I 

111TH CONGRESS 

1ST SESSION H. R. 2323 

To direct the Secretary of Health and Human Services to develop a national 

strategic action plan to assist health professionals in preparing for and 

responding to the public health effects of climate change, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 7, 2009 

Mrs. CAPPS (for herself, Ms. MATSUI, and Ms. BALDWIN) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To direct the Secretary of Health and Human Services to 

develop a national strategic action plan to assist health 

professionals in preparing for and responding to the public health effects of climate change, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Climate Change Health 

5 Protection and Promotion Act’’. 


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1 SEC. 2. SENSE OF CONGRESS ON PUBLIC HEALTH AND CLI2 MATE CHANGE. 

3 It is the sense of the Congress that the Federal Gov4 ernment, in cooperation with international, State, tribal, 

5 and local governments, concerned public and private orga6 nizations, and citizens, should use all practicable means 

7 and measures— 

8 (1) to assist the efforts of public health and 

9 health care professionals, first responders, States, 

10 tribes, municipalities, and local communities to in11 corporate measures to prepare health systems to re12 spond to the impacts of climate change; 

13 (2) to ensure— 

14 (A) that the Nation’s health professionals 

15 have sufficient information to prepare for and 

16 respond to the adverse health impacts of cli17 mate change; 

18 (B) the utility and value of scientific re19 search in advancing understanding of— 

20 (i) the health impacts of climate 

21 change; and 

22 (ii) strategies to prepare for and re23 spond to the health impacts of climate 

24 change; 

25 (C) the identification of communities vul26 nerable to the health effects of climate change 


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1 and the development of strategic response plans 

2 to be carried out by health professionals for 

3 those communities; 

4 (D) the improvement of health status and 

5 health equity through efforts to prepare for and 

6 respond to climate change; and 

7 (E) the inclusion of health policy in the de8 velopment of climate change responses; 

9 (3) to encourage further research, interdiscipli10 nary partnership, and collaboration among stake11 holders in order to— 

12 (A) understand and monitor the health im13 pacts of climate change; and 

14 (B) improve public health knowledge and 

15 response strategies to climate change; 

16 (4) to enhance preparedness activities, and pub17 lic health infrastructure, relating to climate change 

18 and health; 

19 (5) to encourage each and every American to 

20 learn about the impacts of climate change on health; 

21 and 

22 (6) to assist the efforts of developing nations to 

23 incorporate measures to prepare health systems to 

24 respond to the impacts of climate change. 


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1 SEC. 3. RELATIONSHIP TO OTHER LAWS. 

2 Nothing in this Act in any manner limits the author3 ity provided to or responsibility conferred on any Federal 

4 department or agency by any provision of any law (includ5 ing regulations) or authorizes any violation of any provi6 sion of any law (including regulations), including any 

7 health, energy, environmental, transportation, or any 

8 other law or regulation. 

9 SEC. 4. NATIONAL STRATEGIC ACTION PLAN. 

10 (a) REQUIREMENT.— 

11 (1) IN GENERAL.—The Secretary of Health and 

12 Human Services, within 2 years after the date of the 

13 enactment of this Act, on the basis of the best avail14 able science, and in consultation pursuant to para15 graph (2), shall publish a strategic action plan to as16 sist health professionals in preparing for and re17 sponding to the impacts of climate change on public 

18 health in the United States and other nations, par19 ticularly developing nations. 

20 (2) CONSULTATION.—In developing or making 

21 any revision to the national strategic action plan, the 

22 Secretary shall— 

23 (A) consult with the Director of the Cen24 ters for Disease Control and Prevention, the 

25 Administrator of the Environmental Protection 

26 Agency, the Director of the National Institutes 


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1 of Health, the Secretary of Energy, other ap2 propriate Federal agencies, Indian tribes, State 

3 and local governments, public health organiza4 tions, scientists, and other interested stake5 holders; and 

6 (B) provide opportunity for public input. 

7 (b) CONTENTS.— 

8 (1) IN GENERAL.—The Secretary, acting 

9 through the Director of the Centers for Disease 

10 Control and Prevention, shall assist health profes11 sionals in preparing for and responding effectively 

12 and efficiently to the health effects of climate change 

13 through measures including— 

14 (A) developing, improving, integrating, and 

15 maintaining domestic and international disease 

16 surveillance systems and monitoring capacity to 

17 respond to health-related effects of climate 

18 change, including on topics addressing— 

19 (i) water, food, and vector borne infec20 tious diseases and climate change; 

21 (ii) pulmonary effects, including re22 sponses to aeroallergens; 

23 (iii) cardiovascular effects, including 

24 impacts of temperature extremes; 


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1 (iv) air pollution health effects, includ2 ing heightened sensitivity to air pollution; 

3 (v) hazardous algal blooms; 

4 (vi) mental and behavioral health im5 pacts of climate change; 

6 (vii) the health of refugees, displaced 

7 persons, and vulnerable communities; 

8 (viii) the implications for communities 

9 vulnerable to health effects of climate 

10 change, as well as strategies for responding 

11 to climate change within these commu12 nities; and 

13 (ix) local and community-based health 

14 interventions for climate-related health im15 pacts; 

16 (B) creating tools for predicting and moni17 toring the public health effects of climate 

18 change on the international, national, regional, 

19 State, and local levels, and providing technical 

20 support to assist in their implementation; 

21 (C) developing public health communica22 tions strategies and interventions for extreme 

23 weather events and disaster response situations; 

24 (D) identifying and prioritizing commu25 nities and populations vulnerable to the health 


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1 effects of climate change, and determining ac2 tions and communication strategies that should 

3 be taken to inform and protect these commu4 nities and populations from the health effects of 

5 climate change; 

6 (E) developing health communication, pub7 lic education, and outreach programs aimed at 

8 public health and health care professionals, as 

9 well as the general public, to promote prepared10 ness and response strategies relating to climate 

11 change and public health, including the identi12 fication of greenhouse gas reduction behaviors 

13 that are health-promoting; and 

14 (F) developing academic and regional cen15 ters of excellence devoted to— 

16 (i) researching relationships between 

17 climate change and health; 

18 (ii) expanding and training the public 

19 health workforce to strengthen the capacity 

20 of such workforce to respond to and pre21 pare for the health effects of climate 

22 change; 

23 (iii) creating and supporting academic 

24 fellowships focusing on the health effects 

25 of climate change; and 


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1 (iv) training senior health ministry of2 ficials from developing nations to strength3 en the capacity of such nations to— 

4 (I) prepare for and respond to 

5 the health effects of climate change; 

6 and 

7 (II) build an international net8 work of public health professionals 

9 with the necessary climate change 

10 knowledge base; 

11 (G) using techniques, including health im12 pact assessments, to assess various climate 

13 change public health preparedness and response 

14 strategies on international, national, State, re15 gional, tribal, and local levels, and make rec16 ommendations as to those strategies that best 

17 protect the public health; 

18 (H)(i) assisting in the development, imple19 mentation, and support of State, regional, trib20 al, and local preparedness, communication, and 

21 response plans (including with respect to the 

22 health departments of such entities) to antici23 pate and reduce the health threats of climate 

24 change; and 


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1 (ii) acting through the Director of the Cen2 ters for Disease Control and Prevention or an 

3 appropriate Federal agency, pursuing collabo4 rative efforts to develop, integrate, and imple5 ment such plans; 

6 (I) acting through the Director of the Cen7 ters for Disease Control and Prevention or an 

8 appropriate Federal agency, creating a program 

9 to advance research as it relates to the effects 

10 of climate change on public health across Fed11 eral agencies, including research to— 

12 (i) identify and assess climate change 

13 health effects preparedness and response 

14 strategies; 

15 (ii) prioritize critical public health in16 frastructure projects related to potential 

17 climate change impacts that affect public 

18 health; and 

19 (iii) coordinate preparedness for cli20 mate change health impacts, including the 

21 development of modeling and forecasting 

22 tools; 

23 (J) providing technical assistance for the 

24 development, implementation, and support of 

25 preparedness and response plans to anticipate 


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1 and reduce the health threats of climate change 

2 in developing nations; and 

3 (K) carrying out other activities deter4 mined appropriate by the Secretary to plan for 

5 and respond to the impacts of climate change 

6 on public health. 

7 (c) REVISION.—The Secretary shall revise the na8 tional strategic action plan not later than July 1, 2014, 

9 and every 4 years thereafter, to reflect new information 

10 collected pursuant to implementation of the national stra11 tegic action plan and otherwise, including information 

12 on— 

13 (1) the status of critical environmental health 

14 parameters and related human health impacts; 

15 (2) the impacts of climate change on public 

16 health; and 

17 (3) advances in the development of strategies 

18 for preparing for and responding to the impacts of 

19 climate change on public health. 

20 (d) IMPLEMENTATION.— 

21 (1) IMPLEMENTATION THROUGH HHS.—The 

22 Secretary shall exercise the Secretary’s authority 

23 under this Act and other Federal statutes to achieve 

24 the goals and measures of the national strategic ac25 tion plan. 


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1 (2) OTHER PUBLIC HEALTH PROGRAMS AND

2 INITIATIVES.—The Secretary and Federal officials of 

3 other relevant Federal agencies shall administer 

4 public health programs and initiatives authorized by 

5 statutes other than this Act, subject to the require6 ments of such statutes, in a manner designed to 

7 achieve the goals of the national strategic action 

8 plan. 

9 (3) CDC.—In furtherance of the national stra10 tegic action plan, the Director of the Centers for 

11 Disease Control and Prevention shall— 

12 (A) conduct scientific research to assist 

13 health professionals in preparing for and re14 sponding to the impacts of climate change on 

15 public health; and 

16 (B) provide funding for— 

17 (i) research on the health effects of 

18 climate change; and 

19 (ii) preparedness planning on the 

20 international, national, State, regional, and 

21 local levels to respond to or reduce the bur22 den of health effects of climate change; 

23 and 

24 (C) carry out other activities determined 

25 appropriate by the Director to prepare for and 


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1 respond to the impacts of climate change on 

2 public health. 

3 SEC. 5. ADVISORY BOARD. 

4 (a) ESTABLISHMENT.—The Secretary shall establish 

5 a permanent science advisory board comprised of not less 

6 than 10 and not more than 20 members. 

7 (b) APPOINTMENT OF MEMBERS.—The Secretary 

8 shall appoint the members of the science advisory board 

9 from among individuals who— 

10 (1) are recommended by the President of the 

11 National Academy of Sciences; and 

12 (2) have expertise in public health and human 

13 services, climate change, and other relevant dis14 ciplines. 

15 (c) FUNCTIONS.—The science advisory board shall— 

16 (1) provide scientific and technical advice and 

17 recommendations to the Secretary on the domestic 

18 and international impacts of climate change on pub19 lic health, populations and regions particularly vul20 nerable to the effects of climate change, and strate21 gies and mechanisms to prepare for and respond to 

22 the impacts of climate change on public health; and 

23 (2) advise the Secretary regarding the best 

24 science available for purposes of issuing the national 

25 strategic action plan. 


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1 SEC. 6. REPORTS. 

2 (a) NEEDS ASSESSMENT.— 

3 (1) IN GENERAL.—The Secretary shall seek to 

4 enter into, by not later than 6 months after the date 

5 of the enactment of this Act, an agreement with the 

6 National Research Council and the Institute of Med7 icine to complete a report that— 

8 (A) assesses the needs for health profes9 sionals to prepare for and respond to climate 

10 change impacts on public health; and 

11 (B) recommends programs to meet those 

12 needs. 

13 (2) SUBMISSION.—The agreement under para14 graph (1) shall require the completed report to be 

15 submitted to the Congress and the Secretary and 

16 made publicly available not later than 1 year after 

17 the date of the agreement. 

18 (b) CLIMATE CHANGE HEALTH PROTECTION AND

19 PROMOTION REPORTS.— 

20 (1) IN GENERAL.—The Secretary shall offer to 

21 enter into, not later than 6 months after the submis22 sion of the report under subsection (a)(2), an agree23 ment with the National Research Council and the 

24 Institute of Medicine, under which the National Re25 search Council and the Institute of Medicine will 

26 prepare periodic reports to aid health professionals 


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1 in preparing for and responding to the adverse 

2 health effects of climate change that— 

3 (A) review scientific developments on 

4 health impacts of climate change; and 

5 (B) recommend changes to the national 

6 strategic action plan. 

7 (2) SUBMISSION.—The agreement under para8 graph (1) shall require a report to be submitted to 

9 the Congress and the Secretary and made publicly 

10 available not later than July 1, 2013, and every 4 

11 years thereafter. 

12 SEC. 7. DEFINITIONS. 

13 In this Act: 

14 (1) HEALTH IMPACT ASSESSMENT.—The term 

15 ‘‘health impact assessment’’ means a combination of 

16 procedures, methods, and tools by which a policy, 

17 program, or project may be judged as to its potential 

18 effects on the health of a population, and the dis19 tribution of those effects within the population. 

20 (2) NATIONAL STRATEGIC ACTION PLAN.—The 

21 term ‘‘national strategic action plan’’ means the 

22 plan issued and revised under section 4. 

23 (3) SECRETARY.—Unless otherwise specified, 

24 the term ‘‘Secretary’’ means the Secretary of Health 

25 and Human Services. 


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1 SEC. 8. AUTHORIZATION OF APPROPRIATIONS. 

2 (a) IN GENERAL.—There are authorized to be appro3 priated such sums as may be necessary to carry out this 

4 Act. 

5 (b) APPROPRIATIONS TO HHS.—All funds appro6 priated to carry out this Act shall be appropriated to the 

7 Secretary. 

8 (c) DISTRIBUTION OF FUNDS BY HHS.—In carrying 

9 out this Act, the Secretary may make funds appropriated 

10 pursuant to this section available to— 

11 (1) other departments, agencies, and offices of 

12 the Federal Government; 

13 (2) foreign, State, tribal, and local govern14 ments; and 

15 (3) such other entities as the Secretary deter16 mines appropriate. 

17 (d) SUPPLEMENT, NOT REPLACE.—It is the intent 

18 of the Congress that funds appropriated to carry out this 

19 Act should be used to supplement, and not replace, exist20 ing sources of funding for public health. 

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