclusions.--The proposed regulations under
subparagraph (A) shall--
(i) support good labor conditions, worker
protections, and employee rights to organize
and collectively bargain; and
(ii) ensure the global trade
competitiveness of the United States, including
by considering the comparative carbon intensity
of domestic and internationally manufactured
pharmaceuticals and medical products.
(3) Grant program.--Based on the findings of the assessment
conducted under paragraph (1)(A), the Council shall develop
recommendations for a grant program to be carried out by the
Secretary under which the Secretary would make grants for
medical manufacturing to support the development and
establishment of sustainable and zero-emission medical supply
chains based in the United States.
(d) Regulations.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, the Secretary shall develop and
promulgate regulations to support a medical supply chain that
is--
(A) sustainable;
(B) free of greenhouse gas emissions; and
(C) based in the United States.
(2) Requirement.--The Secretary shall develop the
regulations under paragraph (1) based on the recommendations
for regulations developed by the Council under subsection
(c)(2).
(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as are necessary.
TITLE V--A HEALTH WORKFORCE TO TACKLE THE CLIMATE CRISIS
SEC. 501. EDUCATION AND TRAINING RELATING TO HEALTH RISKS ASSOCIATED
WITH CLIMATE CHANGE.
Part D of title VII of the Public Health Service Act (42 U.S.C. 294
et seq.) is amended by inserting after section 757 the following:
``SEC. 758. EDUCATION AND TRAINING RELATING TO HEALTH RISKS ASSOCIATED
WITH CLIMATE CHANGE.
``(a) In General.--Not later than 1 year after the date of the
enactment of the Green New Deal for Health Act, the Secretary shall
establish a competitive grant program to award grants to health
professions schools to support the development and integration into
such schools of education and training programs for identifying,
treating, and mitigating mental and physical health risks associated
with climate change for whole populations and for individuals
disproportionately affected by climate change.
``(b) Application.--To be eligible for a grant under this section,
a health profession school shall submit to the Secretary an application
at such time, in such form, and containing such information as the
Secretary may require, which shall include, at a minimum, a description
of the following:
``(1) How the health profession school will engage with
frontline communities to climate change or environmental
justice communities, and stakeholder organizations representing
such communities, in developing and implementing the education
and training programs supported by the grant.
``(2) How the health profession school will engage with
individuals disproportionately affected by climate change, and
stakeholder organizations representing such individuals, in
developing and implementing the education and training programs
supported by the grant.
``(3) How the health profession school will ensure that
such education and training programs will address racial and
ethnic disparities in exposure to, and the effects of, risks
associated with climate change for individuals vulnerable to
climate change.
``(4) How the health profession school will build inclusive
career opportunities and pathways to build up and expand the
health care workforce ready to address the health burdens of
climate change.
``(c) Use of Funds.--A health profession school awarded a grant
under this section shall use the grant funds to develop, and integrate
into the curriculum and continuing education of such health profession
school, education and training on each of the following:
``(1) Identifying risks associated with climate change for
individuals disproportionately affected by climate change, with
consideration of co-morbidities and socioeconomic risk factors.
``(2) Identifying risks to reproductive health associated
with climate change for individuals disproportionately affected
by climate change.
``(3) How risks and combinations of risks associated with
climate change affect individuals disproportionately affected
by climate change and individuals with the intent to become
pregnant.
``(4) Racial and ethnic disparities in exposure to, and the
effects of, risks associated with climate change for
individuals disproportionately affected by climate change and
individuals with the intent to become pregnant.
``(5) Patient counseling and mitigation strategies relating
to risks associated with climate change for both mental and
physical health for individuals disproportionately affected by
climate change.
``(6) Relevant services and support for individuals
disproportionately affected by climate change relating to risks
associated with climate change and strategies for ensuring that
such individuals have access to such services and support.
``(7) Implicit and explicit bias, racism, and
discrimination.
``(8) Related topics identified by such health profession
school based on the engagement of such health profession school
with individuals vulnerable to climate change and stakeholder
organizations representing such individuals.
``(d) Partnerships.--In carrying out activities with grant funds, a
health profession school awarded a grant under this section may partner
with one or more of the following:
``(1) A State, local, or Tribal public health department.
``(2) A labor union organization representing workers in
health care settings.
``(3) A health care professional membership association.
``(4) A patient advocacy organization.
``(5) A community health center or organization.
``(6) A health profession school or other institution of
higher education, which may be a health profession school.
``(7) A public school or school district.
``(e) Technical Assistance.--The Secretary shall provide technical
assistance to health profession schools and partnership organizations
to assist application planning and preparation for schools and
partnerships that train individuals from, and that serve, medically
underserved communities.
``(f) Reports to Secretary.--
``(1) Annual report.--For each fiscal year during which a
health profession school receives grant funds under this
section, such health profession school shall submit to the
Secretary a report that describes the activities carried out
with such grant funds during such fiscal year.
``(2) Final report.--Not later than the date that is 1 year
after the end of the last fiscal year during which a health
profession school receives grant funds under this section, the
health profession school shall submit to the Secretary a final
report that summarizes the activities carried out with such
grant funds.
``(g) Report to Congress.--Not later than 6 years after the date on
which the program is established under subsection (a), the Secretary
shall submit to Congress and publish on the public website of the
Department of Health and Human Services a report that includes the
following:
``(1) A summary of the reports submitted under subsection
(e).
``(2) Recommendations to improve education and training
programs at health profession schools with respect to
identifying and addressing risks associated with climate change
for individuals vulnerable to climate change.
``(h) Definitions.--In this section:
``(1) Environmental justice community.--The term
`environmental justice community' has the meaning given such
term in section 2 of the Green New Deal for Health Act.
``(2) Health profession school.--The term `health
profession school' means an accredited--
``(A) medical school;
``(B) school of nursing;
``(C) midwifery program or other evidence-based
birth care training program;
``(D) physician assistant education program;
``(E) school of psychiatry, psychology, counseling,
or social work;
``(F) career and technical education health
sciences program;
``(G) public health program;
``(H) community health worker training program;
``(I) teaching hospital;
``(J) residency or fellowship program; or
``(K) other school or program determined
appropriate by the Secretary.
``(3) Individual disproportionately affected by climate
change.--The term `individual disproportionately affected by
climate change' means an individual that may face elevated
mental and physical health risks due to climate change based on
2 or more of the following factors:
``(A) Age under 5 years old or over 65 years old.
``(B) Race and ethnicity, and experience of racial
bias.
``(C) Sex, gender, and gender minority status.
``(D) Being of reproductive age.
``(E) Exposure to environmental health risks due to
living conditions or location, including current or
past experience of homelessness.
``(F) Occupation or exposure to occupational
hazards.
``(G) Household income.
``(H) Disability.
``(I) Co-morbidities.
``(J) Current or past exposure to personal or
systemic trauma, including natural disasters.
``(K) Immigration status.
``(L) Language isolation.
``(4) Medically underserved community.--The term `medically
underserved community' has the meaning given such term in
section 799B.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $9,000,000,000 for fiscal year
2027, to remain available until expended.''.
SEC. 502. BUILDING A COMMUNITY HEALTH WORKFORCE FOR THE CLIMATE CRISIS.
Section 399V of the Public Health Service Act (42 U.S.C. 280g-11)
is amended--
(1) in subsection (b)--
(A) by redesignating the paragraphs (2) through (6)
as paragraphs (4) through (8), respectively;
(B) by inserting after paragraph (1) the following:
``(2) build career paths for community health workers by--
``(A) establishing accessible, inclusive, low-cost
or no-cost training, credentialing, or apprenticeship
opportunities for community health workers to acquire
skills and expertise concerning health risks caused by
climate change and environmental hazards;
``(B) establishing accessible, inclusive, low-cost
or no-cost educational, training, credentialing, or
apprenticeship opportunities for entry into the
community health worker profession; or
``(C) expanding career advancement opportunities
and career pathways, including scholarships for
advanced or specialized training;
``(3) expand the community health workforce by establishing
permanent community health worker positions that pay, at
minimum, the prevailing wage for such workers, through long-
term, stable funding, in order to staff the medical needs of a
community sufficiently while ensuring reasonable workloads for
individual workers;'';
(C) in paragraph (4) (as so redesignated)--
(i) in subparagraph (A)(i), by inserting
``and linguistically isolated populations''
before the semicolon; and
(ii) in subparagraph (B)--
(I) in clause (i), by striking
``and'' after the semicolon;
(II) by redesignating clause (ii)
as clause (iii); and
(III) by inserting after clause (i)
the following:
``(ii) connecting population groups at
disproportionate risk for specific health
threats and effects from environmental hazards,
climate change, and extreme weather, such as
increased heat-related illnesses and injuries,
degraded air and water quality, vector-borne
illnesses, mental and behavioral health
effects, and food, water, and nutrient
insecurity to available resources; and'';
(D) in paragraph (7) (as so redesignated), by
striking ``and'' after the semicolon;
(E) in paragraph (8) (as so redesignated), by
striking the period at the end and inserting a
semicolon; and
(F) by adding at the end the following:
``(9) support community health workers in educating,
guiding, and providing home visitation services regarding the
assessment and mitigation of the health risks of climate
change, including geography-specific and condition-specific
risks and environmental health hazards and the cumulative
health impacts of such risks and hazards; and
``(10) provide outreach and communication to promote
preparedness and response strategies to climate change and
extreme weather.'';
(2) in subsection (d)--
(A) in paragraph (1)--
(i) in subparagraph (D), by striking ``or''
at the end;
(ii) in subparagraph (E), by adding ``or''
after the semicolon; and
(iii) by adding at the end the following:
``(F) environmental justice communities (as defined
in section 2 of the Green New Deal for Health Act);'';
(B) in paragraph (3), by inserting ``and experience
training community health workers'' before the
semicolon;
(C) in paragraph (4), by striking ``and'' at the
end;
(D) in paragraph (5), by striking the period at the
end and inserting ``; and''; and
(E) by adding at the end the following:
``(6) have a documented collective bargaining agreement
with 1 or more labor organizations representing employees of
the applicant or have an explicit policy not to interfere with
the rights of employees of the applicant under section 7 of the
National Labor Relations Act.'';
(3) by redesignating subsections (e) through (j) as
subsections (f) through (k), respectively;
(4) by inserting after subsection (d) the following:
``(e) Workforce Expansion.--The Secretary, in consultation with the
Secretary of Labor, shall develop a plan to expand the community health
workforce by 150,000 workers by 2031 through the creation of career
pathways, full-time positions, and training opportunities described in
subsection (b).'';
(5) in subsection (j) (as so redesignated), by striking
``$50,000,000 for each of fiscal years 2023 through 2027'' and
inserting ``$10,000,000,000 for each of fiscal years 2027
through 2036''; and
(6) in paragraph (1) of subsection (k) (as so
redesignated)--
(A) by inserting ``a nonprofit community health
organization, a nonprofit community health worker
association,'' after ``a public health department,'';
and
(B) by striking ``((as defined'' and inserting
``(as defined''.
SEC. 503. SAFEGUARDING ESSENTIAL HEALTH CARE WORKERS.
The Public Health Service Act is amended by inserting after section
319D-1 (42 U.S.C. 247d-4b) the following:
``SEC. 319D-2. EMERGENCY GRANTS TO SAFEGUARD ESSENTIAL HEALTH CARE
WORKERS.
``(a) Definitions.--In this section:
``(1) Emergency or disaster.--The term `emergency or
disaster' means--
``(A) a major disaster declared by the President
under section 401 of the Robert T. Stafford Disaster
Relief and Emergency Assistance Act;
``(B) an emergency declared by the President under
section 501 of the Robert T. Stafford Disaster Relief
and Emergency Assistance Act;
``(C) a national emergency declared by the
President under the National Emergencies Act;
``(D) a public health emergency declared under
section 319; and
``(E) a State or local emergency or disaster, as
declared by the applicable State or local government.
``(2) Eligible health care worker.--The term `eligible
health care worker' means an essential health care worker whose
work cannot be conducted remotely.
``(3) Essential health care worker.--The term `essential
health care worker' means--
``(A) a health care provider, including a direct
care worker (as defined in section 799B);
``(B) a medical technologist;
``(C) a public health worker;
``(D) an orderly (as defined in the 2010 Standard
Occupational Classifications of the Department of Labor
under the code for Orderlies (31-1015));
``(E) an environmental service, janitorial, or
custodial worker in a health care setting; and
``(F) any other professional role that the
Secretary determines is essential to the care of
patients or the maintenance of public health.
``(b) Grants.--
``(1) In general.--The Secretary may make grants to public
or private nonprofit health care facilities and home health
agencies for use in accordance with paragraph (2).
``(2) Use of funds.--
``(A) Hazardous duty compensation.--
``(i) In general.--The recipient of a grant
under paragraph (1) shall use the grant funds
to provide hazardous duty compensation to
eligible health care workers for work performed
during the period of an emergency or disaster
in cases in which the Secretary determines
that--
``(I) the performance of the work
by the eligible health care worker for
the applicable health care facility or
home health agency is hazardous; or
``(II) the commute of the eligible
health care worker is hazardous.
``(ii) Requirement.--
``(I) In general.--Subject to
subclause (II), the amount of hazardous
duty compensation under clause (i)
shall be not more than $13 per hour,
which shall be in addition to the wages
or remuneration the eligible health
care worker otherwise receives for the
work.
``(II) Maximum amount.--The total
amount of hazardous duty compensation
received by any 1 eligible health care
worker under this subparagraph may not
exceed $25,000 per year.
``(B) Additional uses.--The recipient of a grant
under paragraph (1) may use the grant funds to provide
safety measures to safeguard and protect eligible
health care workers from hazards due to the applicable
emergency or disaster, including alternative transit
options, personal protective equipment, and other
safety measures.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be
necessary.''.
TITLE VI--SAFE, STRONG, AND RESILIENT COMMUNITIES
Subtitle A--Empowering Resilient Community Mental Health
SEC. 601. GRANTS FOR RESILIENT COMMUNITY MENTAL HEALTH.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by inserting after section 317V the following:
``SEC. 317W. GRANT PROGRAM FOR COMMUNITY WELLNESS AND RESILIENCE
PROGRAMS.
``(a) Grants.--
``(1) Program grants.--
``(A) Awards.--The Secretary, in coordination with
the Assistant Secretary for Mental Health and Substance
Use and the Administrator of the Health Resources and
Services Administration, shall carry out a program of
awarding grants to eligible entities, on a competitive
basis, for the purpose of establishing, operating, or
expanding community mental wellness and resilience
programs.
``(B) Amount.--An eligible entity awarded a grant
under subparagraph (A) may receive not more than
$300,000 per year for not more than 4 years.
``(2) Planning grants.--
``(A) Awards.--The Secretary, in coordination with
the Assistant Secretary for Mental Health and Substance
Use and the Administrator of the Health Resources and
Services Administration, shall award grants to
entities--
``(i) to organize a resilience coordinating
network that meets the requirements of
subsection (c)(2);
``(ii) to perform assessments of need with
respect to community mental wellness and
resilience; and
``(iii) to prepare an application for a
grant under paragraph (1).
``(B) Amount.--The amount of a grant under
subparagraph (A), with respect to any resilience
coordinating network to be organized for applying for a
grant under paragraph (1), shall not exceed $100,000.
``(b) Program Requirements.--A community mental wellness and
resilience program funded pursuant to a grant under subsection (a)(1)
shall take a public health approach to mental health to strengthen the
entire community's psychological and emotional wellness and resilience,
including by--
``(1) collecting and analyzing information from residents
as well as quantitative data to identify--
``(A) protective factors that enhance and sustain
the community's capacity for mental wellness and
resilience; and
``(B) risk factors that undermine such capacity;
``(2) strengthening such protective factors and addressing
such risk factors;
``(3) building awareness, skills, tools, curricula, and
leadership in the community to--
``(A) facilitate using a public health approach to
mental health; and
``(B) heal mental health and psychosocial problems
among all adults and youth; and
``(4) developing, implementing, and continually evaluating
and improving a comprehensive strategic plan for carrying out
the activities described in paragraphs (1), (2) and (3) that
includes utilizing developmentally, linguistically, and
culturally appropriate evidence-based, evidence-informed,
promising-best, or indigenous practices for--
``(A) engaging community members in building social
connections across cultural, geographic, and economic
boundaries;
``(B) enhancing local economic and environmental
conditions and environmental resilience, including with
respect to the built environment;
``(C) becoming trauma-informed and learning simple
self-administrable mental wellness and resilience
skills;
``(D) engaging in community activities and mutual
aid networks that strengthen mental wellness and
resilience;
``(E) partaking in nonclinical group and community-
minded recovery and healing programs;
``(F) embedding trauma-informed climate education
and mental resilience curricula and programming into
schools for students, workers, and the broader
community; and
``(G) other activities to promote mental wellness
and resilience, manage climate anxiety, and heal
individual and community traumas.
``(c) Eligible Entities.--
``(1) In general.--To be eligible to receive a grant under
subsection (a)(1), an applicant shall be a nonprofit or
community organization that has--
``(A) organized a resilience coordinating network
that meets the requirements of paragraph (2); and
``(B) been approved by such resilience coordinating
network to serve as its fiscal sponsor.
``(2) Resilience coordinating networks described.--A
resilience coordinating network organized under paragraph
(1)(A) shall be composed of 1 or more representatives of
entities from not fewer than 8 of the following categories:
``(A) Grassroots groups, neighborhood associations,
and volunteer civic organizations.
``(B) Elementary and secondary schools,
institutions of higher education including community
colleges, job-training programs, and other education or
training agencies or organizations.
``(C) Youth after-school and summer programs.
``(D) Family and early childhood education
programs.
``(E) Faith and spirituality organizations.
``(F) Senior care organizations.
``(G) Climate change mitigation and adaptation, and
environmental conservation, groups and organizations.
``(H) Social and environmental justice groups and
organizations.
``(I) Disaster preparedness and response groups and
organizations.
``(J) Local labor organizations.
``(K) Businesses and business associations.
``(L) Agencies and organizations involved with
community safety.
``(M) Social work, mental health, behavioral
health, substance use, physical health, and public
health professionals; public health agencies and
institutions; and mental health, behavioral health,
social work, and other professionals, groups,
organizations, agencies, and institutions in the health
and human services fields.
``(N) The general public, including individuals who
have experienced mental health or psychosocial problems
who can represent and engage with populations relevant
to the community.
``(d) Report.--
``(1) Submission.--Not later than December 31, 2031, the
Secretary shall submit a report to the Congress on the results
of the grants under subsection (a)(1).
``(2) Contents.--Such report shall include a summary of the
best practices used by grantees in establishing, operating, or
expanding community mental wellness and resilience programs.
``(e) Technical Assistance.--The Secretary shall provide technical
assistance--
``(1) to assist eligible entities in developing
applications for grants under paragraph (1) or (2) of
subsection (a); and
``(2) to enable the sharing of best practices learned from
successful resilience coordinating networks.
``(f) Definitions.--In this section:
``(1) The term `community' means people, groups, and
organizations that reside in or work within a specific
geographic area, such as a city, neighborhood, subdivision,
urban, suburban, or rural locale.
``(2) The term `community trauma' means a blow to the basic
fabric of social life that damages the bonds attaching people
together, impairs their prevailing sense of community,
undermines their fundamental sense of safety, justice, equity,
and security, and heightens individual and collective fears and
feelings of vulnerability.
``(3) The term `mental wellness' means a state of well-
being in which an individual can--
``(A) realize their own potential;
``(B) constructively cope with the stresses of
life;
``(C) work productively and fruitfully; and
``(D) make a contribution to their community.
``(4) The term `protective factors' means strengths,
skills, resources, and characteristics that--
``(A) are associated with a lower likelihood of
negative outcomes of adversities; or
``(B) reduce the impact on people of toxic stresses
or a traumatic experience.
``(5) The term `psychosocial problem' means the ways in
which an individual's mental health or behavioral health
problem disturbs others such as children, families,
communities, or society.
``(6) The term `public health approach to mental health'
means methods that--
``(A) take a population-level approach to promote
mental wellness and resilience to prevent problems
before they emerge and heal them when they do appear,
not merely treating individuals one at a time after
symptoms of pathology appear; and
``(B) address mental health and psychosocial
problems by--
``(i) identifying and strengthening
existing protective factors, and forming new
ones, that buffer people from and enhance their
capacity for psychological and emotional
resilience; and
``(ii) taking a holistic systems
perspective that recognizes that most mental
health and psychosocial problems result from
numerous interrelated personal, family, social,
economic, and environmental factors that
require multipronged community-based
interventions.
``(7) The term `resilience' means that people develop
cognitive, psychological, emotional capabilities and social
connections that enable them to calm their body, mind,
emotions, and behaviors during toxic stresses or traumatic
experiences in ways that enable them to--
``(A) respond without negative consequences for
themselves or others; and
``(B) use the experiences as catalysts to develop a
constructive new sense of meaning, purpose, and hope.
``(8) The term `Secretary' means the Secretary, acting
through the Director of the Centers for Disease Control and
Prevention.
``(9) The term `toxic stress' means exposure to persistent
overwhelming traumatic and stressful situations.
``(g) Funding.--
``(1) Authorization of appropriations.--To carry out this
section, there is authorized to be appropriated $100,000,000
for each of fiscal years 2027 through 2031.
``(2) Rural communities.--The Secretary shall award not
less than 20 percent of the amounts made available under
paragraph (1) for grants under paragraphs (1) and (2) of
subsection (a) to eligible entities that are establishing,
operating, or expanding community mental wellness and
resilience programs that are located in or serve a rural area
(as defined in section 520 of the Housing Act of 1949 (42
U.S.C. 1490)).
``(3) Environmental justice communities.--The Secretary
shall award not less than 20 percent of the amounts made
available under paragraph (1) for grants under paragraphs (1)
and (2) of subsection (a) to eligible entities that are
establishing, operating, or expanding community mental wellness
and resilience programs that serve environmental justice
communities (as defined in section 2 of the Green New Deal for
Health Act).''.
Subtitle B--Understanding and Preventing Heat Risk
SEC. 611. DEFINITIONS.
In this subtitle:
(1) Extreme heat.--The term ``extreme heat'' means heat
that substantially exceeds local climatological norms in terms
of any combination of the following:
(A) Duration of an individual heat event.
(B) Intensity.
(C) Season length.
(D) Frequency.
(2) Heat.--The term ``heat'' means any combination of the
atmospheric parameters associated with modulating human thermal
regulation, such as air temperature, humidity, solar exposure,
and wind speed.
(3) Heat event.--The term ``heat event'' means an
occurrence of extreme heat that may have heat-health
implications.
(4) Heat-health.--The term ``heat-health'' means mental and
physical health effects to humans from heat or the risk of such
effects.
(5) Planning.--The term ``planning'' means activities
performed across time scales (including days, weeks, months,
years, and decades) with scenario-based, probabilistic or
deterministic information to identify and take actions to
proactively mitigate heat-health risks from increased
frequency, duration, and intensity of heat waves and increased
ambient temperature.
(6) Preparedness.--The term ``preparedness'' means
activities performed across time scales (including days, weeks,
months, years, and decades) with probabilistic or deterministic
information to manage risk in advance of a heat event and
increased ambient temperature.
(7) Tribal government.--The term ``Tribal government''
means the recognized governing body of any Indian or Alaska
Native tribe, band, nation, pueblo, village, community,
component band, or component reservation, individually
identified (including parenthetically) in the list published
most recently as of the date of enactment of this Act pursuant
to section 104 of the Federally Recognized Indian Tribe List
Act of 1994 (25 U.S.C. 5131).
(8) Vulnerable populations.--The term ``vulnerable
populations'' means populations that face health, financial,
educational, or housing disparities that would render them more
susceptible to the negative impacts of extreme heat.
SEC. 612. STUDY ON EXTREME HEAT INFORMATION AND RESPONSE.
(a) Study.--
(1) In general.--Not later than 120 days after the date of
the enactment of this Act, the Under Secretary of Commerce for
Oceans and Atmosphere, in consultation with representatives
from the Department of Health and Human Services as the
Secretary of Health and Human Services considers appropriate,
shall seek to enter into an agreement with the National
Academies of Sciences, Engineering, and Medicine to conduct a
study on extreme heat information and response, to be completed
not later than 2 years after the date of the enactment of this
Act.
(2) Elements.--The study described in paragraph (1) shall--
(A) identify the policy, research, operations,
communications, and data gaps affecting heat-health
planning, preparedness, response, resilience, and
adaptation, and impacts to vulnerable populations;
(B) provide recommendations for addressing gaps
identified under subparagraph (A);
(C) provide recommendations, in addition to the
recommendations provided under subparagraph (B), which
may include strategies for--
(i) communicating warnings to and promoting
resilience of populations vulnerable to extreme
heat;
(ii) distributing extreme heat warnings,
including to individuals with limited English
proficiency and individuals who may have other
established barriers to such information;
(iii) designing warnings described in
clause (ii) to convey the urgency and severity
of heat events and achieve behavior changes
that reduce the mortality and morbidity of
extreme heat effects;
(iv) understanding compound and cascading
risks to inform development and implementation
of heat-health risk reduction interventions;
and
(v) promoting community resilience and
addressing specific decision support service
needs of vulnerable populations; and
(D) consider the effectiveness of country- or
local-level heat awareness and communication tools,
preparedness plans, or mitigation.
(3) Development of definitions.--In conducting the study
described in paragraph (1), the National Academies of Sciences,
Engineering, and Medicine shall work with heat and health
experts to identify consistent and agreed-upon definitions for
heat events, heat waves, and other relevant terms.
(b) Report.--Not later than 90 days after completion of the study
described in subsection (a)(1), the Under Secretary of Commerce for
Oceans and Atmosphere shall--
(1) make available to the public on an internet website of
the National Oceanic and Atmospheric Administration a report on
the findings and conclusions of the study; and
(2) submit the report to--
(A) the Committee on Commerce, Science, and
Transportation of the Senate;
(B) the Committee on Health, Education, Labor, and
Pensions of the Senate;
(C) the Committee on Science, Space, and Technology
of the House of Representatives;
(D) the Committee on Energy and Commerce of the
House of Representatives; and
(E) the Committee on Education and Workforce of the
House of Representatives.
SEC. 613. FINANCIAL ASSISTANCE FOR RESEARCH AND RESILIENCE IN
ADDRESSING EXTREME HEAT RISKS.
(a) Establishment of Program.--Subject to the availability of
appropriations, not later than 1 year after the date of the enactment
of this Act, the Under Secretary of Commerce for Oceans and Atmosphere
shall establish and administer a community heat resilience program to
provide financial assistance to eligible entities to carry out projects
described in subsection (e) to ameliorate the mental and physical human
health impacts of extreme heat events.
(b) Purpose.--The purpose of the financial assistance provided
under this section is to further scientific research regarding extreme
heat and fund efforts to educate communities about extreme heat.
(c) Forms of Assistance.--Financial assistance provided under this
section may be in the form of contracts, grants, or cooperative
agreements.
(d) Eligible Entities.--Entities eligible to receive financial
assistance under this section to carry out projects described in
subsection (e) include--
(1) nonprofit entities;
(2) academic institutions;
(3) States;
(4) Tribal governments;
(5) local governments; and
(6) political subdivisions of States, Tribal governments,
and local governments.
(e) Eligible Projects.--Projects described in this subsection
include projects--
(1) to expand public awareness of heat risks;
(2) to conduct heat mapping campaigns;
(3) to conduct scientific research to assess gaps and
priorities regarding the risks of extreme heat in communities;
(4) to communicate risks to isolated communities; and
(5) to educate such communities about how to respond to
extreme heat events.
(f) Priorities.--In selecting eligible entities to receive
financial assistance under this section, the Under Secretary of
Commerce for Oceans and Atmosphere shall prioritize entities that will
carry out projects that provide benefits for historically disadvantaged
communities and communities found to have the greatest risk or highest
incidence of heat-related illnesses and mortalities.
SEC. 614. AUTHORIZATION OF APPROPRIATIONS.
(a) Study on Extreme Heat Information and Response.--There is
authorized to be appropriated to the National Oceanic and Atmospheric
Administration to contract with the National Academies of Sciences,
Engineering, and Medicine to carry out section 612 $500,000 for each of
fiscal years 2027 through 2029.
(b) Financial Assistance To Address Extreme Heat.--There is
authorized to be appropriated to the National Oceanic and Atmospheric
Administration to carry out section 613 $30,000,000 for each of fiscal
years 2027 through 2031.
Subtitle C--Home Resiliency for Medical Needs
SEC. 621. MEDICARE COVERAGE OF MEDICALLY NECESSARY HOME RESILIENCY
SERVICES.
(a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)--
(A) in subparagraph (JJ), by striking ``and'' at
the end;
(B) in subparagraph (KK), by inserting ``and'' at
the end; and
(C) by adding at the end the following new
subparagraph:
``(LL) in the case of an individual who is medically at
risk in the event of a climate or man-made disaster (as
determined by the Secretary in accordance with subsection
(ooo)), home resiliency services (as defined in such
subsection);''; and
(2) by adding at the end the following new subsection:
``(ooo) Home Resiliency Services; Determination of Individuals
Medically at Risk.--
``(1) Home resiliency services.--The term `home resiliency
services' means items and services--
``(A) furnished on or after January 1, 2027, to an
individual described in subsection (s)(2)(LL); and
``(B) that the Secretary determines are medically
necessary for such individual in the case of a climate
or man-made disaster, such as a heat pump for an
individual vulnerable to extreme temperatures, solar
batteries for an individual reliant on electrical
medical equipment (including home mechanical
ventilators), and energy-efficient cold storage for
heat-sensitive medical supplies.
``(2) Determination of individuals medically at risk.--For
purposes of subsection (s)(2)(LL) and this subsection, the
Secretary, in consultation with the Office of Climate Change
and Health Equity established by section 102(a)(1) of the Green
New Deal for Health Act, the National Institutes of Health, the
Centers of Medicare & Medicaid Services, and the National
Oceanic and Atmospheric Administration, shall establish a
process to determine the conditions under which an individual
would be determined to be medically at risk in the event of a
disaster or climate hazards, including extreme heat, extreme
cold, flooding, and loss of power. Such a process shall
consider--
``(A) geography-specific climate risks and regional
preparedness for different climate risks;
``(B) the regional history of disaster or climate
hazards and infrastructure failure in the preceding 20
years or the forward-looking predicted risk of disaster
or climate hazards and infrastructure failure in the
next 20 years;
``(C) medical reliance on equipment,
pharmaceuticals, mobility aids, and other supplies that
are sensitive to exposure to extreme temperatures, poor
air quality, flooding and water damage, or dependent on
electrical power; and
``(D) chronic medical conditions, disabilities, and
co-morbidities that increase patient vulnerability
during disaster.''.
(b) Payment.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and'' before ``(HH)''; and
(2) by inserting before the semicolon at the end the
following: ``and (II) with respect to home resiliency services
described in section 1861(s)(2)(LL), the amount paid shall be
an amount equal to 100 percent of the lesser of the actual
charge for the services or the amount determined under a fee
schedule established by the Secretary''.
TITLE VII--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH
SEC. 701. RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following:
``PART X--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH
``SEC. 399PP. NATIONAL CLIMATE AND HEALTH RESEARCH AND INNOVATION
INITIATIVE.
``(a) Establishment.--The President shall establish and implement
an initiative, to be known as the `National Climate and Health Research
and Innovation Initiative' (referred to in this part as the
`Initiative'), to be carried out by the Secretary, acting through the
Assistant Secretary for Health.
``(b) Purpose.--The purpose of the Initiative is to develop the
tools, research, innovations, and understanding of climate change and
health needed to prevent, treat, and mitigate the health harms of
climate change in order to protect the collective health and well-being
of the people of the United States.
``(c) Activities.--In carrying out the Initiative, the President,
acting through the Office of Climate Change and Health Equity, the
Interagency Committee, and such agency heads as the President considers
appropriate, shall carry out activities that include the following:
``(1) Supporting research to understand, predict, and
prevent the health burdens of climate change and improve the
ability to treat health harms due to climate change,
including--
``(A) research to understand and predict the
impacts of climate change on both physical and mental
health, including disproportionate impacts based on
race, ethnicity, language, gender, sex, pregnancy
status, disability, age, location, occupation, and
immigration status;
``(B) research into, and mitigation of, adverse
mental and physical health effects of historical and
ongoing environmental racism and the subsequent
combined health risk of climate change and
environmental pollution;
``(C) research to model and predict occupational
hazards that will occur or intensify due to climate
change;
``(D) development of medical education curricula
relating to the clinical hazards of, and interventions
for, climate-change-based health burdens;
``(E) research to address climate-related housing
and community development issues, including the impact
of, and mitigation strategies for, challenges such as
isolation, low-quality housing, housing precarity, and
homelessness, and the vulnerabilities and the mental
and physical health risks those challenges present; and
``(F) research to study the social and economic
factors and policies that create healthy, resilient
communities prepared to adapt to the challenges posed
by climate change.
``(2) Supporting research and development of sustainable
and equitable health care operations and clinical practices
that reduce greenhouse gas emissions, climate risk, and
environmental health hazards, including--
``(A) research into effective models of health care
delivery--
``(i) to mitigate the impact of long-
standing climate change and environmental
hazards on health; and
``(ii) in preparation for, and in response
to, climate disasters;
``(B) research to model and predict the necessary
health care capacity surplus required to absorb both
acute and chronic surges in health care demand due to
climate-generated health burden, with attention to
geographical climate risks and patient demographic
health care needs;
``(C) the development of methods to reduce health
sector environmental pollution;
``(D) research into, and mitigation of, the
environmental impacts of hazardous substances used in
health care and the health care supply chain, including
the placement of facilities that use hazardous
substances and the proximity of those facilities to
historically marginalized communities;
``(E)(i) research and development of innovations
that shift the lifecycle of medical supplies and
devices from single use to sustainable, circular
economies, including low-environmental impact
sterilization techniques; and
``(ii) support of public-private partnerships that
enable scientific translation of those innovations;
``(F) the development of clinically equivalent and
improved, low-climate-footprint interventions and
pharmaceuticals and the study of the environmental
impacts of those interventions and pharmaceuticals to
enable high-quality, environmentally conscious clinical
decision making; and
``(G) conducting and supporting research,
development, demonstration, and commercial application
of renewable energy technologies and strategies to meet
the energy demand and energy security needs of
infrastructure critical to health care.
``(d) Termination.--The Initiative shall terminate on December 31,
2036.
``SEC. 399PP-1. INTERAGENCY COORDINATION.
``(a) In General.--Not later than 1 year after the date of
enactment of the Green New Deal for Health Act, the President shall
establish an interagency committee (referred to in this part as the
`Interagency Committee'), to coordinate the Initiative, as appropriate,
among the departments, offices, and agencies described in subsection
(b)(1).
``(b) Membership.--
``(1) In general.--The membership of the Interagency
Committee shall consist of--
``(A) 3 representatives of the Department of Health
and Human Services, which shall include--
``(i) 1 representative of the Office of
Climate Change and Health Equity; and
``(ii) 1 representative of the National
Institutes of Health;
``(B) 1 representative of the Office of Science and
Technology Policy;
``(C) 1 representative of the National Science
Foundation;
``(D) 1 representative of the Environmental
Protection Agency;
``(E) 1 representative of the Department of Energy;
``(F) 1 representative of the Department of Housing
and Urban Development; and
``(G) 1 representative of the Department of Labor.
``(2) Co-chairs.--The Interagency Committee shall be co-
chaired by the representatives described in subparagraphs
(A)(i) and (B) of paragraph (1).
``(c) Meetings.--The Interagency Committee shall meet not less
frequently than quarterly.
``(d) Duties.--The Interagency Committee shall--
``(1) provide for interagency coordination of the
activities of the Initiative;
``(2) develop a plan that describes how the departments,
offices, and agencies described in subsection (b)(1) will
collectively carry out the activities described in section
399PP(c), including--
``(A) a description of how each department, office,
and agency will execute a subset of the activities
described in that section; and
``(B) a description of collaborations across the
departments, offices, and agencies;
``(3) annually submit to Congress a report describing the
progress of the Initiative, activities of the Interagency
Committee, and policy recommendations that derive from the
results of the Initiative; and
``(4) as part of the President's annual budget request to
Congress, propose an annually coordinated interagency budget
for the Initiative to the Office of Management and Budget that
is intended to ensure that the balance of funding across the
Initiative is sufficient to meet the goals and priorities
established for the Initiative.
``SEC. 399PP-2. ADVISORY COUNCIL.
``(a) In General.--The Secretary shall establish an advisory
council (referred to in this section as the `Advisory Council') to
advise and provide recommendations to the Initiative.
``(b) Membership.--
``(1) In general.--The membership of the Advisory Council
shall consist of--
``(A) the members of the Interagency Committee; and
``(B) the non-Federal members appointed under
paragraph (2).
``(2) Appointed members.--The Secretary shall appoint the
following non-Federal members of the Advisory Council:
``(A) Not more than 4 members who are
representatives of research institutions, academic
institutions, or medical industry entities.
``(B) Not fewer than 1 member who is a
representative of a critical access hospital (as
defined in section 1861(mm)(1) of the Social Security
Act).
``(C) Not fewer than 1 member who is a
representative of a hospital that receives
disproportionate share payments under section
1886(d)(5)(F) of the Social Security Act.
``(D) Not fewer than 1 member who is a
representative of a community health center receiving
funding under section 330.
``(E) Not fewer than 1 member who is a
representative of an Indian Health Service facility
operated by an Indian tribe or tribal organization (as
defined in section 4 of the Indian Health Care
Improvement Act).
``(F) Not fewer than 1 member who is a
representative of a State, local, or Tribal department
of public health.
``(G) Not fewer than 4 members who--
``(i) are representatives of labor
organizations representing health care workers;
and
``(ii) collectively represent a diversity
of health care professions, such as workers in
environmental services, direct care workers,
nurses, and physicians.
``(H) Not fewer than 4 members who are
representatives of community-based patient advocacy or
public health advocacy organizations, each of which are
from different geographic regions of the United States.
``(3) Diverse representation.--The Secretary shall ensure
that the membership of the Advisory Council reflects the
diversity of the patient populations that are geographically
and demographically representative of the United States,
especially frontline populations and populations that are
subject to negative disparate outcomes in health.
``(4) Duties.--The Advisory Council shall advise the
President and the Secretary on matters relating to the
Initiative, including recommendations related to--
``(A) the research and innovation needs of
frontline communities, environmental justice
communities (as defined in section 2 of the Green New
Deal for Health Act), medically underserved communities
(as defined in section 799B), and individuals
vulnerable to climate change;
``(B) the current gaps and challenges in the
scientific understanding of the health impacts of
climate change and the impact of health care on
climate;
``(C) emerging research and innovation needs from
clinical practice;
``(D) whether issues of health disparities are
adequately addressed by the Initiative;
``(E) the balance of activities and funding across
the Initiative;
``(F) bottlenecks in translating research findings
into clinical advances, mitigation strategies, and
workplace safety; and
``(G) accountability and ethical use of research
funds.
``(5) Meetings.--The Advisory Council shall meet not less
frequently than annually, and such meetings shall be open to
the public.
``(6) Termination.--The Advisory Council shall terminate on
December 31, 2036.
``SEC. 399PP-3. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated to carry out section 399PP
$5,000,000,000 for each of fiscal years 2027 through 2036.''.
<all>Official legislative text sourced from the public record (cached on CivicsHQ).
Official source
View the original bill, actions, and full legislative record on Congress.gov.
Status
In Committee
- 1Introduced
- 2Committee
- 3Floor
- 4Passed
- 5Signed
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Sponsors
- Sen. Markey, Edward J. [D-MA]DSenateMA
Votes
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