,,ii #aaith ,,congress #b;d ,session ,s4 #ebib ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,august #f1 #bjbf,mr4 ,markey introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to provide for green and resilient health care infrastructure1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,granting ,resources for ,eliminating ,emissions ,now in ,hospitals ,act or the ,,green ,hospitals ,act4 #b4 ,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 stormwater drainage1 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 infrastructure 7regardless of the source of original funding for such infrastructure72 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 be deemed to be complete for purposes of section #c7;d77#b7 of the ,granting ,resources for ,eliminating ,emissions ,now in ,hospitals ,act1 and the application shall be deemed to have been submitted for purposes of consideration for a planning grant under that section4 4 #c4 ,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 ,act7 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