II 

110TH CONGRESS 

2D SESSION S. 3586 

To provide loans to hospitals and nonprofit health care institutions to implement green building technologies, waste management techniques, and 

other environmentally sustainable practices to improve employee performance, reduce healthcare costs, and improve patient outcomes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25 (legislative day, SEPTEMBER 17), 2008 

Mrs. CLINTON introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide loans to hospitals and nonprofit health care institutions to implement green building technologies, waste 

management techniques, and other environmentally sustainable practices to improve employee performance, reduce healthcare costs, and improve patient outcomes. 

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 ‘‘Green Hospitals, 

5 Healthy Hospitals Act of 2008’’. 


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1 SEC. 2. LOANS FOR HEALTH CARE. 

2 (a) IN GENERAL.—The Secretary of Health and 

3 Human Services (referred to in this Act as the ‘‘Sec4 retary’’), acting in conjunction with the Administrator of 

5 the Health Resources and Services Administration, shall 

6 make available to eligible non-profit hospitals and non7 profit health care institutions 30-year no interest loans to 

8 be used to assist such entities to carry out new construc9 tion or to make renovations that will— 

10 (1) enable such entities to achieve compliance 

11 with the guidelines of the ‘‘Green Guide for Health 

12 Care’’; or 

13 (2) enable such entities to achieve compliance 

14 with any successor regulations determined appro15 priate by the Secretary. 

16 (b) ELIGIBILITY.—To be eligible to receive a loan 

17 under subsection (a), a non-profit hospital or non-profit 

18 health care institution shall submit to the Secretary an 

19 application at such time, in such manner, and containing 

20 such information and agreements as the Secretary may 

21 require. 

22 (c) GENERAL PROVISIONS RELATING TO LOANS.— 

23 (1) TERMS AND CONDITIONS.—The Secretary 

24 may not approve an application for a loan under this 

25 section unless the Secretary determines that the 

26 terms, conditions, security, and schedule and 


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1 amount of repayments with respect to the loan are 

2 sufficient to protect the financial interests of the 

3 United States and are otherwise reasonable. 

4 (2) PAYMENTS.—The Secretary may not ap5 prove an application for a loan under this section 

6 unless— 

7 (A) the Secretary is reasonably satisfied 

8 that the applicant therefore will be able to make 

9 payments of principal thereon when due; and 

10 (B) the applicant provides the Secretary 

11 with reasonable assurances that there will be 

12 available to such applicant such additional 

13 funds as may be necessary to complete the 

14 project or undertaking with respect to which 

15 such loan is requested. 

16 (3) REQUIREMENTS.—A loan made under this 

17 section shall— 

18 (A) have such security; 

19 (B) have such maturity date; 

20 (C) be repayable in such installments; and 

21 (D) be subject to such other terms and 

22 conditions (including provisions for recovery in 

23 case of default), as the Secretary determines to 

24 be necessary to carry out the purposes of this 


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1 section while adequately protecting the financial 

2 interests of the United States. 

3 (4) WAIVER OR RIGHT OF RECOVERY.—The 

4 Secretary may, for good cause but with due regard 

5 to the financial interests of the United States, waive 

6 any right of recovery which the Secretary has by 

7 reason of the failure of a applicant to make pay8 ments of principal on a loan made under this sec9 tion. 

10 (d) REGULATIONS.—Not later than 150 days after 

11 the date of enactment of this Act, the Secretary, in con12 sultation with the Secretary of the Treasury, shall promul13 gate final regulations and rules (with a comment period 

14 that does not exceed 60 days), that shall be in addition 

15 to, and consistent with this Act that shall be used to deter16 mine eligibility for participation in the program under this 

17 section, the scope of such program, the purposes for which 

18 loan funds may be used, the application requirements, the 

19 security requirements, and the requirements for the ad20 ministration and oversight of the program which shall in21 clude a system in which such loans are repaid to the 

22 United States. Such regulations shall provide that in de23 termining the entities that are eligible for participation in 

24 such loan program and in approving the applications of 

25 such entities, the Secretary shall give priority considerVerDate Aug 31 2005 06:03 Sep 29, 2008 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3586.IS S3586

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1 ation to non-profit hospitals or non-profit health institu2 tions that have a low income utilization rate (as defined 

3 in section 1923(b)(3) of the Social Security Act (42 

4 U.S.C. 1396r–4(b)(3))) that is greater than 25 percent. 

5 (e) EVALUATIONS.—Not later than 1 year after mak6 ing a loan under this section, and annually thereafter, the 

7 Secretary shall conduct an evaluation of new or updated 

8 green health care guidelines developed by entities such as 

9 the United States Green Building Council, and determine 

10 whether such guidelines should be included in the require11 ments for the loan program established under this section. 

12 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

13 authorized to be appropriated to carry out this section, 

14 $100,000,000 for each of fiscal years 2009 through 2013. 

15 Of the amount appropriate for any fiscal year under the 

16 preceding sentence, such sums as are determined nec17 essary by the Secretary shall be allocated to the Health 

18 Resource and Services Administration for the Administra19 tion of the program under this section. 

20 (g) CARRYOVER.—Amounts appropriated for a fiscal 

21 year under subsection (f) that are not disbursed in such 

22 fiscal year may be carried forward to the next fiscal year 

23 to be used under this section and applied to that fiscal 

24 year’s allocation. 


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1 SEC. 3. RESEARCH FOR HEALTH CARE. 

2 (a) INSTITUTE OF MEDICINE.—The Secretary shall 

3 enter into a contract with the Institute of Medicine for 

4 the submission of a report on the ways in which the use 

5 of green building technologies, waste management tech6 niques, and other environmentally sustainable practices 

7 improve employee performance, reduce health care costs, 

8 and improve patient outcomes. 

9 (b) AGENCY FOR HEALTHCARE RESEARCH AND

10 QUALITY.—Not later than 3 years after the date of enact11 ment of this Act, and every 3 years thereafter, the Agency 

12 for Healthcare Research and Quality shall include in the 

13 health care quality report under section 913(b)(2) of the 

14 Public Health Service Act (42 U.S.C. 299b–2(b)(2)), a 

15 section that summarizes the most recent research on green 

16 health care and the ways in which environmentally sus17 tainable practices can improve employee performance, re18 duce healthcare costs, and improve patient outcomes. 

Æ 


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