,,ii #aaith ,,congress #b;d ,session ,s4 #eacd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #bg1 #bjbf,mr4 ,markey 7for himself1 ,ms4 ,warren1 ,mr4 ,sanders1 ,mr4 ,merkley1 and ,mr4 ,booker7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 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 workers1 our communities1 and our planet in the face of the climate crisis1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,green ,new ,deal for ,health ,act4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,definitions4,sec4 #c4 ,findings and sense of ,congress on health and climate change4,,title ,i--,whole-of-government approach,sec4 #aja4 ,definitions4,sec4 #ajb4 ,office of ,climate ,change and ,health ,equity2 national strategic action plan4,sec4 #ajc4 ,advisory board4,sec4 #ajd4 ,climate change health protection and promotion reports4,sec4 #aje4 ,authorization of appropriations4,,title ,,ii--,protecting essential health care access,sec4 #bja4 ,maintenance of health care access relating to hospital discontinuation of services or closure4,sec4 #bjb4 ,empowering community health in environmental justice communities4,,title ,,iii--,green and resilient health care infrastructure,sec4 #cja4 ,green ,hill-,burton funds for climate-ready medical facilities4,sec4 #cjb4 ,planning and ,evaluation ,grant ,program4,,title ,,iv--,health care sector decarbonization,sec4 #dja4 ,office of ,sustainability and ,environmental ,impact4,sec4 #djb4 ,climate risk disclosure for medical supplies4,sec4 #djc4 ,green health care manufacturing4,,title ,v--,a health workforce to tackle the climate crisis,sec4 #eja4 ,education and training relating to health risks associated with climate change4,sec4 #ejb4 ,building a community health workforce for the climate crisis4,sec4 #ejc4 ,safeguarding essential health care workers4,,title ,,vi--,safe1 strong1 and resilient communities,subtitle ,a--,empowering resilient community mental health,sec4 #fja4 ,grants for resilient community mental health4,subtitle ,b--,understanding and preventing heat risk,sec4 #faa4 ,definitions4,sec4 #fab4 ,study on extreme heat information and response4,sec4 #fac4 ,financial assistance for research and resilience in addressing extreme heat risks4,sec4 #fad4 ,authorization of appropriations4,subtitle ,c--,home resiliency for medical needs,sec4 #fba4 ,medicare coverage of medically necessary home resiliency services4,,title ,,vii--,research and innovation for climate and health,sec4 #gja4 ,research and innovation for climate and health4 #b4 ,definitions ,in this ,act3 7#a7 ,environmental justice community ,the term environmental justice community means a community with significant representation of communities of color1 low-income communities1 or ,tribal and ,indigenous communities that experiences1 or is at risk of experiencing1 higher or more adverse human health or environmental effects4 7#b7 ,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 #b or more of the following factors3 7,a7 ,age under #e years old or over #fe years old4 7,b7 ,race and ethnicity1 and experience of racial bias4 7,c7 ,sex1 gender1 and gender minority status4 7,d7 ,being of reproductive age4 7,e7 ,exposure to environmental health risks due to living conditions or location1 including current or past experience of homelessness4 7,f7 ,occupation or exposure to occupational hazards4 7,g7 ,household income4 7,h7 ,disability4 7,i7 ,co-morbidities4 7,j7 ,current or past exposure to personal or systemic trauma1 including natural disasters4 7,k7 ,immigration status4 7,l7 ,language isolation4 7#c7 ,medically underserved community ,the term medically underserved community has the meaning given such term in section #gii;,b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #biep74 #c4 ,findings and sense of ,congress on health and climate change 7a7 ,findings ,congress finds that1 according to the assessment of the ,united ,states ,global ,change ,research ,program entitled ,the ,impacts of ,climate ,change on ,human ,health in the ,united ,states3 ,a ,scientific ,assessment and dated #bjaf-- 7#a7 the impacts of human-induced climate change are increasing nationwide2 7#b7 rising greenhouse gas concentrations result in increases in temperature1 changes in precipitation1 increases in the frequency and intensity of some extreme weather events1 and rising sea levels2 7#c7 the climate change impacts described in paragraph 7#b7 endanger our health by affecting-- 7,a7 our access to care1 food1 and water sources2 7,b7 the air we breathe2 7,c7 the weather we experience2 and 7,d7 our interactions with the built and natural environments2 and 7#d7 as the climate continues to change1 the risks to human health continue to grow4 7b7 ,sense of ,congress ,it is the sense of ,congress that-- 7#a7 climate change poses threats to the ,united ,states and globally through its impacts on society1 the economy1 the physical environment1 and physical and mental health2 7#b7 climate change health threats are growing in scale and severity2 7#c7 climate change disproportionately affects individuals in the ,united ,states who are economically disadvantaged1 belong to communities of color1 or have other social and health vulnerabilities2 7#d7 the health care sector accounts for #h4e percent of ,united ,states emissions1 further worsening the overall health impacts of climate change2 and 7#e7 the ,federal ,government1 working with international1 ,state1 ,tribal1 and local governments1 nongovernmental organizations1 businesses1 and individuals1 should use all practicable means and measures-- 7,a7 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 operations2 7,b7 to build a just health care ecosystem where all ,americans have access to dignified1 high-quality care in their communities2 7,c7 to ensure the health care system is resilient to extreme weather and can continue to provide care before1 during1 and after crises2 7,d7 to lead the health sector to decarbonize its facilities and operations in an equitable and just manner2 7,e7 to empower a thriving health workforce with good1 high-wage union jobs and to recognize the value of all of the essential workers that enable high-quality health care2 and 7,f7 to invest in1 empower1 and build safe1 strong1 and resilient communities4 ,i ,whole-of-government approach #aja4 ,definitions ,in this title3 7#a7 ,director ,the term ,director means the ,director of the ,office4 7#b7 ,national strategic action plan ,the term national strategic action plan means the national strategic action plan published pursuant to section #ajb7;b77#a74 7#c7 ,office ,the term ,office means the ,office of ,climate ,change and ,health ,equity established by section #ajb7;a77#a74 7#d7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 #ajb4 ,office of ,climate ,change and ,health ,equity2 national strategic action plan 7a7 ,office of ,climate ,change and ,health ,equity 7#a7 ,establishment 7,a7 ,in general ,there is established within the ,department of ,health and ,human ,services the ,office of ,climate ,change and ,health ,equity4 7,b7 ,purpose ,the purpose of the ,office shall be to facilitate a robust1 ,federal response to the impact of climate change on the health of the ,american people and the health care system4 7,c7 ,director ,there is established the position of ,director of the ,office1 who-- 7i7 shall be the head of the ,office2 and 7ii7 may report to the ,assistant ,secretary for ,health4 7#b7 ,activities ,the duties of the ,office shall be to address priority health actions relating to the health impacts of climate change1 including by doing each of the following3 7,a7 ,contribute to assessments of how climate change is affecting the health of individuals living in the ,united ,states4 7,b7 ,understand the needs of the populations most disproportionately affected by climate-related health threats4 7,c7 ,serve as a credible source of information on the physical1 mental1 and behavioral health consequences of climate change4 7,d7 ,align ,federal efforts to deploy climate-conscious human services and direct services to support and protect populations composed of individuals disproportionately affected by climate change4 7,e7 ,create and distribute tools and resources to support climate resilience for the health sector1 community-based organizations1 and individuals4 7,f7 ,create and distribute tools and resources to support health sector efforts to track and decrease greenhouse gas emissions4 7,g7 ,lead efforts to reduce the carbon footprint and environmental impacts of the health sector4 7,h7 ,carry out other activities determined appropriate by the ,secretary4 7b7 ,national strategic action plan 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary1 on the basis of the best available science1 and in consultation pursuant to paragraph 7#b71 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 ,states4 7#b7 ,consultation ,in developing or making any revision to the national strategic action plan1 the ,secretary shall-- 7,a7 consult with the ,director1 the ,administrator of the ,environmental ,protection ,agency1 the ,under ,secretary of ,commerce for ,oceans and ,atmosphere1 the ,administrator of the ,national ,aeronautics and ,space ,administration1 the ,director of the ,indian ,health ,service1 the ,secretary of ,labor1 the ,secretary of ,defense1 the ,secretary of ,state1 the ,secretary of ,veterans ,affairs1 the ,national ,environmental ,justice ,advisory ,council1 the heads of other appropriate ,federal agencies1 ,tribal governments1 and ,state and local government officials2 and 7,b7 provide meaningful opportunity for engagement1 comment1 and consultation with relevant public stakeholders1 particularly representatives of populations composed of individuals disproportionately affected by climate change1 environmental justice communities1 ,tribal communities1 health care providers1 public health organizations1 and scientists4 7#c7 ,national strategic action plan components ,the national strategic action plan shall include an assessment of1 and strategies to improve1 the health sector capacity of the ,united ,states to address climate change1 including-- 7,a7 identifying1 prioritizing1 and engaging communities and populations who are disproportionately affected by exposures to climate hazards2 7,b7 addressing mental and physical health disparities exacerbated by climate impacts to enhance community health resilience2 7,c7 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 injustice2 7,d7 providing outreach and communication aimed at public health and health care professionals and the public to promote preparedness and response strategies2 7,e7 tracking and assessing programs across ,federal agencies to advance research related to the impacts of climate change on health2 7,f7 identifying and assessing existing preparedness and response strategies for the health impacts of climate change2 7,g7 prioritizing critical public health and health care infrastructure projects2 7,h7 providing modeling and forecasting tools of climate change health impacts1 including local impacts1 where feasible2 7,i7 establishing academic and regional centers of excellence2 7,j7 recommending models for maintaining access to health care during extreme weather2 7,k7 providing technical assistance and support for preparedness and response plans for the health threats of climate change in ,states1 municipalities1 territories1 ,indian ,tribes1 and developing countries2 7,l7 addressing the impacts of fossil fuel pollution and greenhouse gas emissions on the health of individuals living in the ,united ,states2 7,m7 tracking health care sector contributions to greenhouse gas emissions and identifying actions to reduce those emissions2 7,n7 recommending new regulations or policies to address identified gaps in the health system capacity to effectively reduce emissions1 reduce environmental impact1 and address climate change2 and 7,o7 developing1 improving1 integrating1 and maintaining disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change1 including on topics addressing-- 7i7 water-1 food-1 and vector-borne infectious diseases and climate change2 7ii7 pulmonary effects1 including responses to aeroallergens1 infectious agents1 and toxic exposures2 7iii7 cardiovascular effects1 including impacts of temperature extremes2 7iv7 air pollution health effects1 including heightened sensitivity to air pollution such as wildfire smoke2 7v7 reproductive health effects1 including access to reproductive health care2 7vi7 harmful algal blooms2 7vii7 mental and behavioral health impacts of climate change2 7viii7 the health of migrants1 refugees1 displaced persons1 and communities composed of individuals disproportionately affected by climate change2 7ix7 the implications for communities and populations vulnerable to the health effects of climate change1 as well as strategies for responding to climate change within such communities2 7x7 ,tribal1 local1 and community-based health interventions for climate-related health impacts2 7xi7 extreme heat and weather events2 7xii7 decreased nutritional value of crops2 and 7xiii7 disruptions in access to routine and acute medical care1 public health programs1 and other supportive services for maintaining health4 7c7 ,periodic assessment and revision ,not later than #a year after the date of first publication of the national strategic action plan1 and annually thereafter1 the ,secretary shall periodically assess1 and revise as necessary1 the national strategic action plan1 to reflect new information collected1 including information on-- 7#a7 the status of and trends in critical environmental health indicators and related human health impacts2 7#b7 the trends in and impacts of climate change on public health2 7#c7 advances in the development of strategies for preparing for and responding to the impacts of climate change on public health2 and 7#d7 the effectiveness of the implementation of the national strategic action plan in protecting against climate change health threats4 7d7 ,implementation 7#a7 ,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 plan4 7#b7 ,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 title1 subject to the requirements of such laws1 in a manner designed to achieve the goals of the ,office and the national strategic action plan4 7#c7 ,health impact assessment 7,a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall identify proposed and current laws1 policies1 and programs that are of particular interest for their impact in contributing to or alleviating health burdens and the health impacts of climate change4 7,b7 ,assessments ,not later than #b years after the date of enactment of this ,act1 the head of each relevant ,federal agency shall-- 7i7 assess the impacts that the proposed and current laws1 policies1 and programs identified under subparagraph 7,a7 under their jurisdiction have or may have on protection against the health threats of climate change2 and 7ii7 assist ,state1 ,tribal1 local1 and territorial governments in conducting such assessments4 #ajc4 ,advisory board 7a7 ,establishment ,the ,secretary shall1 pursuant to chapter #aj of title #e1 ,united ,states ,code1 establish a permanent science advisory board to be composed of not less than #aj and not more than #bj members4 7b7 ,appointment of members 7#a7 ,in general ,the ,secretary shall appoint the members of the science advisory board from among individuals who-- 7,a7 are recommended by the ,president of the ,national ,academy of ,sciences or the ,president of the ,national ,academy of ,medicine2 and 7,b7 have expertise in essential public health and health care services1 including with respect to diverse populations1 climate change1 environmental and climate justice1 and other relevant disciplines4 7#b7 ,requirement ,the ,secretary shall ensure that the science advisory board includes members with practical or lived experience with relevant issues described in paragraph 7#a77;,b74 7c7 ,functions ,the science advisory board shall-- 7#a7 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 change1 and strategies and mechanisms to prepare for and respond to the impacts of climate change on public health2 7#b7 advise the ,secretary regarding the best science available for purposes of issuing the national strategic action plan and conducting the climate and health program2 and 7#c7 submit a report to ,congress on its activities and recommendations not later than #a year after the date of enactment of this ,act and not later than every year thereafter4 7d7 ,support ,the ,secretary shall provide financial and administrative support to the board4 #ajd4 ,climate change health protection and promotion reports 7a7 ,in general ,the ,secretary shall offer to enter into an agreement1 including the provision of such funding as may be necessary1 with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine1 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-- 7#a7 review scientific developments on health impacts and health disparities of climate change2 7#b7 evaluate the measurable impacts of activities undertaken at the directive of the national strategic action plan2 and 7#c7 recommend changes to the national strategic action plan and climate and health program4 7b7 ,submission ,the agreement under subsection 7a7 shall require a report to be submitted to ,congress and the ,secretary and made publicly available not later than #a year after the first publication of the national strategic action plan1 and every #d years thereafter4 #aje4 ,authorization of appropriations 7a7 ,office of climate change and health equity ,there is authorized to be appropriated to the ,secretary to carry out section #ajb7;a7 #aj1jjj1jjj for each of fiscal years #bjbg through #bjcc4 7b7 ,national strategic action plan ,there is authorized to be appropriated to the ,secretary to carry out section #ajb7;b7 #b1jjj1jjj for fiscal year #bjbg1 to remain available until expended4 7c7 ,advisory board ,there is authorized to be appropriated to the ,secretary to carry out section #ajc7;c7 #ejj1jjj for fiscal year #bjbg1 to remain available until expended4 ,,ii ,protecting essential health care access #bja4 ,maintenance of health care access relating to hospital discontinuation of services or closure ,section #ahff of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 in subparagraph 7,x71 by striking and at the end2 7,b7 in subparagraph 7,y77ii77,v71 by striking the period and inserting 1 and2 and 7,c7 by inserting after subparagraph 7,y7 the following new subparagraph3 7,z7 beginning #fj days after the date of the enactment of this subparagraph1 in the case of a hospital1 to comply with the requirements of subsection 7l7 7relating to discontinuation of services or closure74 2 and 7#b7 by adding at the end the following new subsection3 7l7 ,requirements for hospitals relating to discontinuation of services or closure 7#a7 ,requirements 7,a7 ,in general ,for purposes of subsection 7a77#a77,z71 except as provided in subparagraph 7,b71 the requirements described in this subsection are that a hospital-- 7i7 notify the ,secretary1 in accordance with paragraph 7#b71 not less than #ij days prior to the discontinuation of services or full hospital closure2 7ii7 prohibit the discontinuation of essential services 7as defined in paragraph 7#f77 during the notification period 7as defined in such paragraph7 unless there is a clear harm posed to patient or employee health or safety in the hospital continuing to furnish such services2 7iii7 respond to any inquiries by the ,secretary relating to the implementation of this subsection1 including the determination of essential services under paragraph 7#f77;,c72 and 7iv7 if applicable-- 7,i7 submit a mitigation plan and related information as described in paragraph 7#c72 and 7,,ii7 participate in the public comment and review process 7including1 if applicable1 the alternative mitigation plan7 described in paragraph 7#d74 7,b7 ,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 7as defined by the ,secretary71 the requirements described in subparagraph 7,a7 shall apply1 except-- 7i7 the hospital shall provide the notification under clause 7i7 of such subparagraph not later than #cj days after the catastrophic event or as soon as feasible as determined by the ,secretary2 and 7ii7 clause 7ii7 of such subparagraph 7relating to prohibiting the discontinuation of services7 shall not apply4 7#b7 ,notification information ,for purposes of paragraph 7#a77;,a77i71 the notification under such paragraph shall include the following information with respect to a hospital3 7,a7 ,discontinuation of services ,in the case where the hospital is discontinuing services 7without full hospital closure73 7i7 ,the services that will be discontinued and number of hospital beds impacted4 7ii7 ,the number of individuals furnished such services annually and a breakdown of the type of insurance used by such individuals for such services4 7iii7 ,the number of impacted employees and what labor organization represents them 7and the contact information for such organization74 7iv7 ,the names and addresses of any organized health care coalitions and community groups that represent the communities impacted by the discontinuation of such services4 7v7 ,alternative providers of such services1 including provider type1 contact information1 and distance and transportation time by car and public transit from the hospital4 7,b7 ,full hospital closure ,in the case of full hospital closure3 7i7 ,hospital ownership entities4 7ii7 ,the full extent of services that will no longer be furnished by the hospital4 7iii7 ,the number of individuals furnished services annually by the hospital1 a description of the services furnished1 and a breakdown of the type of insurance type used by such individuals for such services4 7iv7 ,the number of impacted employees and1 if applicable1 what labor organizations represent them 7and the contact information for each such organization74 7v7 ,the names and addresses of any organized health care coalitions and community groups that represent the communities impacted by the closure4 7vi7 ,alternative providers1 including provider type1 contact information1 and distance and transportation time by car and public transit from the hospital4 7vii7 ,steps taken prior to the decision to close in order to avoid closure4 7viii7 ,distribution of liquidation proceeds 7cash or assets7 or any payments 7cash or assets7 made to employees1 owners1 or contractors related to the closure4 7#c7 ,submission of mitigation plan and related information for essential services 7,a7 ,notification by ,secretary ,if the ,secretary determines that the discontinuation of services or closure of an applicable hospital would negatively impact access to essential services1 the ,secretary shall notify the applicable hospital of such determination4 7,b7 ,submission of mitigation plan and related information ,if an applicable hospital receives a notification under subparagraph 7,a71 the applicable hospital shall1 not later than #ae days after receiving such notification1 submit to the ,secretary-- 7i7 a plan to-- 7,i7 preserve access to essential services for impacted communities through partnerships1 commitments from surrounding facilities1 transportation plan access1 and preparation for surge response2 and 7,,ii7 support employees in transitioning to new positions within health care2 7ii7 information on workforce and public engagement to ensure awareness of the discontinuation of services or closure2 and 7iii7 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 option4 7,c7 ,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 ,services4 7#d7 ,public comment and review process2 alternative mitigation plan 7,a7 ,public comment period 7i7 ,in general ,the ,secretary shall provide a public comment period of not less than #de days with the opportunity to submit written comments regarding the impact of the potential discontinuation of services or closure of an applicable hospital4 7ii7 ,notice ,notice of the opportunity to submit comments shall be published in the ,federal ,register and distributed to-- 7,i7 providers of services and suppliers that may be impacted by the discontinuation of services or closure of the applicable hospital2 7,,ii7 any labor organization that represents any subdivision of employees of the applicable hospital2 7,,iii7 organized health care coalitions and community groups that represent the communities impacted by the discontinuation of services or closure2 7,,iv7 the ,state health agency2 and 7,v7 the local department of public health4 7,b7 ,alternative mitigation plan 7i7 ,in general ,if1 after reviewing the mitigation plan submitted by an applicable hospital under paragraph 7#c7 and the comments submitted during the public comment period under subparagraph 7,a7 with respect to the discontinuation of services or closure of the applicable hospital1 the ,secretary finds that the discontinuation of services or closure of the applicable hospital would have a significant impact on access to essential services1 the ,secretary shall work with the applicable hospital or other providers of services and suppliers in the area1 as appropriate1 to develop and implement an alternative plan to the plan submitted by the applicable hospital under paragraph 7#c7 7referred to in this subsection as the alternative mitigation plan7 in order to ensure continued access to essential services1 which may include an agreement to delay the discontinuation of services or closure of the applicable hospital until the alternative mitigation plan is complete4 7ii7 ,technical assistance ,an alternative mitigation plan under clause 7i7 may include technical assistance or information on available funding mechanisms to support the furnishing of essential services4 7iii7 ,collaboration ,the ,secretary should1 to the extent practicable1 collaborate with ,state and municipal government officials in the development of an alternative mitigation plan under clause 7i74 7iv7 ,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 ,services4 7,c7 ,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 hospital4 7,d7 ,prohibition ,in the case where the ,secretary finds that a hospital has violated the requirements of this subsection1 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 #ahff7;j7 until the earlier of-- 7i7 the date that is #c years after the date on which the hospital discontinues services or closes2 7ii7 the date on which the ,secretary determines essential health services that were negatively impacted by the discontinuation or closure have been restored2 or 7iii7 such time as the ,secretary is satisfied with the mitigation plan submitted by the hospital under paragraph 7#c7 or the alternative mitigation plan under this paragraph4 7#e7 ,annual reports ,the ,secretary shall submit an annual report to ,congress on the discontinuation of services and full closure of hospitals4 ,each report submitted under the preceding sentence shall include-- 7,a7 a description of trends in the discontinuation of services and closures of hospitals1 including hospital ownership type1 geographic location1 types of services furnished1 demographic served1 and insurance type2 7,b7 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 7such as a pandemic or climate disaster72 7,c7 recommendations for such administrative or legislative changes as the ,secretary determines appropriate to preserve access to essential services nationwide4 7#f7 ,definitions ,in this subsection3 7,a7 ,applicable hospital ,the term applicable hospital means a hospital that submits a notification under paragraph 7#a77;,a77i7 of a discontinuation of services or full hospital closure4 7,b7 ,discontinuation ,the term discontinuation may include any reduction or discontinuation of services furnished by an applicable hospital1 including those that occur as part of a merger or acquisition agreement4 7,c7 ,essential services ,the term essential services means1 with respect to an applicable hospital1 services that are necessary for preserving health care access 7as determined by the ,secretary71 including services for which the ,secretary determines-- 7i7 there are no equivalent services available within the same travel time2 7ii7 that loss of the services would result in meaningful reductions in surge capacity that will negatively impact access to services2 7iii7 that loss of the services would limit health care access for specific demographics of individuals based on sex1 sexuality1 race1 nationality1 age1 or disability status2 7iv7 that loss of the services would have a meaningful impact on the ability of health systems to respond to impacts of climate change2 or 7v7 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 7#a77;,a77i7 of a discontinuation of services or full hospital closure4 7,d7 ,notification period ,the term notification period means1 with respect to an applicable hospital1 the period beginning on the date on which the hospital submits notification under paragraph 7#a77;,a77i7 of a discontinuation of services or full hospital closure and ending on the date of such discontinuation of services or closure4 7#g7 ,no preemption of ,state law ,nothing in subsection 7a77#a77,z7 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 services4 4 #bjb4 ,empowering community health in environmental justice communities ,section #ajejc of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,j71 by striking and at the end2 and 7ii7 by adding at the end the following3 7,l7 #acj1jjj1jjj1jjj for the period of fiscal years #bjbg through #bjca2 and 2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,k71 by striking and at the end2 7ii7 in subparagraph 7,l71 by striking the period and inserting 2 and2 and 7iii7 by adding at the end the following3 7,m7 #b1jjj1jjj1jjj for each of fiscals years #bjbg through #bjca4 2 and 7#b7 by adding at the end the following3 7f7 ,environmental justice communities ,the ,secretary shall ensure that not less than #ej percent of the amounts appropriated under subsection 7b7 on or after #bjbg are awarded to entities for use with respect to projects or sites located in or serving environmental justice communities 7as defined in section #b of the ,green ,new ,deal for ,health ,act74 7g7 ,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 #bjc7;a7 of the ,labor-,management ,reporting and ,disclosure ,act of #aiei 7#bi ,u4,s4,c4 #dcc7;a774 4 ,,iii ,green and resilient health care infrastructure #cja4 ,green ,hill-,burton funds for climate-ready medical facilities 7a7 ,grants for construction or modernization projects 7#a7 ,in general ,section #afaj7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjr7a77 is amended-- 7,a7 in paragraph 7#a77;,a7-- 7i7 in clause 7i71 by striking 1 or and inserting a semicolon2 7ii7 in clause 7ii71 by striking the period at the end and inserting 2 or2 and 7iii7 by adding at the end the following3 7iii7 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 need4 2 and 7,b7 by striking paragraph 7#c7 and inserting the following3 7#c7 ,priority ,in awarding grants under this subsection1 the ,secretary shall give priority to applicants whose projects will include1 by design1 resilience against natural disasters1 climate change mitigation1 or other necessary predisaster adaptations to ensure continuous health care access and combat health risks due to climate change1 such as-- 7,a7 installation of onsite distributed generation that combines energy-efficient devices1 energy storage1 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 reductions2 7,b7 improving air conditioning1 monitoring1 and purifying through installation of high-efficiency heat pumps that provide both cooling and heating1 air purifiers1 air filtration systems1 and air quality monitoring systems integrated with energy systems and energy efficiency considerations in preparation for future natural hazards and public health crises1 such as wildfire1 smog1 extreme heat events1 and pandemics2 7,c7 installation and maintenance of wetlands1 drainage ponds1 and any other green infrastructure to protect the medical facility from projected severe effects with respect to extreme weather1 natural disasters1 or climate-change-related events1 including sea-level rise1 flooding1 and increased risk of wildfire2 7,d7 green rooftops1 walls1 and indoor plantings1 particularly those that can provide publicly accessible temperature management and air quality improvements2 7,e7 tree planting and other green infrastructure to create publicly accessible cool space to address urban heat islands2 7,f7 infrastructure upgrades that protect access routes to the medical facility1 such as long-term flood1 wildfire1 and other disaster mitigation for the roads1 sidewalks1 and public transit infrastructure that service the medical facility2 7,g7 the long-term maintenance of decarbonization and zero-emissions infrastructure2 and 7,h7 any other type of plan or project the ,secretary determines will increase the sustainability and resiliency of a medical facility1 protect patient health and community access during extreme weather1 and advance environmental justice4 7#d7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this subsection #ajj1jjj1jjj1jjj for fiscal year #bjbg1 to remain available until expended4 4 7#b7 ,technical amendment ,section #afaj7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjr7b77 is amended by striking paragraph 7#c74 7b7 ,medical facility project applications 7#a7 ,in general ,section #afba7;b77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjs-#a7;b77#a77 is amended-- 7,a7 in subparagraph 7,j71 by striking and at the end2 7,b7 in subparagraph 7,k71 by striking the period at the end and inserting a semicolon2 and 7,c7 by adding at the end the following3 7,l7 reasonable assurance that the facility will have adequate staffing to fulfill the community service obligation2 and 7,m7 reasonable assurance that the facility-- 7i7 has a collective bargaining agreement with #a or more labor organizations representing employees at the facility2 or 7ii7 has an explicit policy not to interfere with the rights of employees of the facility under section #g of the ,national ,labor ,relations ,act4 4 7#b7 ,application for planning grants ,section #afba of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjs-#a7 is amended by adding at the end the following3 7c7 ,application for planning grants ,an application for a project submitted under part ,a or ,b shall deemed to be complete for purposes of section #cjb7;d77#b7 of the ,green ,new ,deal for ,health ,act1 and the application shall be deemed to have been submitted for purposes of consideration for a planning grant under that section4 4 #cjb4 ,planning and ,evaluation ,grant ,program 7a7 ,definitions ,in this section3 7#a7 ,medical facility ,the term medical facility means a hospital1 public health center1 outpatient medical facility1 rehabilitation facility1 facility for long-term care1 or other facility 7as may be designated by the ,secretary7 for the provision of health care to ambulatory patients4 7#b7 ,proposed project ,the term proposed project means a construction or modernization project proposed by an eligible entity in a sustainability and resiliency plan4 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#d7 ,sustainability and resiliency plan ,the term sustainability and resiliency plan means a plan1 including comprehensive preproject evaluation1 for a construction or modernization project that would1 in order to protect patient health and community access1 enhance-- 7,a7 the sustainability of a medical facility and infrastructure surrounding the medical facility2 and 7,b7 the resiliency of that medical facility and infrastructure surrounding the medical facility to climate change and public health crises4 7b7 ,establishment ,the ,secretary shall establish a grant program1 to be known as the ,planning and ,evaluation ,grant ,program1 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 facilities4 7c7 ,eligible entities ,to be eligible to receive a planning grant under subsection 7b71 an applicant shall be-- 7#a7 a ,state1 ,tribal government1 or political subdivision of a ,state or ,tribal government1 including any city1 town1 county1 borough1 hospital district authority1 or public or quasi-public corporation2 or 7#b7 a nonprofit private entity4 7d7 ,applications 7#a7 ,in general ,except as provided in paragraph 7#b71 an eligible entity seeking a planning grant under subsection 7b7 shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may by regulation prescribe1 including-- 7,a7 a description of the proposed project2 7,b7 a summary and breakdown of the demographics of the patient population served or potentially served by the medical facility under the proposed project1 including information on-- 7i7 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 7#db ,u4,s4,c4 #acie et seq4 and #acif et seq472 and 7ii7 other indications that individuals vulnerable to climate change are served or potentially served by the medical facility2 7,c7 a description of the ways in which the proposed project-- 7i7 will carry out #a or more activities described in subsection 7g72 7ii7 meet the needs of the community the medical facility serves1 especially the needs of vulnerable populations2 and 7iii7 meet the sustainability and resiliency needs of the medical facility due to climate risks and hazards2 7,d7 a description of whether the community served by the medical facility is an environmental justice community2 7,e7 a description of the ways in which the planning grant would be used to carry out #a or more planning and evaluation activities described in subsection 7f72 7,f7 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 #ca of part ,a of subtitle ,,ii of title #dj1 ,united ,states ,code 7commonly referred to as the ,davis-,bacon ,act71 and the ,secretary of ,labor shall have with respect to such labor standards the authority and functions set forth in ,reorganization ,plan ,numbered #ad of #aiej 7#fd ,stat4 #abfg2 #e ,u4,s4,c4 ,app47 and section #cade of title #dj1 ,united ,states ,code2 and 7,g7 reasonable assurance that the facility-- 7i7 has a collective bargaining agreement with #a or more labor organizations representing employees at the facility2 or 7ii7 has an explicit policy not to interfere with the rights of employees at the facility under section #g of the ,national ,labor ,relations ,act 7#bi ,u4,s4,c4 #aeg74 7#b7 ,additional applications ,an application submitted under part ,a or ,b of title ,,xvi of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjjq et seq4 and #db ,u4,s4,c4 #cjjr7 shall be deemed to be a complete application submitted for purposes of consideration for a planning grant under subsection 7b74 7e7 ,selection ,the ,secretary shall-- 7#a7 in coordination with the ,secretary of ,energy and the ,administrator of the ,environmental ,protection ,agency1 if necessary1 develop metrics to evaluate applications for planning grants under subsection 7b72 and 7#b7 give priority to applications that focus on improving a medical facility-- 7,a7 for which-- 7i7 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 7#db ,u4,s4,c4 #acie et seq4 and #acif et seq472 or 7ii7 a high proportion of patients is uninsured1 as determined by the ,secretary2 and 7,b7 that is located in a neighborhood or serves a patient population that-- 7i7 experiences low air quality2 7ii7 lacks green space2 7iii7 bears higher cumulative pollution burdens2 or 7iv7 is at disproportionate risk of experiencing the adverse effects of climate change4 7f7 ,planning activities ,planning and evaluation activities carried out by an eligible entity using grant funds received under subsection 7b7 shall include #a or more of the following3 7#a7 ,performing project planning1 community outreach and engagement1 feasibility studies1 and needs assessments of the local community and patient populations4 7#b7 ,performing engineering and climate-risk assessments of the medical facility infrastructure and the access routes to the medical facility4 7#c7 ,providing management and operational assistance for developing and receiving funding for the proposed project4 7#d7 ,other planning and evaluation activities and assessments as the ,secretary determines appropriate4 7g7 ,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 7b7 may include-- 7#a7 improvements to the infrastructure1 buildings1 and grounds of the medical facility1 including-- 7,a7 installation of onsite distributed generation that combines energy-efficient devices1 energy storage1 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 reductions2 and 7,b7 improving air conditioning1 monitoring1 and purifying through installation of high-efficiency heat pumps that provide both cooling and heating1 air purifiers1 air filtration systems1 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 wildfire1 smog1 extreme heat events1 and pandemics2 7#b7 green infrastructure projects1 such as-- 7,a7 installation and maintenance of wetlands1 drainage ponds1 and any other green infrastructure that would protect the medical facility from projected severe effects with respect to extreme weather1 natural disasters1 or climate-change-related events1 including sea-level rise1 flooding1 and increased risk of wildfire2 and 7,b7 green rooftops1 walls1 and indoor plantings1 particularly those that can provide publicly accessible temperature management and air quality improvements2 7#c7 resiliency projects to secure local accessibility to the medical facility by protecting the access routes to the medical facility1 such as-- 7,a7 infrastructure upgrades that protect access routes to the medical facility1 such as long-term flood1 wildfire1 and other disaster mitigation for the roads1 sidewalks1 and public transit infrastructure that service the medical facility2 and 7,b7 the long-term maintenance of decarbonization and zero-emissions infrastructure2 and 7#d7 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 weather4 7h7 ,amount of grant ,the total amount of a grant under subsection 7b7 shall not exceed #ejj1jjj4 7i7 ,technical assistance ,the ,secretary1 in coordination with the ,secretary of ,energy1 the ,administrator of the ,environmental ,protection ,agency1 and the ,secretary of ,transportation1 if necessary1 directly or through partnerships with ,states1 ,tribal governments1 and nonprofit organizations1 shall provide technical assistance to eligible entities interested in carrying out proposed projects that-- 7#a7 serve environmental justice communities or medically underserved communities2 7#b7 demonstrate a commitment to provide job training1 apprenticeship programs1 and contracting opportunities to residents and small businesses owned by residents of the community that the medical facility serves2 7#c7 identify and further community priority actions and conduct robust community engagement2 and 7#d7 employ nature-based solutions that focus on protection1 restoration1 or management of ecological systems to safeguard public health1 provide clean air and water1 increase natural hazard resilience1 and sequester carbon4 7j7 ,prohibition on training repayment ,as a condition of receiving a grant or technical assistance under this section1 an eligible entity shall certify that the eligible entity does not use1 and if the eligible entity contracts with any staffing agency or training provider1 that such agency or provider does not use1 any provision in employment agreements1 job training agreements1 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 terminated4 7k7 ,environmental justice communities ,the ,secretary shall ensure that not less than #ej percent of grant funds awarded under subsection 7b7 are used for sustainability and resiliency plans for proposed projects located in environmental justice communities4 7l7 ,authorization of ,appropriations ,there is authorized to be appropriated to the ,secretary to carry out this section #e1jjj1jjj1jjj for fiscal year #bjbg1 to remain available until expended4 ,,iv ,health care sector decarbonization #dja4 ,office of ,sustainability and ,environmental ,impact 7a7 ,establishment ,there is hereby established in the ,centers for ,medicare ,medicaid ,services an ,office of ,sustainability and ,environmental ,impact 7in this section referred to as the ,office7 to prepare the health care system for the impacts of climate change by supporting health care decarbonization1 sustainability1 and environmental efforts and to ensure that the health care system minimizes and mitigates its climate harm while advancing patient health and safety4 7b7 ,priority goals ,the ,office shall-- 7#a7 collaborate with the ,office of ,climate ,change and ,health ,equity1 the ,environmental ,protection ,agency1 and other interagency committees to support a whole-of-government and whole-of-health approach to addressing the climate crisis2 7#b7 develop and promulgate regulations that support climate-informed care1 support health care decarbonization and sustainability1 and mitigate the environmental impacts of the health care system upon patients1 communities1 and health care workers2 7#c7 develop and promulgate regulations that support patient access to1 and coverage of1 climate-informed health care services to prevent and address the health impacts of climate change2 7#d7 conduct oversight of health care systems1 their climate emissions1 and environmental harms and provide interagency technical assistance in remediating such emissions and environmental harms2 and 7#e7 issue ,climate-,friendly health system designations and accreditations that identify health systems that demonstrate commitment to1 and substantial evidence of1 reducing emissions and environmental harm while advancing health care quality and patient and worker safety4 7c7 ,director 7#a7 ,in general ,the ,office shall be headed by a ,director1 to be known as the ,director of ,sustainability and ,environmental ,impact1 who shall be appointed by the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary74 7#b7 ,functions ,the ,director shall-- 7,a7 convene stakeholders 7including key health care stakeholders7 for strategic planning towards the priority goals of the ,office2 7,b7 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 impact2 7,c7 collaborate with academic experts and community leaders to understand and establish best practices for decarbonizing health care operations2 and 7,d7 develop and evaluate the ,office's strategy to tackle health care decarbonization and sustainability and mitigating environmental impacts within the ,centers for ,medicare ,medicaid ,services4 7d7 ,report to ,congress ,not later than #b years after the date of the enactment of this ,act1 and every #b years thereafter1 the ,secretary shall submit to ,congress a ,health ,care ,sustainability and ,environmental ,impact ,report1 which shall be prepared by the ,director of ,sustainability and ,environmental ,impact1 with appropriate assistance from other agencies in the executive branch of the ,federal ,government4 ,each such report shall include the following3 7#a7 ,a summary of interagency collaboration4 7#b7 ,a methodology to designate and accredit health systems that achieve substantial reductions in emissions and environmental harm as ,climate-,friendly health systems4 7#c7 ,an inventory of ,climate-,friendly designated health systems1 their strategies1 challenges1 and best practices for sustainability and mitigating environmental impact1 and any significant effects of these efforts on-- 7,a7 quality of care2 7,b7 patient safety2 7,c7 safety of health care workers and health care facility workers2 7,d7 health care costs2 and 7,e7 environmental health and overall health of the community served4 7#d7 ,an analysis of the demographics and climate vulnerability of patients and types of communities served by ,climate-,friendly health systems4 7#e7 ,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 designation4 7#f7 ,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 preparedness1 mitigation1 and response4 7#g7 ,recommendations for such legislation and administration action as the ,secretary determines appropriate to regulate and promote health care sustainability1 decarbonization1 and mitigate environmental impact within the health care system4 7e7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #b1jjj1jjj for each of fiscal years #bjbg through #bjcf4 #djb4 ,climate risk disclosure for medical supplies ,subchapter ,a of chapter ,v of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cea et seq47 is amended by adding at the end the following3 #ebd;,c4 ,climate risk disclosure for medical supplies 7a7 ,task force 7#a7 ,in general ,the ,secretary1 in coordination with the ,commissioner and the ,administrator of the ,environmental ,protection ,agency1 shall establish a task force for purposes of developing a strategy to establish climate risk disclosure policies for manufacturers of drugs 7including biological products7 and devices4 7#b7 ,duties ,the task force established under paragraph 7#a7 shall-- 7,a7 recommend a methodology for drug and device manufacturers to calculate the emissions and climate risk due to clinical use of the drug or device1 factoring in emissions from the manufacture1 transport1 use1 processing1 reprocessing1 and waste relating to the drug or device2 7,b7 recommend a policy and process for mandatory public disclosure of emissions and climate risk relating to drugs and devices2 7,c7 recommend a policy for oversight of disclosures to ensure accuracy and transparency of emissions reporting as described in subparagraph 7,b71 and to ensure that patient safety and necessary access is maintained2 7,d7 develop methods to disseminate information to clinicians for low environmental impact options for clinically equivalent treatment options2 7,e7 develop suggestions for the reduction of emissions by drug and device manufacturers without harming or risking patient safety2 and 7,f7 provide technical assistance and establish partnerships to facilitate lower emissions design and manufacture of comparable drugs and comparable devices4 7#c7 ,membership ,the task force established under paragraph 7#a7 shall be composed of the following3 7,a7 #c representatives of the ,food and ,drug ,administration1 appointed by the ,commissioner4 7,b7 #c representatives of the ,environmental ,protection ,agency1 appointed by the ,administrator of the ,environmental ,protection ,agency4 7,c7 #c representatives of the ,office of ,climate ,change and ,health ,equity of the ,department of ,health and ,human ,services1 appointed by the ,secretary4 7b7 ,regulations ,not later than #a year after the date of enactment of the ,green ,new ,deal for ,health ,act1 the ,secretary shall promulgate regulations to-- 7#a7 establish mandatory climate risk disclosure and transparency policies for drugs and devices approved1 licensed1 or cleared under section #eje1 #eaj7k71 #eac7;f77#b71 or #eae of this ,act or section #cea of the ,public ,health ,service ,act2 and 7#b7 incorporate climate risk into policies related to transparency1 labeling1 and other regulatory policies related to drugs and devices1 based on the recommendations of the task force described in subsection 7a74 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #d1jjj1jjj for fiscal year #bjbg1 to remain available until expended4 4 #djc4 ,green health care manufacturing 7a7 ,in general ,there is established a ,federal interagency working group1 to be known as the ,council on ,green ,health ,care ,manufacturing 7referred to in this section as the ,council74 7b7 ,membership ,the membership of the ,council shall consist of-- 7#a7 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 who shall serve as the ,chair2 7#b7 the ,secretary of ,energy2 7#c7 the ,secretary of ,transportation2 7#d7 the ,secretary of ,labor2 7#e7 the ,administrator of the ,environmental ,protection ,agency2 7#f7 the ,director of the ,office of ,climate ,change and ,health ,equity2 7#g7 the ,director of ,sustainability and ,environmental ,impact2 7#h7 the ,chair of the ,council on ,environmental ,quality2 7#i7 the ,united ,states ,trade ,representative2 and 7#aj7 the heads of other ,federal agencies1 as determined necessary by the ,chair4 7c7 ,duties 7#a7 ,assessment and report 7,a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,council shall conduct an assessment of global and domestic medical supply chains1 including an assessment of-- 7i7 the environmental and climate impacts of medical supply chains1 including-- 7,i7 emissions from the production1 transportation1 and packaging of medical and pharmaceutical products2 7,,ii7 chemical and other environmental pollution2 7,,iii7 excessive energy consumption2 7,,iv7 negative externalities relating to waste2 and 7,v7 any other environmental or climate impacts the ,council determines relevant2 7ii7 labor conditions for workers in the ,united ,states and globally who produce medical and pharmaceutical products consumed by individuals residing in the ,united ,states1 including the degree to which such workers-- 7,i7 are ensured a protected right to organize2 7,,ii7 are provided adequate workplace safety protections2 and 7,,iii7 are adequately compensated2 7iii7 efficiency and resiliency of processes under medical supply chains1 including the ability of medical supply chains to adapt to sudden shifts in demand1 including shifts in demand within discrete geographic regions2 7iv7 the reliance of the ,united ,states on international supply chains for medical products1 including information about which types of medical products are primarily manufactured outside of the ,united ,states1 and where such products are manufactured2 and 7v7 human rights abuses in manufacturing of medical and pharmaceutical products and sourcing of those products1 including abuses of indigenous rights and traditions4 7,b7 ,report ,on completion of the assessment conducted under subparagraph 7,a71 the ,council shall submit to ,congress and make publicly available a report1 to be known as the ,green ,health ,care ,manufacturing ,report1 that describes the findings of the assessment4 7#b7 ,recommendations 7,a7 ,in general ,based on the findings of the assessment conducted under paragraph 7#a77;,a71 the ,council shall develop recommendations for regulations that would support a medical supply chain that is-- 7i7 sustainable2 7ii7 free of greenhouse gas emissions2 and 7iii7 based in the ,united ,states4 7,b7 ,inclusions ,the proposed regulations under subparagraph 7,a7 shall-- 7i7 support good labor conditions1 worker protections1 and employee rights to organize and collectively bargain2 and 7ii7 ensure the global trade competitiveness of the ,united ,states1 including by considering the comparative carbon intensity of domestic and internationally manufactured pharmaceuticals and medical products4 7#c7 ,grant program ,based on the findings of the assessment conducted under paragraph 7#a77;,a71 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 ,states4 7d7 ,regulations 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall develop and promulgate regulations to support a medical supply chain that is-- 7,a7 sustainable2 7,b7 free of greenhouse gas emissions2 and 7,c7 based in the ,united ,states4 7#b7 ,requirement ,the ,secretary shall develop the regulations under paragraph 7#a7 based on the recommendations for regulations developed by the ,council under subsection 7c77#b74 7e7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as are necessary4 ,v ,a health workforce to tackle the climate crisis #eja4 ,education and training relating to health risks associated with climate change ,part ,d of title ,,vii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid et seq47 is amended by inserting after section #geg the following3 #geh4 ,education and training relating to health risks associated with climate change 7a7 ,in general ,not later than #a year after the date of the enactment of the ,green ,new ,deal for ,health ,act1 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 identifying1 treating1 and mitigating mental and physical health risks associated with climate change for whole populations and for individuals disproportionately affected by climate change4 7b7 ,application ,to be eligible for a grant under this section1 a health profession school shall submit to the ,secretary an application at such time1 in such form1 and containing such information as the ,secretary may require1 which shall include1 at a minimum1 a description of the following3 7#a7 ,how the health profession school will engage with frontline communities to climate change or environmental justice communities1 and stakeholder organizations representing such communities1 in developing and implementing the education and training programs supported by the grant4 7#b7 ,how the health profession school will engage with individuals disproportionately affected by climate change1 and stakeholder organizations representing such individuals1 in developing and implementing the education and training programs supported by the grant4 7#c7 ,how the health profession school will ensure that such education and training programs will address racial and ethnic disparities in exposure to1 and the effects of1 risks associated with climate change for individuals vulnerable to climate change4 7#d7 ,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 change4 7c7 ,use of funds ,a health profession school awarded a grant under this section shall use the grant funds to develop1 and integrate into the curriculum and continuing education of such health profession school1 education and training on each of the following3 7#a7 ,identifying risks associated with climate change for individuals disproportionately affected by climate change1 with consideration of co-morbidities and socioeconomic risk factors4 7#b7 ,identifying risks to reproductive health associated with climate change for individuals disproportionately affected by climate change4 7#c7 ,how risks and combinations of risks associated with climate change affect individuals disproportionately affected by climate change and individuals with the intent to become pregnant4 7#d7 ,racial and ethnic disparities in exposure to1 and the effects of1 risks associated with climate change for individuals disproportionately affected by climate change and individuals with the intent to become pregnant4 7#e7 ,patient counseling and mitigation strategies relating to risks associated with climate change for both mental and physical health for individuals disproportionately affected by climate change4 7#f7 ,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 support4 7#g7 ,implicit and explicit bias1 racism1 and discrimination4 7#h7 ,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 individuals4 7d7 ,partnerships ,in carrying out activities with grant funds1 a health profession school awarded a grant under this section may partner with one or more of the following3 7#a7 ,a ,state1 local1 or ,tribal public health department4 7#b7 ,a labor union organization representing workers in health care settings4 7#c7 ,a health care professional membership association4 7#d7 ,a patient advocacy organization4 7#e7 ,a community health center or organization4 7#f7 ,a health profession school or other institution of higher education1 which may be a health profession school4 7#g7 ,a public school or school district4 7e7 ,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 from1 and that serve1 medically underserved communities4 7f7 ,reports to secretary 7#a7 ,annual report ,for each fiscal year during which a health profession school receives grant funds under this section1 such health profession school shall submit to the ,secretary a report that describes the activities carried out with such grant funds during such fiscal year4 7#b7 ,final report ,not later than the date that is #a year after the end of the last fiscal year during which a health profession school receives grant funds under this section1 the health profession school shall submit to the ,secretary a final report that summarizes the activities carried out with such grant funds4 7g7 ,report to congress ,not later than #f years after the date on which the program is established under subsection 7a71 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 following3 7#a7 ,a summary of the reports submitted under subsection 7e74 7#b7 ,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 change4 7h7 ,definitions ,in this section3 7#a7 ,environmental justice community ,the term environmental justice community has the meaning given such term in section #b of the ,green ,new ,deal for ,health ,act4 7#b7 ,health profession school ,the term health profession school means an accredited-- 7,a7 medical school2 7,b7 school of nursing2 7,c7 midwifery program or other evidence-based birth care training program2 7,d7 physician assistant education program2 7,e7 school of psychiatry1 psychology1 counseling1 or social work2 7,f7 career and technical education health sciences program2 7,g7 public health program2 7,h7 community health worker training program2 7,i7 teaching hospital2 7,j7 residency or fellowship program2 or 7,k7 other school or program determined appropriate by the ,secretary4 7#c7 ,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 #b or more of the following factors3 7,a7 ,age under #e years old or over #fe years old4 7,b7 ,race and ethnicity1 and experience of racial bias4 7,c7 ,sex1 gender1 and gender minority status4 7,d7 ,being of reproductive age4 7,e7 ,exposure to environmental health risks due to living conditions or location1 including current or past experience of homelessness4 7,f7 ,occupation or exposure to occupational hazards4 7,g7 ,household income4 7,h7 ,disability4 7,i7 ,co-morbidities4 7,j7 ,current or past exposure to personal or systemic trauma1 including natural disasters4 7,k7 ,immigration status4 7,l7 ,language isolation4 7#d7 ,medically underserved community ,the term medically underserved community has the meaning given such term in section #gii;,b4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #i1jjj1jjj1jjj for fiscal year #bjbg1 to remain available until expended4 4 #ejb4 ,building a community health workforce for the climate crisis ,section #cii,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#aa7 is amended-- 7#a7 in subsection 7b7-- 7,a7 by redesignating the paragraphs 7#b7 through 7#f7 as paragraphs 7#d7 through 7#h71 respectively2 7,b7 by inserting after paragraph 7#a7 the following3 7#b7 build career paths for community health workers by-- 7,a7 establishing accessible1 inclusive1 low-cost or no-cost training1 credentialing1 or apprenticeship opportunities for community health workers to acquire skills and expertise concerning health risks caused by climate change and environmental hazards2 7,b7 establishing accessible1 inclusive1 low-cost or no-cost educational1 training1 credentialing1 or apprenticeship opportunities for entry into the community health worker profession2 or 7,c7 expanding career advancement opportunities and career pathways1 including scholarships for advanced or specialized training2 7#c7 expand the community health workforce by establishing permanent community health worker positions that pay1 at minimum1 the prevailing wage for such workers1 through long-term1 stable funding1 in order to staff the medical needs of a community sufficiently while ensuring reasonable workloads for individual workers2 2 7,c7 in paragraph 7#d7 7as so redesignated7-- 7i7 in subparagraph 7,a77i71 by inserting and linguistically isolated populations before the semicolon2 and 7ii7 in subparagraph 7,b7-- 7,i7 in clause 7i71 by striking and after the semicolon2 7,,ii7 by redesignating clause 7ii7 as clause 7iii72 and 7,,iii7 by inserting after clause 7i7 the following3 7ii7 connecting population groups at disproportionate risk for specific health threats and effects from environmental hazards1 climate change1 and extreme weather1 such as increased heat-related illnesses and injuries1 degraded air and water quality1 vector-borne illnesses1 mental and behavioral health effects1 and food1 water1 and nutrient insecurity to available resources2 and 2 7,d7 in paragraph 7#g7 7as so redesignated71 by striking and after the semicolon2 7,e7 in paragraph 7#h7 7as so redesignated71 by striking the period at the end and inserting a semicolon2 and 7,f7 by adding at the end the following3 7#i7 support community health workers in educating1 guiding1 and providing home visitation services regarding the assessment and mitigation of the health risks of climate change1 including geography-specific and condition-specific risks and environmental health hazards and the cumulative health impacts of such risks and hazards2 and 7#aj7 provide outreach and communication to promote preparedness and response strategies to climate change and extreme weather4 2 7#b7 in subsection 7d7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,d71 by striking or at the end2 7ii7 in subparagraph 7,e71 by adding or after the semicolon2 and 7iii7 by adding at the end the following3 7,f7 environmental justice communities 7as defined in section #b of the ,green ,new ,deal for ,health ,act72 2 7,b7 in paragraph 7#c71 by inserting and experience training community health workers before the semicolon2 7,c7 in paragraph 7#d71 by striking and at the end2 7,d7 in paragraph 7#e71 by striking the period at the end and inserting 2 and2 and 7,e7 by adding at the end the following3 7#f7 have a documented collective bargaining agreement with #a 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 #g of the ,national ,labor ,relations ,act4 2 7#c7 by redesignating subsections 7e7 through 7j7 as subsections 7f7 through 7k71 respectively2 7#d7 by inserting after subsection 7d7 the following3 7e7 ,workforce expansion ,the ,secretary1 in consultation with the ,secretary of ,labor1 shall develop a plan to expand the community health workforce by #aej1jjj workers by #bjca through the creation of career pathways1 full-time positions1 and training opportunities described in subsection 7b74 2 7#e7 in subsection 7j7 7as so redesignated71 by striking #ej1jjj1jjj for each of fiscal years #bjbc through #bjbg and inserting #aj1jjj1jjj1jjj for each of fiscal years #bjbg through #bjcf2 and 7#f7 in paragraph 7#a7 of subsection 7k7 7as so redesignated7-- 7,a7 by inserting a nonprofit community health organization1 a nonprofit community health worker association1 after a public health department12 and 7,b7 by striking 77as defined and inserting 7as defined4 #ejc4 ,safeguarding essential health care workers ,the ,public ,health ,service ,act is amended by inserting after section #cai;,d-#a 7#db ,u4,s4,c4 #bdg;d-#d;b7 the following3 #cai;,d-#b4 ,emergency grants to safeguard essential health care workers 7a7 ,definitions ,in this section3 7#a7 ,emergency or disaster ,the term emergency or disaster means-- 7,a7 a major disaster declared by the ,president under section #dja of the ,robert ,t4 ,stafford ,disaster ,relief and ,emergency ,assistance ,act2 7,b7 an emergency declared by the ,president under section #eja of the ,robert ,t4 ,stafford ,disaster ,relief and ,emergency ,assistance ,act2 7,c7 a national emergency declared by the ,president under the ,national ,emergencies ,act2 7,d7 a public health emergency declared under section #cai2 and 7,e7 a ,state or local emergency or disaster1 as declared by the applicable ,state or local government4 7#b7 ,eligible health care worker ,the term eligible health care worker means an essential health care worker whose work cannot be conducted remotely4 7#c7 ,essential health care worker ,the term essential health care worker means-- 7,a7 a health care provider1 including a direct care worker 7as defined in section #gii;,b72 7,b7 a medical technologist2 7,c7 a public health worker2 7,d7 an orderly 7as defined in the #bjaj ,standard ,occupational ,classifications of the ,department of ,labor under the code for ,orderlies 7#ca-ajae772 7,e7 an environmental service1 janitorial1 or custodial worker in a health care setting2 and 7,f7 any other professional role that the ,secretary determines is essential to the care of patients or the maintenance of public health4 7b7 ,grants 7#a7 ,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 7#b74 7#b7 ,use of funds 7,a7 ,hazardous duty compensation 7i7 ,in general ,the recipient of a grant under paragraph 7#a7 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-- 7,i7 the performance of the work by the eligible health care worker for the applicable health care facility or home health agency is hazardous2 or 7,,ii7 the commute of the eligible health care worker is hazardous4 7ii7 ,requirement 7,i7 ,in general ,subject to subclause 7,,ii71 the amount of hazardous duty compensation under clause 7i7 shall be not more than #ac per hour1 which shall be in addition to the wages or remuneration the eligible health care worker otherwise receives for the work4 7,,ii7 ,maximum amount ,the total amount of hazardous duty compensation received by any #a eligible health care worker under this subparagraph may not exceed #be1jjj per year4 7,b7 ,additional uses ,the recipient of a grant under paragraph 7#a7 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 disaster1 including alternative transit options1 personal protective equipment1 and other safety measures4 7c7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as may be necessary4 4 ,,vi ,safe1 strong1 and resilient communities ,a ,empowering resilient community mental health #fja4 ,grants for resilient community mental health ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by inserting after section #cag,v the following3 #cag,w4 ,grant program for community wellness and resilience programs 7a7 ,grants 7#a7 ,program grants 7,a7 ,awards ,the ,secretary1 in coordination with the ,assistant ,secretary for ,mental ,health and ,substance ,use and the ,administrator of the ,health ,resources and ,services ,administration1 shall carry out a program of awarding grants to eligible entities1 on a competitive basis1 for the purpose of establishing1 operating1 or expanding community mental wellness and resilience programs4 7,b7 ,amount ,an eligible entity awarded a grant under subparagraph 7,a7 may receive not more than #cjj1jjj per year for not more than #d years4 7#b7 ,planning grants 7,a7 ,awards ,the ,secretary1 in coordination with the ,assistant ,secretary for ,mental ,health and ,substance ,use and the ,administrator of the ,health ,resources and ,services ,administration1 shall award grants to entities-- 7i7 to organize a resilience coordinating network that meets the requirements of subsection 7c77#b72 7ii7 to perform assessments of need with respect to community mental wellness and resilience2 and 7iii7 to prepare an application for a grant under paragraph 7#a74 7,b7 ,amount ,the amount of a grant under subparagraph 7,a71 with respect to any resilience coordinating network to be organized for applying for a grant under paragraph 7#a71 shall not exceed #ajj1jjj4 7b7 ,program requirements ,a community mental wellness and resilience program funded pursuant to a grant under subsection 7a77#a7 shall take a public health approach to mental health to strengthen the entire community's psychological and emotional wellness and resilience1 including by-- 7#a7 collecting and analyzing information from residents as well as quantitative data to identify-- 7,a7 protective factors that enhance and sustain the community's capacity for mental wellness and resilience2 and 7,b7 risk factors that undermine such capacity2 7#b7 strengthening such protective factors and addressing such risk factors2 7#c7 building awareness1 skills1 tools1 curricula1 and leadership in the community to-- 7,a7 facilitate using a public health approach to mental health2 and 7,b7 heal mental health and psychosocial problems among all adults and youth2 and 7#d7 developing1 implementing1 and continually evaluating and improving a comprehensive strategic plan for carrying out the activities described in paragraphs 7#a71 7#b7 and 7#c7 that includes utilizing developmentally1 linguistically1 and culturally appropriate evidence-based1 evidence-informed1 promising-best1 or indigenous practices for-- 7,a7 engaging community members in building social connections across cultural1 geographic1 and economic boundaries2 7,b7 enhancing local economic and environmental conditions and environmental resilience1 including with respect to the built environment2 7,c7 becoming trauma-informed and learning simple self-administrable mental wellness and resilience skills2 7,d7 engaging in community activities and mutual aid networks that strengthen mental wellness and resilience2 7,e7 partaking in nonclinical group and community-minded recovery and healing programs2 7,f7 embedding trauma-informed climate education and mental resilience curricula and programming into schools for students1 workers1 and the broader community2 and 7,g7 other activities to promote mental wellness and resilience1 manage climate anxiety1 and heal individual and community traumas4 7c7 ,eligible entities 7#a7 ,in general ,to be eligible to receive a grant under subsection 7a77#a71 an applicant shall be a nonprofit or community organization that has-- 7,a7 organized a resilience coordinating network that meets the requirements of paragraph 7#b72 and 7,b7 been approved by such resilience coordinating network to serve as its fiscal sponsor4 7#b7 ,resilience coordinating networks described ,a resilience coordinating network organized under paragraph 7#a77;,a7 shall be composed of #a or more representatives of entities from not fewer than #h of the following categories3 7,a7 ,grassroots groups1 neighborhood associations1 and volunteer civic organizations4 7,b7 ,elementary and secondary schools1 institutions of higher education including community colleges1 job-training programs1 and other education or training agencies or organizations4 7,c7 ,youth after-school and summer programs4 7,d7 ,family and early childhood education programs4 7,e7 ,faith and spirituality organizations4 7,f7 ,senior care organizations4 7,g7 ,climate change mitigation and adaptation1 and environmental conservation1 groups and organizations4 7,h7 ,social and environmental justice groups and organizations4 7,i7 ,disaster preparedness and response groups and organizations4 7,j7 ,local labor organizations4 7,k7 ,businesses and business associations4 7,l7 ,agencies and organizations involved with community safety4 7,m7 ,social work1 mental health1 behavioral health1 substance use1 physical health1 and public health professionals2 public health agencies and institutions2 and mental health1 behavioral health1 social work1 and other professionals1 groups1 organizations1 agencies1 and institutions in the health and human services fields4 7,n7 ,the general public1 including individuals who have experienced mental health or psychosocial problems who can represent and engage with populations relevant to the community4 7d7 ,report 7#a7 ,submission ,not later than ,december #ca1 #bjca1 the ,secretary shall submit a report to the ,congress on the results of the grants under subsection 7a77#a74 7#b7 ,contents ,such report shall include a summary of the best practices used by grantees in establishing1 operating1 or expanding community mental wellness and resilience programs4 7e7 ,technical assistance ,the ,secretary shall provide technical assistance-- 7#a7 to assist eligible entities in developing applications for grants under paragraph 7#a7 or 7#b7 of subsection 7a72 and 7#b7 to enable the sharing of best practices learned from successful resilience coordinating networks4 7f7 ,definitions ,in this section3 7#a7 ,the term community means people1 groups1 and organizations that reside in or work within a specific geographic area1 such as a city1 neighborhood1 subdivision1 urban1 suburban1 or rural locale4 7#b7 ,the term community trauma means a blow to the basic fabric of social life that damages the bonds attaching people together1 impairs their prevailing sense of community1 undermines their fundamental sense of safety1 justice1 equity1 and security1 and heightens individual and collective fears and feelings of vulnerability4 7#c7 ,the term mental wellness means a state of well-being in which an individual can-- 7,a7 realize their own potential2 7,b7 constructively cope with the stresses of life2 7,c7 work productively and fruitfully2 and 7,d7 make a contribution to their community4 7#d7 ,the term protective factors means strengths1 skills1 resources1 and characteristics that-- 7,a7 are associated with a lower likelihood of negative outcomes of adversities2 or 7,b7 reduce the impact on people of toxic stresses or a traumatic experience4 7#e7 ,the term psychosocial problem means the ways in which an individual's mental health or behavioral health problem disturbs others such as children1 families1 communities1 or society4 7#f7 ,the term public health approach to mental health means methods that-- 7,a7 take a population-level approach to promote mental wellness and resilience to prevent problems before they emerge and heal them when they do appear1 not merely treating individuals one at a time after symptoms of pathology appear2 and 7,b7 address mental health and psychosocial problems by-- 7i7 identifying and strengthening existing protective factors1 and forming new ones1 that buffer people from and enhance their capacity for psychological and emotional resilience2 and 7ii7 taking a holistic systems perspective that recognizes that most mental health and psychosocial problems result from numerous interrelated personal1 family1 social1 economic1 and environmental factors that require multipronged community-based interventions4 7#g7 ,the term resilience means that people develop cognitive1 psychological1 emotional capabilities and social connections that enable them to calm their body1 mind1 emotions1 and behaviors during toxic stresses or traumatic experiences in ways that enable them to-- 7,a7 respond without negative consequences for themselves or others2 and 7,b7 use the experiences as catalysts to develop a constructive new sense of meaning1 purpose1 and hope4 7#h7 ,the term ,secretary means the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention4 7#i7 ,the term toxic stress means exposure to persistent overwhelming traumatic and stressful situations4 7g7 ,funding 7#a7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #ajj1jjj1jjj for each of fiscal years #bjbg through #bjca4 7#b7 ,rural communities ,the ,secretary shall award not less than #bj percent of the amounts made available under paragraph 7#a7 for grants under paragraphs 7#a7 and 7#b7 of subsection 7a7 to eligible entities that are establishing1 operating1 or expanding community mental wellness and resilience programs that are located in or serve a rural area 7as defined in section #ebj of the ,housing ,act of #aidi 7#db ,u4,s4,c4 #adij774 7#c7 ,environmental justice communities ,the ,secretary shall award not less than #bj percent of the amounts made available under paragraph 7#a7 for grants under paragraphs 7#a7 and 7#b7 of subsection 7a7 to eligible entities that are establishing1 operating1 or expanding community mental wellness and resilience programs that serve environmental justice communities 7as defined in section #b of the ,green ,new ,deal for ,health ,act74 4 ,b ,understanding and preventing heat risk #faa4 ,definitions ,in this subtitle3 7#a7 ,extreme heat ,the term extreme heat means heat that substantially exceeds local climatological norms in terms of any combination of the following3 7,a7 ,duration of an individual heat event4 7,b7 ,intensity4 7,c7 ,season length4 7,d7 ,frequency4 7#b7 ,heat ,the term heat means any combination of the atmospheric parameters associated with modulating human thermal regulation1 such as air temperature1 humidity1 solar exposure1 and wind speed4 7#c7 ,heat event ,the term heat event means an occurrence of extreme heat that may have heat-health implications4 7#d7 ,heat-health ,the term heat-health means mental and physical health effects to humans from heat or the risk of such effects4 7#e7 ,planning ,the term planning means activities performed across time scales 7including days1 weeks1 months1 years1 and decades7 with scenario-based1 probabilistic or deterministic information to identify and take actions to proactively mitigate heat-health risks from increased frequency1 duration1 and intensity of heat waves and increased ambient temperature4 7#f7 ,preparedness ,the term preparedness means activities performed across time scales 7including days1 weeks1 months1 years1 and decades7 with probabilistic or deterministic information to manage risk in advance of a heat event and increased ambient temperature4 7#g7 ,tribal government ,the term ,tribal government means the recognized governing body of any ,indian or ,alaska ,native tribe1 band1 nation1 pueblo1 village1 community1 component band1 or component reservation1 individually identified 7including parenthetically7 in the list published most recently as of the date of enactment of this ,act pursuant to section #ajd of the ,federally ,recognized ,indian ,tribe ,list ,act of #aiid 7#be ,u4,s4,c4 #eaca74 7#h7 ,vulnerable populations ,the term vulnerable populations means populations that face health1 financial1 educational1 or housing disparities that would render them more susceptible to the negative impacts of extreme heat4 #fab4 ,study on extreme heat information and response 7a7 ,study 7#a7 ,in general ,not later than #abj days after the date of the enactment of this ,act1 the ,under ,secretary of ,commerce for ,oceans and ,atmosphere1 in consultation with representatives from the ,department of ,health and ,human ,services as the ,secretary of ,health and ,human ,services considers appropriate1 shall seek to enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine to conduct a study on extreme heat information and response1 to be completed not later than #b years after the date of the enactment of this ,act4 7#b7 ,elements ,the study described in paragraph 7#a7 shall-- 7,a7 identify the policy1 research1 operations1 communications1 and data gaps affecting heat-health planning1 preparedness1 response1 resilience1 and adaptation1 and impacts to vulnerable populations2 7,b7 provide recommendations for addressing gaps identified under subparagraph 7,a72 7,c7 provide recommendations1 in addition to the recommendations provided under subparagraph 7,b71 which may include strategies for-- 7i7 communicating warnings to and promoting resilience of populations vulnerable to extreme heat2 7ii7 distributing extreme heat warnings1 including to individuals with limited ,english proficiency and individuals who may have other established barriers to such information2 7iii7 designing warnings described in clause 7ii7 to convey the urgency and severity of heat events and achieve behavior changes that reduce the mortality and morbidity of extreme heat effects2 7iv7 understanding compound and cascading risks to inform development and implementation of heat-health risk reduction interventions2 and 7v7 promoting community resilience and addressing specific decision support service needs of vulnerable populations2 and 7,d7 consider the effectiveness of country- or local-level heat awareness and communication tools1 preparedness plans1 or mitigation4 7#c7 ,development of definitions ,in conducting the study described in paragraph 7#a71 the ,national ,academies of ,sciences1 ,engineering1 and ,medicine shall work with heat and health experts to identify consistent and agreed-upon definitions for heat events1 heat waves1 and other relevant terms4 7b7 ,report ,not later than #ij days after completion of the study described in subsection 7a77#a71 the ,under ,secretary of ,commerce for ,oceans and ,atmosphere shall-- 7#a7 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 study2 and 7#b7 submit the report to-- 7,a7 the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate2 7,b7 the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate2 7,c7 the ,committee on ,science1 ,space1 and ,technology of the ,house of ,representatives2 7,d7 the ,committee on ,energy and ,commerce of the ,house of ,representatives2 and 7,e7 the ,committee on ,education and ,workforce of the ,house of ,representatives4 #fac4 ,financial assistance for research and resilience in addressing extreme heat risks 7a7 ,establishment of program ,subject to the availability of appropriations1 not later than #a year after the date of the enactment of this ,act1 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 7e7 to ameliorate the mental and physical human health impacts of extreme heat events4 7b7 ,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 heat4 7c7 ,forms of assistance ,financial assistance provided under this section may be in the form of contracts1 grants1 or cooperative agreements4 7d7 ,eligible entities ,entities eligible to receive financial assistance under this section to carry out projects described in subsection 7e7 include-- 7#a7 nonprofit entities2 7#b7 academic institutions2 7#c7 ,states2 7#d7 ,tribal governments2 7#e7 local governments2 and 7#f7 political subdivisions of ,states1 ,tribal governments1 and local governments4 7e7 ,eligible projects ,projects described in this subsection include projects-- 7#a7 to expand public awareness of heat risks2 7#b7 to conduct heat mapping campaigns2 7#c7 to conduct scientific research to assess gaps and priorities regarding the risks of extreme heat in communities2 7#d7 to communicate risks to isolated communities2 and 7#e7 to educate such communities about how to respond to extreme heat events4 7f7 ,priorities ,in selecting eligible entities to receive financial assistance under this section1 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 mortalities4 #fad4 ,authorization of appropriations 7a7 ,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 ,sciences1 ,engineering1 and ,medicine to carry out section #fab #ejj1jjj for each of fiscal years #bjbg through #bjbi4 7b7 ,financial assistance ,to address extreme heat ,there is authorized to be appropriated to the ,national ,oceanic and ,atmospheric ,administration to carry out section #fac #cj1jjj1jjj for each of fiscal years #bjbg through #bjca4 ,c ,home resiliency for medical needs #fba4 ,medicare coverage of medically necessary home resiliency services 7a7 ,coverage ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7#a7 in subsection 7s77#b7-- 7,a7 in subparagraph 7,,jj71 by striking and at the end2 7,b7 in subparagraph 7,,kk71 by inserting and at the end2 and 7,c7 by adding at the end the following new subparagraph3 7,,ll7 in the case of an individual who is medically at risk in the event of a climate or man-made disaster 7as determined by the ,secretary in accordance with subsection 7ooo771 home resiliency services 7as defined in such subsection72 2 and 7#b7 by adding at the end the following new subsection3 7ooo7 ,home resiliency services2 determination of individuals medically at risk 7#a7 ,home resiliency services ,the term home resiliency services means items and services-- 7,a7 furnished on or after ,january #a1 #bjbg1 to an individual described in subsection 7s77#b77,,ll72 and 7,b7 that the ,secretary determines are medically necessary for such individual in the case of a climate or man-made disaster1 such as a heat pump for an individual vulnerable to extreme temperatures1 solar batteries for an individual reliant on electrical medical equipment 7including home mechanical ventilators71 and energy-efficient cold storage for heat-sensitive medical supplies4 7#b7 ,determination of individuals medically at risk ,for purposes of subsection 7s77#b77,,ll7 and this subsection1 the ,secretary1 in consultation with the ,office of ,climate ,change and ,health ,equity established by section #ajb7;a77#a7 of the ,green ,new ,deal for ,health ,act1 the ,national ,institutes of ,health1 the ,centers of ,medicare ,medicaid ,services1 and the ,national ,oceanic and ,atmospheric ,administration1 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 hazards1 including extreme heat1 extreme cold1 flooding1 and loss of power4 ,such a process shall consider-- 7,a7 geography-specific climate risks and regional preparedness for different climate risks2 7,b7 the regional history of disaster or climate hazards and infrastructure failure in the preceding #bj years or the forward-looking predicted risk of disaster or climate hazards and infrastructure failure in the next #bj years2 7,c7 medical reliance on equipment1 pharmaceuticals1 mobility aids1 and other supplies that are sensitive to exposure to extreme temperatures1 poor air quality1 flooding and water damage1 or dependent on electrical power2 and 7,d7 chronic medical conditions1 disabilities1 and co-morbidities that increase patient vulnerability during disaster4 4 7b7 ,payment ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7#a7 by striking and before 7,,hh72 and 7#b7 by inserting before the semicolon at the end the following3 and 7,,ii7 with respect to home resiliency services described in section #ahfa7s77#b77,,ll71 the amount paid shall be an amount equal to #ajj percent of the lesser of the actual charge for the services or the amount determined under a fee schedule established by the ,secretary4 ,,vii ,research and innovation for climate and health #gja4 ,research and innovation for climate and health ,title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq47 is amended by adding at the end the following3 ,x ,research and innovation for climate and health #cii,,pp4 ,national ,climate and ,health ,research and ,innovation ,initiative 7a7 ,establishment ,the ,president shall establish and implement an initiative1 to be known as the ,national ,climate and ,health ,research and ,innovation ,initiative 7referred to in this part as the ,initiative71 to be carried out by the ,secretary1 acting through the ,assistant ,secretary for ,health4 7b7 ,purpose ,the purpose of the ,initiative is to develop the tools1 research1 innovations1 and understanding of climate change and health needed to prevent1 treat1 and mitigate the health harms of climate change in order to protect the collective health and well-being of the people of the ,united ,states4 7c7 ,activities ,in carrying out the ,initiative1 the ,president1 acting through the ,office of ,climate ,change and ,health ,equity1 the ,interagency ,committee1 and such agency heads as the ,president considers appropriate1 shall carry out activities that include the following3 7#a7 ,supporting research to understand1 predict1 and prevent the health burdens of climate change and improve the ability to treat health harms due to climate change1 including-- 7,a7 research to understand and predict the impacts of climate change on both physical and mental health1 including disproportionate impacts based on race1 ethnicity1 language1 gender1 sex1 pregnancy status1 disability1 age1 location1 occupation1 and immigration status2 7,b7 research into1 and mitigation of1 adverse mental and physical health effects of historical and ongoing environmental racism and the subsequent combined health risk of climate change and environmental pollution2 7,c7 research to model and predict occupational hazards that will occur or intensify due to climate change2 7,d7 development of medical education curricula relating to the clinical hazards of1 and interventions for1 climate-change-based health burdens2 7,e7 research to address climate-related housing and community development issues1 including the impact of1 and mitigation strategies for1 challenges such as isolation1 low-quality housing1 housing precarity1 and homelessness1 and the vulnerabilities and the mental and physical health risks those challenges present2 and 7,f7 research to study the social and economic factors and policies that create healthy1 resilient communities prepared to adapt to the challenges posed by climate change4 7#b7 ,supporting research and development of sustainable and equitable health care operations and clinical practices that reduce greenhouse gas emissions1 climate risk1 and environmental health hazards1 including-- 7,a7 research into effective models of health care delivery-- 7i7 to mitigate the impact of long-standing climate change and environmental hazards on health2 and 7ii7 in preparation for1 and in response to1 climate disasters2 7,b7 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 burden1 with attention to geographical climate risks and patient demographic health care needs2 7,c7 the development of methods to reduce health sector environmental pollution2 7,d7 research into1 and mitigation of1 the environmental impacts of hazardous substances used in health care and the health care supply chain1 including the placement of facilities that use hazardous substances and the proximity of those facilities to historically marginalized communities2 7,e7 7i7 research and development of innovations that shift the lifecycle of medical supplies and devices from single use to sustainable1 circular economies1 including low-environmental impact sterilization techniques2 and 7ii7 support of public-private partnerships that enable scientific translation of those innovations2 7,f7 the development of clinically equivalent and improved1 low-climate-footprint interventions and pharmaceuticals and the study of the environmental impacts of those interventions and pharmaceuticals to enable high-quality1 environmentally conscious clinical decision making2 and 7,g7 conducting and supporting research1 development1 demonstration1 and commercial application of renewable energy technologies and strategies to meet the energy demand and energy security needs of infrastructure critical to health care4 7d7 ,termination ,the ,initiative shall terminate on ,december #ca1 #bjcf4 #cii,,pp-#a4 ,interagency coordination 7a7 ,in general ,not later than #a year after the date of enactment of the ,green ,new ,deal for ,health ,act1 the ,president shall establish an interagency committee 7referred to in this part as the ,interagency ,committee71 to coordinate the ,initiative1 as appropriate1 among the departments1 offices1 and agencies described in subsection 7b77#a74 7b7 ,membership 7#a7 ,in general ,the membership of the ,interagency ,committee shall consist of-- 7,a7 #c representatives of the ,department of ,health and ,human ,services1 which shall include-- 7i7 #a representative of the ,office of ,climate ,change and ,health ,equity2 and 7ii7 #a representative of the ,national ,institutes of ,health2 7,b7 #a representative of the ,office of ,science and ,technology ,policy2 7,c7 #a representative of the ,national ,science ,foundation2 7,d7 #a representative of the ,environmental ,protection ,agency2 7,e7 #a representative of the ,department of ,energy2 7,f7 #a representative of the ,department of ,housing and ,urban ,development2 and 7,g7 #a representative of the ,department of ,labor4 7#b7 ,co-chairs ,the ,interagency ,committee shall be co-chaired by the representatives described in subparagraphs 7,a77i7 and 7,b7 of paragraph 7#a74 7c7 ,meetings ,the ,interagency ,committee shall meet not less frequently than quarterly4 7d7 ,duties ,the ,interagency ,committee shall-- 7#a7 provide for interagency coordination of the activities of the ,initiative2 7#b7 develop a plan that describes how the departments1 offices1 and agencies described in subsection 7b77#a7 will collectively carry out the activities described in section #cii,,pp7c71 including-- 7,a7 a description of how each department1 office1 and agency will execute a subset of the activities described in that section2 and 7,b7 a description of collaborations across the departments1 offices1 and agencies2 7#c7 annually submit to ,congress a report describing the progress of the ,initiative1 activities of the ,interagency ,committee1 and policy recommendations that derive from the results of the ,initiative2 and 7#d7 as part of the ,president's annual budget request to ,congress1 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 ,initiative4 #cii,,pp-#b4 ,advisory ,council 7a7 ,in general ,the ,secretary shall establish an advisory council 7referred to in this section as the ,advisory ,council7 to advise and provide recommendations to the ,initiative4 7b7 ,membership 7#a7 ,in general ,the membership of the ,advisory ,council shall consist of-- 7,a7 the members of the ,interagency ,committee2 and 7,b7 the non-,federal members appointed under paragraph 7#b74 7#b7 ,appointed members ,the ,secretary shall appoint the following non-,federal members of the ,advisory ,council3 7,a7 ,not more than #d members who are representatives of research institutions1 academic institutions1 or medical industry entities4 7,b7 ,not fewer than #a member who is a representative of a critical access hospital 7as defined in section #ahfa7mm77#a7 of the ,social ,security ,act74 7,c7 ,not fewer than #a member who is a representative of a hospital that receives disproportionate share payments under section #ahhf7;d77#e77;,f7 of the ,social ,security ,act4 7,d7 ,not fewer than #a member who is a representative of a community health center receiving funding under section #ccj4 7,e7 ,not fewer than #a member who is a representative of an ,indian ,health ,service facility operated by an ,indian tribe or tribal organization 7as defined in section #d of the ,indian ,health ,care ,improvement ,act74 7,f7 ,not fewer than #a member who is a representative of a ,state1 local1 or ,tribal department of public health4 7,g7 ,not fewer than #d members who-- 7i7 are representatives of labor organizations representing health care workers2 and 7ii7 collectively represent a diversity of health care professions1 such as workers in environmental services1 direct care workers1 nurses1 and physicians4 7,h7 ,not fewer than #d members who are representatives of community-based patient advocacy or public health advocacy organizations1 each of which are from different geographic regions of the ,united ,states4 7#c7 ,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 ,states1 especially frontline populations and populations that are subject to negative disparate outcomes in health4 7#d7 ,duties ,the ,advisory ,council shall advise the ,president and the ,secretary on matters relating to the ,initiative1 including recommendations related to-- 7,a7 the research and innovation needs of frontline communities1 environmental justice communities 7as defined in section #b of the ,green ,new ,deal for ,health ,act71 medically underserved communities 7as defined in section #gii;,b71 and individuals vulnerable to climate change2 7,b7 the current gaps and challenges in the scientific understanding of the health impacts of climate change and the impact of health care on climate2 7,c7 emerging research and innovation needs from clinical practice2 7,d7 whether issues of health disparities are adequately addressed by the ,initiative2 7,e7 the balance of activities and funding across the ,initiative2 7,f7 bottlenecks in translating research findings into clinical advances1 mitigation strategies1 and workplace safety2 and 7,g7 accountability and ethical use of research funds4 7#e7 ,meetings ,the ,advisory ,council shall meet not less frequently than annually1 and such meetings shall be open to the public4 7#f7 ,termination ,the ,advisory ,council shall terminate on ,december #ca1 #bjcf4 #cii,,pp-#c4 ,authorization of appropriations ,there is authorized to be appropriated to carry out section #cii,,pp #e1jjj1jjj1jjj for each of fiscal years #bjbg through #bjcf4 4