II 

117TH CONGRESS 

1ST SESSION S. 423 

To direct the Secretary of Health and Human Services to establish a grant 

program to protect vulnerable mothers and babies from climate change 

risks, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 24, 2021 

Mr. MARKEY (for himself, Mr. MERKLEY, Mr. BLUMENTHAL, Mr. SANDERS, 

and Mr. BENNET) introduced the following bill; which was read twice and 

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

A BILL 

To direct the Secretary of Health and Human Services to 

establish a grant program to protect vulnerable mothers 

and babies from climate change risks, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Protecting Moms and Babies Against Climate Change 

6 Act’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 


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Sec. 1. Short title; table of contents. 

Sec. 2. Grant program to protect vulnerable mothers and babies from climate 

change risks. 

Sec. 3. Grant program for education and training at health profession schools. 

Sec. 4. NIH Consortium on Birth and Climate Change Research. 

Sec. 5. Strategy for identifying climate change risk zones for vulnerable mothers and babies. 

Sec. 6. Definitions. 

1 SEC. 2. GRANT PROGRAM TO PROTECT VULNERABLE 

2 MOTHERS AND BABIES FROM CLIMATE 

3 CHANGE RISKS. 

4 (a) IN GENERAL.—Not later than 180 days after the 

5 date of the enactment of this Act, the Secretary of Health 

6 and Human Services shall establish a grant program (in 

7 this section referred to as the ‘‘Program’’) to protect vul8 nerable individuals from risks associated with climate 

9 change. 

10 (b) GRANT AUTHORITY.—In carrying out the Pro11 gram, the Secretary may award, on a competitive basis, 

12 grants to 10 covered entities. 

13 (c) APPLICATIONS.—To be eligible for a grant under 

14 the Program, a covered entity shall submit to the Sec15 retary an application at such time, in such form, and con16 taining such information as the Secretary may require, 

17 which shall include, at a minimum, a description of the 

18 following: 

19 (1) Plans for the use of grant funds awarded 

20 under the Program and how patients and stakeVerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423

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1 holder organizations were involved in the develop2 ment of such plans. 

3 (2) How such grant funds will be targeted to 

4 geographic areas that have disproportionately high 

5 levels of risks associated with climate change for vul6 nerable individuals. 

7 (3) How such grant funds will be used to ad8 dress racial and ethnic disparities in— 

9 (A) adverse maternal and infant health 

10 outcomes; and 

11 (B) exposure to risks associated with cli12 mate change for vulnerable individuals. 

13 (4) Strategies to prevent an initiative assisted 

14 with such grant funds from causing— 

15 (A) adverse environmental impacts; 

16 (B) displacement of residents and busi17 nesses; 

18 (C) rent and housing price increases; or 

19 (D) disproportionate adverse impacts on 

20 racial and ethnic minority groups and other un21 derserved populations. 

22 (d) SELECTION OF GRANT RECIPIENTS.— 

23 (1) TIMING.—Not later than 270 days after the 

24 date of the enactment of this Act, the Secretary 


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1 shall select the recipients of grants under the Pro2 gram. 

3 (2) CONSULTATION.—In selecting covered enti4 ties for grants under the Program, the Secretary 

5 shall consult with— 

6 (A) representatives of stakeholder organi7 zations; 

8 (B) the Administrator of the Environ9 mental Protection Agency; 

10 (C) the Administrator of the National Oce11 anic and Atmospheric Administration; and 

12 (D) from the Department of Health and 

13 Human Services— 

14 (i) the Deputy Assistant Secretary for 

15 Minority Health; 

16 (ii) the Administrator of the Centers 

17 for Medicare & Medicaid Services; 

18 (iii) the Administrator of the Health 

19 Resources and Services Administration; 

20 (iv) the Director of the National Insti21 tutes of Health; and 

22 (v) the Director of the Centers for 

23 Disease Control and Prevention. 

24 (3) PRIORITY.—In selecting a covered entity to 

25 be awarded a grant under the Program, the SecVerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423

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1 retary shall give priority to covered entities that 

2 serve a county— 

3 (A) designated, or located in an area des4 ignated, as a nonattainment area pursuant to 

5 section 107 of the Clean Air Act (42 U.S.C. 

6 7407) for any air pollutant for which air quality 

7 criteria have been issued under section 108(a) 

8 of such Act (42 U.S.C. 7408(a)); 

9 (B) with a level of vulnerability of mod10 erate-to-high or higher, according to the Social 

11 Vulnerability Index of the Centers for Disease 

12 Control and Prevention; or 

13 (C) with temperatures that pose a risk to 

14 human health, as determined by the Secretary, 

15 in consultation with the Administrator of the 

16 National Oceanic and Atmospheric Administra17 tion and the Chair of the United States Global 

18 Change Research Program, based on the best 

19 available science. 

20 (4) LIMITATION.—A recipient of grant funds 

21 under the Program may not use such grant funds to 

22 serve a county that is served by any other recipient 

23 of a grant under the Program. 


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1 (e) USE OF FUNDS.—A covered entity awarded grant 

2 funds under the Program may only use such grant funds 

3 for the following: 

4 (1) Initiatives to identify risks associated with 

5 climate change for vulnerable individuals and to pro6 vide services and support to such individuals that 

7 address such risks, which may include— 

8 (A) training for health care providers, 

9 doulas, and other employees in hospitals, birth 

10 centers, midwifery practices, and other health 

11 care practices that provide prenatal or labor 

12 and delivery services to vulnerable individuals 

13 on the identification of, and patient counseling 

14 relating to, risks associated with climate change 

15 for vulnerable individuals; 

16 (B) hiring, training, or providing resources 

17 to community health workers and perinatal 

18 health workers who can help identify risks asso19 ciated with climate change for vulnerable indi20 viduals, provide patient counseling about such 

21 risks, and carry out the distribution of relevant 

22 services and support; 

23 (C) enhancing the monitoring of risks as24 sociated with climate change for vulnerable in25 dividuals, including by— 


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1 (i) collecting data on such risks in 

2 specific census tracts, neighborhoods, or 

3 other geographic areas; and 

4 (ii) sharing such data with local 

5 health care providers, doulas, and other 

6 employees in hospitals, birth centers, mid7 wifery practices, and other health care 

8 practices that provide prenatal or labor 

9 and delivery services to local vulnerable in10 dividuals; and 

11 (D) providing vulnerable individuals— 

12 (i) air conditioning units, residential 

13 weatherization support, filtration systems, 

14 household appliances, or related items; 

15 (ii) direct financial assistance; and 

16 (iii) services and support, including 

17 housing and transportation assistance, to 

18 prepare for or recover from extreme weath19 er events, which may include floods, hurri20 canes, wildfires, droughts, and related 

21 events. 

22 (2) Initiatives to mitigate levels of and exposure 

23 to risks associated with climate change for vulner24 able individuals, which shall be based on the best 


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1 available science and which may include initiatives 

2 to— 

3 (A) develop, maintain, or expand urban or 

4 community forestry initiatives and tree canopy 

5 coverage initiatives; 

6 (B) improve infrastructure, including 

7 buildings and paved surfaces; 

8 (C) develop or improve community out9 reach networks to provide culturally and lin10 guistically appropriate information and notifica11 tions about risks associated with climate change 

12 for vulnerable individuals; and 

13 (D) provide enhanced services to racial and 

14 ethnic minority groups and other underserved 

15 populations. 

16 (f) LENGTH OF AWARD.—A grant under this section 

17 shall be disbursed over 4 fiscal years. 

18 (g) TECHNICAL ASSISTANCE.—The Secretary shall 

19 provide technical assistance to a covered entity awarded 

20 a grant under the Program to support the development, 

21 implementation, and evaluation of activities funded with 

22 such grant. 

23 (h) REPORTS TO SECRETARY.— 

24 (1) ANNUAL REPORT.—For each fiscal year 

25 during which a covered entity is disbursed grant 


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1 funds under the Program, such covered entity shall 

2 submit to the Secretary a report that summarizes 

3 the activities carried out by such covered entity with 

4 such grant funds during such fiscal year, which shall 

5 include a description of the following: 

6 (A) The involvement of stakeholder organi7 zations in the implementation of initiatives as8 sisted with such grant funds. 

9 (B) Relevant health and environmental 

10 data, disaggregated, to the extent practicable, 

11 by race, ethnicity, gender, and pregnancy sta12 tus. 

13 (C) Qualitative feedback received from vul14 nerable individuals with respect to initiatives 

15 assisted with such grant funds. 

16 (D) Criteria used in selecting the geo17 graphic areas assisted with such grant funds. 

18 (E) Efforts to address racial and ethnic 

19 disparities in adverse maternal and infant 

20 health outcomes and in exposure to risks associ21 ated with climate change for vulnerable individ22 uals. 

23 (F) Any negative and unintended impacts 

24 of initiatives assisted with such grant funds, in25 cluding— 


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1 (i) adverse environmental impacts; 

2 (ii) displacement of residents and 

3 businesses; 

4 (iii) rent and housing price increases; 

5 and 

6 (iv) disproportionate adverse impacts 

7 on racial and ethnic minority groups and 

8 other underserved populations. 

9 (G) How the covered entity will address 

10 and prevent any impacts described in subpara11 graph (F). 

12 (2) PUBLICATION.—Not later than 30 days 

13 after the date on which a report is submitted under 

14 paragraph (1), the Secretary shall publish such re15 port on a public website of the Department of 

16 Health and Human Services. 

17 (i) REPORT TO CONGRESS.—Not later than the date 

18 that is 5 years after the date on which the Program is 

19 established, the Secretary shall submit to Congress and 

20 publish on a public website of the Department of Health 

21 and Human Services a report on the results of the Pro22 gram, including the following: 

23 (1) Summaries of the annual reports submitted 

24 under subsection (h). 


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1 (2) Evaluations of the initiatives assisted with 

2 grant funds under the Program. 

3 (3) An assessment of the effectiveness of the 

4 Program in— 

5 (A) identifying risks associated with cli6 mate change for vulnerable individuals; 

7 (B) providing services and support to such 

8 individuals; 

9 (C) mitigating levels of and exposure to 

10 such risks; and 

11 (D) addressing racial and ethnic disparities 

12 in adverse maternal and infant health outcomes 

13 and in exposure to such risks. 

14 (4) A description of how the Program could be 

15 expanded, including— 

16 (A) monitoring efforts or data collection 

17 that would be required to identify areas with 

18 high levels of risks associated with climate 

19 change for vulnerable individuals; 

20 (B) how such areas could be identified 

21 using the strategy developed under section 5; 

22 and 

23 (C) recommendations for additional fund24 ing. 


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1 (j) COVERED ENTITY DEFINED.—In this section, the 

2 term ‘‘covered entity’’ means a consortium of organiza3 tions serving a county that— 

4 (1) shall include a community-based organiza5 tion; and 

6 (2) may include— 

7 (A) another stakeholder organization; 

8 (B) the government of such county; 

9 (C) the governments of one or more mu10 nicipalities within such county; 

11 (D) a State or local public health depart12 ment or emergency management agency; 

13 (E) a local health care practice, which may 

14 include a licensed and accredited hospital, birth 

15 center, midwifery practice, or other health care 

16 practice that provides prenatal or labor and de17 livery services to vulnerable individuals; 

18 (F) an Indian tribe or tribal organization 

19 (as such terms are defined in section 4 of the 

20 Indian Self-Determination and Education As21 sistance Act (25 U.S.C. 5304)); 

22 (G) an Urban Indian organization (as de23 fined in section 4 of the Indian Health Care 

24 Improvement Act (25 U.S.C. 1603)); and 

25 (H) an institution of higher education. 


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1 (k) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section 

3 $100,000,000 for fiscal years 2021 through 2024. 

4 SEC. 3. GRANT PROGRAM FOR EDUCATION AND TRAINING 

5 AT HEALTH PROFESSION SCHOOLS. 

6 (a) IN GENERAL.—Not later than 1 year after the 

7 date of the enactment of this Act, the Secretary of Health 

8 and Human Services shall establish a grant program (in 

9 this section referred to as the ‘‘Program’’) to provide 

10 funds to health profession schools to support the develop11 ment and integration of education and training programs 

12 for identifying and addressing risks associated with cli13 mate change for vulnerable individuals. 

14 (b) GRANT AUTHORITY.—In carrying out the Pro15 gram, the Secretary may award, on a competitive basis, 

16 grants to health profession schools. 

17 (c) APPLICATION.—To be eligible for a grant under 

18 the Program, a health profession school shall submit to 

19 the Secretary an application at such time, in such form, 

20 and containing such information as the Secretary may re21 quire, which shall include, at a minimum, a description 

22 of the following: 

23 (1) How such health profession school will en24 gage with vulnerable individuals, and stakeholder or25 ganizations representing such individuals, in develVerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423

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1 oping and implementing the education and training 

2 programs supported by grant funds awarded under 

3 the Program. 

4 (2) How such health profession school will en5 sure that such education and training programs will 

6 address racial and ethnic disparities in exposure to, 

7 and the effects of, risks associated with climate 

8 change for vulnerable individuals. 

9 (d) USE OF FUNDS.—A health profession school 

10 awarded a grant under the Program shall use the grant 

11 funds to develop, and integrate into the curriculum and 

12 continuing education of such health profession school, edu13 cation and training on each of the following: 

14 (1) Identifying risks associated with climate 

15 change for vulnerable individuals and individuals 

16 with the intent to become pregnant. 

17 (2) How risks associated with climate change 

18 affect vulnerable individuals and individuals with the 

19 intent to become pregnant. 

20 (3) Racial and ethnic disparities in exposure to, 

21 and the effects of, risks associated with climate 

22 change for vulnerable individuals and individuals 

23 with the intent to become pregnant. 


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1 (4) Patient counseling and mitigation strategies 

2 relating to risks associated with climate change for 

3 vulnerable individuals. 

4 (5) Relevant services and support for vulnerable 

5 individuals relating to risks associated with climate 

6 change and strategies for ensuring vulnerable indi7 viduals have access to such services and support. 

8 (6) Implicit and explicit bias, racism, and dis9 crimination. 

10 (7) Related topics identified by such health pro11 fession school based on the engagement of such 

12 health profession school with vulnerable individuals 

13 and stakeholder organizations representing such in14 dividuals. 

15 (e) PARTNERSHIPS.—In carrying out activities with 

16 grant funds, a health profession school awarded a grant 

17 under the Program may partner with one or more of the 

18 following: 

19 (1) A State or local public health department. 

20 (2) A health care professional membership or21 ganization. 

22 (3) A stakeholder organization. 

23 (4) A health profession school. 

24 (5) An institution of higher education. 

25 (f) REPORTS TO SECRETARY.— 


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1 (1) ANNUAL REPORT.—For each fiscal year 

2 during which a health profession school is disbursed 

3 grant funds under the Program, such health profes4 sion school shall submit to the Secretary a report 

5 that describes the activities carried out with such 

6 grant funds during such fiscal year. 

7 (2) FINAL REPORT.—Not later than the date 

8 that is 1 year after the end of the last fiscal year 

9 during which a health profession school is disbursed 

10 grant funds under the Program, the health profes11 sion school shall submit to the Secretary a final re12 port that summarizes the activities carried out with 

13 such grant funds. 

14 (g) REPORT TO CONGRESS.—Not later than the date 

15 that is 6 years after the date on which the Program is 

16 established, the Secretary shall submit to Congress and 

17 publish on a public website of the Department of Health 

18 and Human Services a report that includes the following: 

19 (1) A summary of the reports submitted under 

20 subsection (f). 

21 (2) Recommendations to improve education and 

22 training programs at health profession schools with 

23 respect to identifying and addressing risks associ24 ated with climate change for vulnerable individuals. 


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1 (h) HEALTH PROFESSION SCHOOL DEFINED.—In 

2 this section, the term ‘‘health profession school’’ means 

3 an accredited— 

4 (1) medical school; 

5 (2) school of nursing; 

6 (3) midwifery program; 

7 (4) physician assistant education program; 

8 (5) teaching hospital; 

9 (6) residency or fellowship program; or 

10 (7) other school or program determined appro11 priate by the Secretary. 

12 (i) AUTHORIZATION OF APPROPRIATIONS.—There is 

13 authorized to be appropriated to carry out this section 

14 $5,000,000 for fiscal years 2021 through 2024. 

15 SEC. 4. NIH CONSORTIUM ON BIRTH AND CLIMATE CHANGE 

16 RESEARCH. 

17 (a) ESTABLISHMENT.—Not later than 1 year after 

18 the date of the enactment of this Act, the Director of the 

19 National Institutes of Health shall establish the Consor20 tium on Birth and Climate Change Research (in this sec21 tion referred to as the ‘‘Consortium’’). 

22 (b) DUTIES.— 

23 (1) IN GENERAL.—The Consortium shall co24 ordinate, across the institutes, centers, and offices of 

25 the National Institutes of Health, research on the 


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1 risks associated with climate change for vulnerable 

2 individuals. 

3 (2) REQUIRED ACTIVITIES.—In carrying out 

4 paragraph (1), the Consortium shall— 

5 (A) establish research priorities, including 

6 by prioritizing research that— 

7 (i) identifies the risks associated with 

8 climate change for vulnerable individuals 

9 with a particular focus on disparities in 

10 such risks among racial and ethnic minor11 ity groups and other underserved popu12 lations; and 

13 (ii) identifies strategies to reduce lev14 els of, and exposure to, such risks, with a 

15 particular focus on risks among racial and 

16 ethnic minority groups and other under17 served populations; 

18 (B) identify gaps in available data related 

19 to such risks; 

20 (C) identify gaps in, and opportunities for, 

21 research collaborations; 

22 (D) identify funding opportunities for com23 munity-based organizations and researchers 

24 from racially, ethnically, and geographically di25 verse backgrounds; and 


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1 (E) publish annual reports on the work 

2 and findings of the Consortium on a public 

3 website of the National Institutes of Health. 

4 (c) MEMBERSHIP.—The Director shall appoint to the 

5 Consortium representatives of such institutes, centers, and 

6 offices of the National Institutes of Health as the Director 

7 considers appropriate, including, at a minimum, rep8 resentatives of— 

9 (1) the National Institute of Environmental 

10 Health Sciences; 

11 (2) the National Institute on Minority Health 

12 and Health Disparities; 

13 (3) the Eunice Kennedy Shriver National Insti14 tute of Child Health and Human Development; 

15 (4) the National Institute of Nursing Research; 

16 and 

17 (5) the Office of Research on Women’s Health. 

18 (d) CHAIRPERSON.—The Chairperson of the Consor19 tium shall be designated by the Director and selected from 

20 among the representatives appointed under subsection (c). 

21 (e) CONSULTATION.—In carrying out the duties de22 scribed in subsection (b), the Consortium shall consult 

23 with— 

24 (1) the heads of relevant Federal agencies, in25 cluding— 


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1 (A) the Environmental Protection Agency; 

2 (B) the National Oceanic and Atmospheric 

3 Administration; 

4 (C) the Occupational Safety and Health 

5 Administration; and 

6 (D) from the Department of Health and 

7 Human Services— 

8 (i) the Office of Minority Health in 

9 the Office of the Secretary; 

10 (ii) the Centers for Medicare & Med11 icaid Services; 

12 (iii) the Health Resources and Serv13 ices Administration; 

14 (iv) the Centers for Disease Control 

15 and Prevention; 

16 (v) the Indian Health Service; and 

17 (vi) the Administration for Children 

18 and Families; and 

19 (2) representatives of— 

20 (A) stakeholder organizations; 

21 (B) health care providers and professional 

22 membership organizations with expertise in ma23 ternal health or environmental justice; 

24 (C) State and local public health depart25 ments; 


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1 (D) licensed and accredited hospitals, birth 

2 centers, midwifery practices, or other health 

3 care practices that provide prenatal or labor 

4 and delivery services to vulnerable individuals; 

5 and 

6 (E) institutions of higher education, in7 cluding such institutions that are minority-serv8 ing institutions or have expertise in maternal 

9 health or environmental justice. 

10 SEC. 5. STRATEGY FOR IDENTIFYING CLIMATE CHANGE 

11 RISK ZONES FOR VULNERABLE MOTHERS 

12 AND BABIES. 

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

14 Human Services, acting through the Director of the Cen15 ters for Disease Control and Prevention, shall develop a 

16 strategy (in this section referred to as the ‘‘Strategy’’) for 

17 designating areas that the Secretary determines to have 

18 a high risk of adverse maternal and infant health out19 comes among vulnerable individuals as a result of risks 

20 associated with climate change. 

21 (b) STRATEGY REQUIREMENTS.— 

22 (1) IN GENERAL.—In developing the Strategy, 

23 the Secretary shall establish a process to identify 

24 areas where vulnerable individuals are exposed to a 

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1 comes as a result of risks associated with climate 

2 change in conjunction with other factors that can 

3 impact such health outcomes, including— 

4 (A) the incidence of diseases associated 

5 with air pollution, extreme heat, and other envi6 ronmental factors; 

7 (B) the availability and accessibility of ma8 ternal and infant health care providers; 

9 (C) English-language proficiency among 

10 women of reproductive age; 

11 (D) the health insurance status of women 

12 of reproductive age; 

13 (E) the number of women of reproductive 

14 age who are members of racial or ethnic groups 

15 with disproportionately high rates of adverse 

16 maternal and infant health outcomes; 

17 (F) the socioeconomic status of women of 

18 reproductive age, including with respect to— 

19 (i) poverty; 

20 (ii) unemployment; 

21 (iii) household income; and 

22 (iv) educational attainment; and 

23 (G) access to quality housing, transpor24 tation, and nutrition. 


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1 (2) RESOURCES.—In developing the Strategy, 

2 the Secretary shall identify, and incorporate a de3 scription of, the following: 

4 (A) Existing mapping tools or Federal pro5 grams that identify— 

6 (i) risks associated with climate 

7 change for vulnerable individuals; and 

8 (ii) other factors that can influence 

9 maternal and infant health outcomes, in10 cluding the factors described in paragraph 

11 (1). 

12 (B) Environmental, health, socioeconomic, 

13 and demographic data relevant to identifying 

14 risks associated with climate change for vulner15 able individuals. 

16 (C) Existing monitoring networks that col17 lect data described in subparagraph (B), and 

18 any gaps in such networks. 

19 (D) Federal, State, and local stakeholders 

20 involved in maintaining monitoring networks 

21 identified under subparagraph (C), and how 

22 such stakeholders are coordinating their moni23 toring efforts. 

24 (E) Additional monitoring networks, and 

25 enhancements to existing monitoring networks, 


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1 that would be required to address gaps identi2 fied under subparagraph (C), including at the 

3 subcounty and census tract level. 

4 (F) Funding amounts required to establish 

5 the monitoring networks identified under sub6 paragraph (E) and recommendations for Fed7 eral, State, and local coordination with respect 

8 to such networks. 

9 (G) Potential uses for data collected and 

10 generated as a result of the Strategy, including 

11 how such data may be used in determining re12 cipients of grants under the program estab13 lished by section 2 or other similar programs. 

14 (H) Other information the Secretary con15 siders relevant for the development of the Strat16 egy. 

17 (c) COORDINATION AND CONSULTATION.—In devel18 oping the Strategy, the Secretary shall— 

19 (1) coordinate with the Administrator of the 

20 Environmental Protection Agency and the Adminis21 trator of the National Oceanic and Atmospheric Ad22 ministration; and 

23 (2) consult with— 

24 (A) stakeholder organizations; 


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1 (B) health care providers and professional 

2 membership organizations with expertise in ma3 ternal health or environmental justice; 

4 (C) State and local public health depart5 ments; 

6 (D) licensed and accredited hospitals, birth 

7 centers, midwifery practices, or other health 

8 care providers that provide prenatal or labor 

9 and delivery services to vulnerable individuals; 

10 and 

11 (E) institutions of higher education, in12 cluding such institutions that are minority-serv13 ing institutions or have expertise in maternal 

14 health or environmental justice. 

15 (d) NOTICE AND COMMENT.—At least 240 days be16 fore the date on which the Strategy is published in accord17 ance with subsection (e), the Secretary shall provide— 

18 (1) notice of the Strategy on a public website 

19 of the Department of Health and Human Services; 

20 and 

21 (2) an opportunity for public comment of at 

22 least 90 days. 

23 (e) PUBLICATION.—Not later than 18 months after 

24 the date of the enactment of this Act, the Secretary shall 


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1 publish on a public website of the Department of Health 

2 and Human Services— 

3 (1) the Strategy; 

4 (2) the public comments received under sub5 section (d); and 

6 (3) the responses of the Secretary to such pub7 lic comments. 

8 SEC. 6. DEFINITIONS. 

9 In this Act, the following definitions apply: 

10 (1) ADVERSE MATERNAL AND INFANT HEALTH

11 OUTCOMES.—The term ‘‘adverse maternal and in12 fant health outcomes’’ includes the outcomes of 

13 preterm birth, low birth weight, stillbirth, infant or 

14 maternal mortality, and severe maternal morbidity. 

15 (2) INSTITUTION OF HIGHER EDUCATION.—The 

16 term ‘‘institution of higher education’’ has the 

17 meaning given such term in section 101 of the High18 er Education Act of 1965 (20 U.S.C. 1001). 

19 (3) MINORITY-SERVING INSTITUTION.—The 

20 term ‘‘minority-serving institution’’ means an entity 

21 specified in any of paragraphs (1) through (7) of 

22 section 371(a) of the Higher Education Act of 1965 

23 (20 U.S.C. 1067q(a)). 

24 (4) RACIAL AND ETHNIC MINORITY GROUP.— 

25 The term ‘‘racial and ethnic minority group’’ has the 


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1 meaning given such term in section 1707(g) of the 

2 Public Health Service Act (42 U.S.C. 300u–6(g)). 

3 (5) RISKS ASSOCIATED WITH CLIMATE

4 CHANGE.—The term ‘‘risks associated with climate 

5 change’’ includes risks associated with extreme heat, 

6 air pollution, extreme weather events, and other en7 vironmental issues associated with climate change 

8 that can result in adverse maternal and infant 

9 health outcomes. 

10 (6) STAKEHOLDER ORGANIZATION.—The term 

11 ‘‘stakeholder organization’’ means— 

12 (A) a community-based organization with 

13 expertise in providing assistance to vulnerable 

14 individuals; 

15 (B) a nonprofit organization with expertise 

16 in maternal or infant health or environmental 

17 justice; or 

18 (C) a patient advocacy organization rep19 resenting vulnerable individuals. 

20 (7) VULNERABLE INDIVIDUAL.—The term ‘‘vul21 nerable individual’’ means— 

22 (A) an individual who is pregnant; 

23 (B) an individual who was pregnant during 

24 any portion of the preceding 1-year period; and 


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28 

•S 423 IS

1 (C) an individual under 3 years of age. 

Æ 


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