I 

116TH CONGRESS 

1ST SESSION H. R. 1243 

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

strategic action plan and program to assist health professionals and 

systems in preparing for and responding to the public health effects 

of climate change, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 14, 2019 

Mr. CARTWRIGHT (for himself, Mr. RASKIN, Mr. ENGEL, Mr. KHANNA, Ms. 

PINGREE, Mr. POCAN, Ms. JAYAPAL, Mr. HUFFMAN, Ms. WILD, Mr. 

COHEN, Ms. MATSUI, Mr. SCHNEIDER, Mr. CARBAJAL, Mr. LIPINSKI, 

Mr. CASTEN of Illinois, Ms. MCCOLLUM, Mr. TONKO, Mr. GRIJALVA, Mr. 

ROUDA, Mr. GREEN of Texas, and Ms. NORTON) 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 and program 

to assist health professionals and systems 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 of 2019’’. 


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

3 (a) FINDINGS.—The United States Global Change 

4 Research Program Climate and Health Assessment states 

5 that— 

6 (1) the impacts of human-induced climate 

7 change are increasing nationwide; 

8 (2) rising greenhouse gas concentrations result 

9 in increases in temperature, changes in precipitation, 

10 increases in the frequency and intensity of some ex11 treme weather events, and rising sea levels; 

12 (3) these climate change impacts endanger our 

13 health by affecting our food and water sources, the 

14 air we breathe, the weather we experience, and our 

15 interactions with the built and natural environments; 

16 and 

17 (4) as the climate continues to change, the risks 

18 to human health continue to grow. 

19 (b) SENSE OF CONGRESS.—It is the sense of Con20 gress that— 

21 (1) climate change is real; 

22 (2) human activity significantly contributes to 

23 climate change; 

24 (3) climate change negatively impacts health; 


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1 (4) climate change disproportionately impacts 

2 communities of color and low-income communities; 

3 and 

4 (5) the Federal Government, in cooperation 

5 with international, State, Tribal, and local govern6 ments, concerned public, private, and Native Amer7 ican organizations, and citizens, should use all prac8 ticable means and measures— 

9 (A) to assist the efforts of public health 

10 and health care professionals, first responders, 

11 health care systems, States, the District of Co12 lumbia, territories, municipalities, and Native 

13 American and local communities to incorporate 

14 measures to prepare public health and health 

15 care systems to respond to the impacts of cli16 mate change; 

17 (B) to ensure— 

18 (i) that the Nation’s public health and 

19 health care professionals have sufficient in20 formation to prepare for and respond to 

21 the adverse health impacts of climate 

22 change; 

23 (ii) the application of scientific re24 search in advancing understanding of— 


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1 (I) the health impacts of climate 

2 change; and 

3 (II) strategies to prepare for and 

4 respond to the health impacts of cli5 mate change; 

6 (iii) the identification of communities 

7 and populations vulnerable to the health 

8 impacts of climate change, including in9 fants, children, pregnant women, the elder10 ly, individuals with disabilities or pre11 existing illnesses, low-income populations, 

12 and unhoused individuals, and the develop13 ment of strategic response plans to be car14 ried out by public health and health care 

15 professionals for those communities; 

16 (iv) the improvement of health status 

17 and health equity through efforts to pre18 pare for and respond to climate change; 

19 and 

20 (v) the inclusion of health impacts in 

21 the development of climate change re22 sponses; 

23 (C) to encourage further research, inter24 disciplinary partnership, and collaboration 

25 among stakeholders in order to— 


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1 (i) understand and monitor the health 

2 impacts of climate change; 

3 (ii) improve public health knowledge 

4 and response strategies to climate change; 

5 (iii) identify actions and policies that 

6 are beneficial to health and that mitigate 

7 climate health impacts; and 

8 (iv) develop strategies to address 

9 water-, food-, and vector-borne infectious 

10 diseases and other public health emer11 gencies; 

12 (D) to enhance preparedness activities, and 

13 health care and public health infrastructure, re14 lating to climate change and health; 

15 (E) to encourage each and every commu16 nity to learn about the impacts of climate 

17 change on health; and 

18 (F) to assist the efforts of developing na19 tions to incorporate measures to prepare public 

20 health and health care systems to respond to 

21 the impacts of climate change. 

22 SEC. 3. RELATIONSHIP TO OTHER LAWS. 

23 Nothing in this Act limits the authority provided to 

24 or responsibility conferred on any Federal department or 

25 agency by any provision of any law (including regulations) 


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1 or authorizes any violation of any provision of any law (in2 cluding regulations), including any health, energy, envi3 ronmental, transportation, or any other law or regulation. 

4 SEC. 4. NATIONAL STRATEGIC ACTION PLAN AND PRO5 GRAM. 

6 (a) REQUIREMENT.— 

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

8 Human Services (referred to in this Act as the ‘‘Sec9 retary’’), on the basis of the best available science, 

10 and in consultation pursuant to paragraph (2), shall 

11 publish a strategic action plan and establish a pro12 gram to ensure the public health and health care 

13 systems are prepared for and can respond to the im14 pacts of climate change on health in the United 

15 States and other nations. 

16 (2) CONSULTATION.—In developing or making 

17 any revision to the national strategic action plan and 

18 program, the Secretary shall— 

19 (A) consult with the Director of the Cen20 ters for Disease Control and Prevention, the 

21 Administrator of the Environmental Protection 

22 Agency, the Director of the National Institutes 

23 of Health, the Under Secretary of Commerce 

24 for Oceans and Atmosphere, the Administrator 

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1 istration, the Director of the Indian Health 

2 Service, the Secretary of Defense, the Secretary 

3 of State, the Secretary of Veterans Affairs, 

4 other appropriate Federal agencies, Indian 

5 Tribes, State and local governments, public 

6 health organizations, scientists, representatives 

7 of at-risk populations, and other interested 

8 stakeholders; and 

9 (B) provide opportunity for public input 

10 and consultation with Indian tribes and Native 

11 American organizations. 

12 (b) ACTIVITIES.— 

13 (1) NATIONAL STRATEGIC ACTION PLAN.—Not 

14 later than 2 years after the date of enactment of 

15 this Act, the Secretary, acting through the Director 

16 of the Centers for Disease Control and Prevention, 

17 and in collaboration with other Federal agencies as 

18 appropriate, shall, on the basis of the best available 

19 science, and in consultation with the entities de20 scribed in subsection (a)(2), publish a national stra21 tegic action plan under paragraph (2) to guide the 

22 climate and health program and assist public health 

23 and health care professionals in preparing for and 

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1 lic health in the United States and other nations, 

2 particularly developing nations. 

3 (2) ASSESSMENT OF HEALTH SYSTEM CAPAC4 ITY.—The national strategic action plan shall in5 clude an assessment of the health system capacity of 

6 the United States to address climate change includ7 ing— 

8 (A) identifying and prioritizing commu9 nities and populations vulnerable to the health 

10 impacts of climate change; 

11 (B) providing outreach and communication 

12 aimed at public health and health care profes13 sionals and the public to promote preparedness 

14 and response strategies; 

15 (C) providing for programs across Federal 

16 agencies to advance research related to the im17 pacts of climate change on health; 

18 (D) identifying and assessing existing pre19 paredness and response strategies for the health 

20 impacts of climate change; 

21 (E) prioritizing critical public health and 

22 health care infrastructure projects; 

23 (F) providing modeling and forecasting 

24 tools of climate change health impacts, includ25 ing local impacts where possible; 


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1 (G) establishing academic and regional 

2 centers of excellence; 

3 (H) providing technical assistance and sup4 port for preparedness and response plans for 

5 the health threats of climate change in States, 

6 municipalities, territories, Indian Tribes, and 

7 developing nations; and 

8 (I) developing, improving, integrating, and 

9 maintaining domestic and international disease 

10 surveillance systems and monitoring capacity to 

11 respond to health-related impacts of climate 

12 change, including on topics addressing— 

13 (i) water-, food-, and vector-borne in14 fectious diseases and climate change; 

15 (ii) pulmonary effects, including re16 sponses to aeroallergens and toxic expo17 sures; 

18 (iii) cardiovascular effects, including 

19 impacts of temperature extremes; 

20 (iv) air pollution health effects, includ21 ing heightened sensitivity to air pollution; 

22 (v) harmful algal blooms; 

23 (vi) mental and behavioral health im24 pacts of climate change; 


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1 (vii) the health of migrants, refugees, 

2 displaced persons, and vulnerable commu3 nities; 

4 (viii) the implications for communities 

5 and populations vulnerable to the health 

6 effects of climate change, as well as strate7 gies for responding to climate change with8 in these communities; 

9 (ix) Tribal, local, and community10 based health interventions for climate-re11 lated health impacts; 

12 (x) extreme heat and weather events, 

13 including drought; 

14 (xi) decreased nutritional value of 

15 crops; and 

16 (xii) disruptions in access to routine 

17 and acute medical care. 

18 (3) CLIMATE AND HEALTH PROGRAM.—The 

19 Secretary, acting through the Director of the Cen20 ters for Disease Control and Prevention, and in col21 laboration with other Federal agencies, as appro22 priate, shall ensure that the climate and health pro23 gram established under this section addresses pri24 ority health actions including the following: 


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1 (A) Serve as a credible source of informa2 tion on the physical, mental, and behavioral 

3 health consequences of climate change for the 

4 United States population and globally. 

5 (B) Track data on environmental condi6 tions, disease risks, and disease occurrence re7 lated to climate change. 

8 (C) Expand capacity for modeling and 

9 forecasting health effects that may be climate10 related. 

11 (D) Enhance the science base to better un12 derstand the relationship between climate 

13 change and health outcomes. 

14 (E) Identify locations and population 

15 groups at greatest risk for specific health 

16 threats and effects, such as increased heat 

17 stress, degraded air and water quality, food- or 

18 water-related infections, vector-borne illnesses, 

19 pulmonary and cardiovascular effects, mental 

20 and behavioral health effects, and food, water, 

21 and nutrient insecurity. 

22 (F) Communicate the health-related as23 pects of climate change, including risks and as24 sociated costs and ways to reduce them, to the 


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1 public, decisionmakers, public health profes2 sionals, and health care providers. 

3 (G) Develop partnerships with other gov4 ernment agencies, the private sector, non5 governmental organizations, universities, and 

6 international organizations to more effectively 

7 address domestic and global health aspects of 

8 climate change. 

9 (H) Provide leadership to State and local 

10 governments, community leaders, health care 

11 professionals, nongovernmental organizations, 

12 environmental justice networks, faith-based 

13 communities, the private sector, and the public, 

14 domestically and internationally, regarding 

15 health protection from climate change effects. 

16 (I) Develop and implement preparedness 

17 and response plans for health threats such as 

18 heat waves, severe weather events, and infec19 tious diseases. 

20 (J) Provide technical advice and support to 

21 State and local health departments, the private 

22 sector, and others in developing and imple23 menting national and global preparedness meas24 ures related to the health effects of climate 

25 change. 


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1 (K) Promote workforce development by 

2 helping to ensure the training of a new genera3 tion of competent, experienced public health 

4 and health care professionals to respond to the 

5 health threats posed by climate change. 

6 (c) PERIODIC ASSESSMENT AND REVISION.—Not 

7 later than 4 years after the date of enactment of this Act, 

8 and every 4 years thereafter, the Secretary shall periodi9 cally assess, and revise as necessary, the national strategic 

10 action plan under subsection (b)(1) and the climate and 

11 health program under subsection (b)(1), to reflect new in12 formation collected pursuant to the implementation of the 

13 national strategic action plan and program and otherwise, 

14 including information on— 

15 (1) the status of critical environmental health 

16 indicators and related human health impacts; 

17 (2) the impacts of climate change on public 

18 health; and 

19 (3) advances in the development of strategies 

20 for preparing for and responding to the impacts of 

21 climate change on public health. 

22 (d) IMPLEMENTATION.— 

23 (1) IMPLEMENTATION THROUGH HHS.—The 

24 Secretary shall exercise the Secretary’s authority 

25 under this Act and other Federal statutes to achieve 


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1 the goals and measures of the national strategic ac2 tion plan and climate and health program. 

3 (2) OTHER PUBLIC HEALTH PROGRAMS AND

4 INITIATIVES.—The Secretary and Federal officials of 

5 other relevant Federal agencies shall administer 

6 public health programs and initiatives authorized by 

7 laws other than this Act, subject to the requirements 

8 of such laws, in a manner designed to achieve the 

9 goals of the national strategic action plan and cli10 mate and health program. 

11 SEC. 5. ADVISORY BOARD. 

12 (a) ESTABLISHMENT.—The Secretary shall, pursuant 

13 to the Federal Advisory Committee Act (5 U.S.C. App.), 

14 establish a permanent science advisory board to be com15 prised of not less than 10 and not more than 20 members. 

16 (b) APPOINTMENT OF MEMBERS.—The Secretary 

17 shall appoint the members of the science advisory board 

18 from among individuals who— 

19 (1) are recommended by the President of the 

20 National Academy of Sciences and the President of 

21 the National Academy of Medicine; and 

22 (2) have expertise in essential public health and 

23 health care services, including those related to vul24 nerable populations, climate change, and other rel25 evant disciplines. 


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1 (c) EXPERIENCE.—In appointing the members of the 

2 science advisory board, the Secretary shall ensure that the 

3 science advisory board includes members with practical or 

4 lived experience with relevant issues. 

5 (d) FUNCTIONS.—The science advisory board shall— 

6 (1) provide scientific and technical advice and 

7 recommendations to the Secretary on the domestic 

8 and international impacts of climate change on pub9 lic health, populations and regions particularly vul10 nerable to the effects of climate change, and strate11 gies and mechanisms to prepare for and respond to 

12 the impacts of climate change on public health; and 

13 (2) advise the Secretary regarding the best 

14 science available for purposes of issuing the national 

15 strategic action plan and conducting the climate and 

16 health program. 

17 SEC. 6. CLIMATE CHANGE HEALTH PROTECTION AND PRO18 MOTION REPORTS. 

19 (a) IN GENERAL.—The Secretary shall offer to enter 

20 into an agreement with the National Academies, under 

21 which the National Academies will prepare periodic re22 ports to aid public health and health care professionals 

23 in preparing for and responding to the adverse health ef24 fects of climate change that— 


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1 (1) review scientific developments on health im2 pacts of climate change; and 

3 (2) recommend changes to the national stra4 tegic action plan and climate and health program. 

5 (b) SUBMISSION.—The agreement under subsection 

6 (a) shall require a report to be submitted to Congress and 

7 the Secretary and made publicly available not later than 

8 2 years after the date of enactment of this Act, and every 

9 4 years thereafter. 

Æ 


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