I 

118TH CONGRESS 

1ST SESSION H. R. 5007 

To provide for green and resilient health care infrastructure, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 27, 2023 

Ms. JAYAPAL introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To provide for green and resilient health care infrastructure, 

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 ‘‘Granting Resources 

5 for Eliminating Emissions Now in Hospitals Act’’ or the 

6 ‘‘GREEN Hospitals Act’’. 

7 SEC. 2. GREEN HILL-BURTON FUNDS FOR CLIMATE-READY 

8 MEDICAL FACILITIES. 

9 (a) GRANTS FOR CONSTRUCTION OR MODERNIZA10 TION PROJECTS.— 


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1 (1) IN GENERAL.—Section 1610(a) of the Pub2 lic Health Service Act (42 U.S.C. 300r(a)) is 

3 amended— 

4 (A) in paragraph (1)(A)— 

5 (i) in clause (i), by striking ‘‘, or’’ and 

6 inserting a semicolon; 

7 (ii) in clause (ii), by striking the pe8 riod at the end and inserting ‘‘; or’’; and 

9 (iii) by adding at the end the fol10 lowing: 

11 ‘‘(iii) increase capacity to provide essential 

12 health care and update medical facilities to become 

13 more resilient to climate disasters and public health 

14 crises to ensure access and availability of quality 

15 health care for communities in need.’’; and 

16 (B) by striking paragraph (3) and insert17 ing the following: 

18 ‘‘(3) PRIORITY.—In awarding grants under this sub19 section, the Secretary shall give priority to applicants 

20 whose projects will include, by design, resilience against 

21 natural disasters, climate change mitigation, or other nec22 essary predisaster adaptations to ensure continuous health 

23 care access and combat health risks due to climate change, 

24 such as— 


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1 ‘‘(A) installation of onsite distributed genera2 tion that combines energy-efficient devices, energy 

3 storage, and renewable energy in accordance with 

4 modern electrical safety standards for medical facili5 ties to allow the medical facility to access essential 

6 energy during power outages and optimize use of on7 site and offsite energy sources for emissions reduc8 tions; 

9 ‘‘(B) improving air conditioning, monitoring, 

10 and purifying through installation of high-efficiency 

11 heat pumps that provide both cooling and heating, 

12 air purifiers, air filtration systems, and air quality 

13 monitoring systems integrated with energy systems 

14 and energy efficiency considerations in preparation 

15 for future natural hazards and public health crises, 

16 such as wildfire, smog, extreme heat events, and 

17 pandemics; 

18 ‘‘(C) installation and maintenance of wetlands, 

19 drainage ponds, stormwater drainage, and any other 

20 green infrastructure to protect the medical facility 

21 from projected severe effects with respect to extreme 

22 weather, natural disasters, or climate change-related 

23 events, including sea-level rise, flooding, and in24 creased risk of wildfire; 


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1 ‘‘(D) green rooftops, walls, and indoor plant2 ings, particularly those that can provide publicly ac3 cessible temperature management and air quality 

4 improvements; 

5 ‘‘(E) tree planting and other green infrastruc6 ture to create publicly accessible cool space to ad7 dress urban heat islands; 

8 ‘‘(F) infrastructure upgrades that protect ac9 cess routes to the medical facility, such as long-term 

10 flood, wildfire, and other disaster mitigation for the 

11 roads, sidewalks, and public transit infrastructure 

12 that service the medical facility; 

13 ‘‘(G) the long-term maintenance of 

14 decarbonization and zero-emissions infrastructure in15 stalled using funds made available pursuant to para16 graph (4) or other funds; and 

17 ‘‘(H) any other type of plan or project the Sec18 retary determines will increase the sustainability and 

19 resiliency of a medical facility, protect patient health 

20 and community access during extreme weather, and 

21 advance environmental justice. 

22 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.—There 

23 is authorized to be appropriated to carry out this sub24 section $100,000,000,000 for fiscal year 2024, to remain 

25 available until expended.’’. 


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1 (2) TECHNICAL AMENDMENT.—Section 1610(b) 

2 of the Public Health Service Act (42 U.S.C. 

3 300r(b)) is amended by striking paragraph (3). 

4 (b) MEDICAL FACILITY PROJECT APPLICATIONS.— 

5 (1) IN GENERAL.—Section 1621(b)(1) of the 

6 Public Health Service Act (42 U.S.C. 300s–1(b)(1)) 

7 is amended— 

8 (A) in subparagraph (J), by striking ‘‘and’’ 

9 at the end; 

10 (B) in subparagraph (K), by striking the 

11 period at the end and inserting a semicolon; 

12 and 

13 (C) by adding at the end the following: 

14 ‘‘(L) reasonable assurance that the facility 

15 will have adequate staffing to fulfill the commu16 nity service obligation; and 

17 ‘‘(M) reasonable assurance that the facil18 ity— 

19 ‘‘(i) has a collective bargaining agree20 ment with 1 or more labor organizations 

21 representing employees at the facility; or 

22 ‘‘(ii) has an explicit policy not to 

23 interfere with the rights of employees of 

24 the facility under section 7 of the National 

25 Labor Relations Act.’’. 


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1 (2) APPLICATION FOR PLANNING GRANTS.— 

2 Section 1621 of the Public Health Service Act (42 

3 U.S.C. 300s–1) is amended by adding at the end the 

4 following: 

5 ‘‘(c) APPLICATION FOR PLANNING GRANTS.—An ap6 plication for a project submitted under part A or B shall 

7 deemed to be complete for purposes of section 3(d)(2) of 

8 the Granting Resources for Eliminating Emissions Now 

9 in Hospitals Act, and the application shall be deemed to 

10 have been submitted for purposes of consideration for a 

11 planning grant under that section.’’. 

12 SEC. 3. PLANNING AND EVALUATION GRANT PROGRAM. 

13 (a) DEFINITIONS.—In this section: 

14 (1) MEDICAL FACILITY.—The term ‘‘medical 

15 facility’’ means a hospital, public health center, out16 patient medical facility, rehabilitation facility, facil17 ity for long-term care, or other facility (as may be 

18 designated by the Secretary) for the provision of 

19 health care to ambulatory patients. 

20 (2) PROPOSED PROJECT.—The term ‘‘proposed 

21 project’’ means a construction or modernization 

22 project proposed by an eligible entity in a sustain23 ability and resiliency plan. 

24 (3) SECRETARY.—The term ‘‘Secretary’’ means 

25 the Secretary of Health and Human Services. 


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1 (4) SUSTAINABILITY AND RESILIENCY PLAN.— 

2 The term ‘‘sustainability and resiliency plan’’ means 

3 a plan, including comprehensive preproject evalua4 tion, for a construction or modernization project 

5 that would, in order to protect patient health and 

6 community access, enhance— 

7 (A) the sustainability of a medical facility 

8 and infrastructure surrounding the medical fa9 cility; and 

10 (B) the resiliency of that medical facility 

11 and infrastructure surrounding the medical fa12 cility to climate change and public health crises. 

13 (b) ESTABLISHMENT.—The Secretary shall establish 

14 a grant program, to be known as the ‘‘Planning and Eval15 uation Grant Program’’, under which the Secretary shall 

16 make planning grants to eligible entities to develop sus17 tainability and resiliency plans for medical facilities owned 

18 or operated by the eligible entity and infrastructure sur19 rounding the medical facilities. 

20 (c) ELIGIBLE ENTITIES.—To be eligible to receive a 

21 planning grant under subsection (b), an applicant shall 

22 be— 

23 (1) a State, Tribal government, or political sub24 division of a State or Tribal government, including 


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1 any city, town, county, borough, hospital district au2 thority, or public or quasi-public corporation; or 

3 (2) a nonprofit private entity. 

4 (d) APPLICATIONS.— 

5 (1) IN GENERAL.—Except as provided in para6 graph (2), an eligible entity seeking a planning 

7 grant under subsection (b) shall submit to the Sec8 retary an application at such time, in such manner, 

9 and containing such information as the Secretary 

10 may by regulation prescribe, including— 

11 (A) a description of the proposed project; 

12 (B) a summary and breakdown of the de13 mographics of the patient population served or 

14 potentially served by the medical facility under 

15 the proposed project, including information 

16 on— 

17 (i) whether the medical facility is a fa18 cility for which a majority of the revenue 

19 the facility receives for patient care is from 

20 reimbursements for medical care furnished 

21 to Medicare and Medicaid beneficiaries 

22 under titles XVIII and XIX of the Social 

23 Security Act (42 U.S.C. 1395 et seq. and 

24 1396 et seq.); and 


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1 (ii) other indications that individuals 

2 vulnerable to climate change are served or 

3 potentially served by the medical facility; 

4 (C) a description of the ways in which the 

5 proposed project— 

6 (i) will carry out 1 or more activities 

7 described in subsection (g); 

8 (ii) meet the needs of the community 

9 the medical facility serves, especially the 

10 needs of vulnerable populations; and 

11 (iii) meet the sustainability and resil12 iency needs of the medical facility due to 

13 climate risks and hazards; 

14 (D) a description of whether the commu15 nity served by the medical facility is an environ16 mental justice community; 

17 (E) a description of the ways in which the 

18 planning grant would be used to carry out 1 or 

19 more planning and evaluation activities de20 scribed in subsection (f); 

21 (F) reasonable assurance that all laborers 

22 and mechanics employed by contractors or sub23 contractors in the performance of work on a 

24 project will be paid wages at rates not less than 

25 those prevailing on similar work in the locality 


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1 as determined by the Secretary of Labor in ac2 cordance with subchapter IV of chapter 31 of 

3 part A of subtitle II of title 40, United States 

4 Code (commonly referred to as the ‘‘Davis5 Bacon Act’’) and the Secretary of Labor shall 

6 have with respect to such labor standards the 

7 authority and functions set forth in Reorganiza8 tion Plan Numbered 14 of 1950 (64 Stat. 

9 1267; 5 U.S.C. App.) and section 3145 of title 

10 40, United States Code; and 

11 (G) reasonable assurance that the facil12 ity— 

13 (i) has a collective bargaining agree14 ment with 1 or more labor organizations 

15 representing employees at the facility; or 

16 (ii) has an explicit policy not to inter17 fere with the rights of employees at the fa18 cility under section 7 of the National 

19 Labor Relations Act (29 U.S.C. 157). 

20 (2) ADDITIONAL APPLICATIONS.—An applica21 tion submitted under part A or B of title XVI of the 

22 Public Health Service Act (42 U.S.C. 300q et seq. 

23 and 42 U.S.C. 300r) shall be deemed to be a com24 plete application submitted for purposes of consider25 ation for a planning grant under subsection (b). 


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1 (e) SELECTION.—The Secretary shall— 

2 (1) in coordination with the Secretary of En3 ergy and the Administrator of the Environmental 

4 Protection Agency, if necessary, develop metrics to 

5 evaluate applications for planning grants under sub6 section (b); and 

7 (2) give priority to applications that focus on 

8 improving a medical facility— 

9 (A) for which— 

10 (i) a majority of the revenue the facil11 ity receives for patient care is from reim12 bursements for medical care furnished to 

13 Medicare and Medicaid beneficiaries under 

14 titles XVIII and XIX of the Social Secu15 rity Act (42 U.S.C. 1395 et seq. and 1396 

16 et seq.); or 

17 (ii) a high proportion of patients is 

18 uninsured, as determined by the Secretary; 

19 and 

20 (B) that is located in a neighborhood or 

21 serves a patient population that— 

22 (i) experiences low-air quality; 

23 (ii) lacks green space; 

24 (iii) bears higher cumulative pollution 

25 burdens; or 


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1 (iv) is at disproportionate risk of ex2 periencing the adverse effects of climate 

3 change. 

4 (f) PLANNING ACTIVITIES.—Planning and evaluation 

5 activities carried out by an eligible entity using grant 

6 funds received under subsection (b) shall include 1 or 

7 more of the following: 

8 (1) Performing project planning, community 

9 outreach and engagement, feasibility studies, and 

10 needs assessments of the local community and pa11 tient populations. 

12 (2) Performing engineering and climate-risk as13 sessments of the medical facility infrastructure and 

14 the access routes to the medical facility. 

15 (3) Providing management and operational as16 sistance for developing and receiving funding for the 

17 proposed project. 

18 (4) Other planning and evaluation activities and 

19 assessments as the Secretary determines appro20 priate. 

21 (g) PROPOSED PROJECTS.—Construction and mod22 ernization activities carried out by a proposed project 

23 under a sustainability and resiliency plan developed pursu24 ant to a planning grant received under subsection (b) may 

25 include— 


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1 (1) improvements to the infrastructure, build2 ings, and grounds of the medical facility, includ3 ing— 

4 (A) installation of onsite distributed gen5 eration that combines energy-efficient devices, 

6 energy storage, and renewable energy in accord7 ance with modern electrical safety standards for 

8 medical facilities to allow the medical facility to 

9 access essential energy during power outages 

10 and optimize use of onsite and offsite energy 

11 sources for emissions reductions; and 

12 (B) improving air conditioning, monitoring, 

13 and purifying through installation of high-effi14 ciency heat pumps that provide both cooling 

15 and heating, air purifiers, air filtration systems, 

16 and air quality monitoring systems integrated 

17 with energy systems and energy efficiency con18 siderations in preparation for future natural 

19 hazards and public health crises such as wild20 fire, smog, extreme heat events, and pandemics; 

21 (2) green infrastructure projects, such as— 

22 (A) installation and maintenance of wet23 lands, drainage ponds, and any other green in24 frastructure that would protect the medical fa25 cility from projected severe effects with respect 


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1 to extreme weather, natural disasters, or cli2 mate change-related events, including sea-level 

3 rise, flooding, and increased risk of wildfire; 

4 and 

5 (B) green rooftops, walls, and indoor 

6 plantings, particularly those that can provide 

7 publicly accessible temperature management 

8 and air quality improvements; 

9 (3) resiliency projects to secure local accessi10 bility to the medical facility by protecting the access 

11 routes to the medical facility, such as— 

12 (A) infrastructure upgrades that protect 

13 access routes to the medical facility, such as 

14 long-term flood, wildfire, and other disaster 

15 mitigation for the roads, sidewalks, and public 

16 transit infrastructure that service the medical 

17 facility; and 

18 (B) the long-term maintenance of 

19 decarbonization and zero-emissions infrastruc20 ture; and 

21 (4) any other type of activity the Secretary de22 termines will increase the sustainability and resil23 iency of a medical facility and protect patient health 

24 and community access during extreme weather. 


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1 (h) AMOUNT OF GRANT.—The total amount of a 

2 grant under subsection (b) shall not exceed $500,000. 

3 (i) TECHNICAL ASSISTANCE.—The Secretary, in co4 ordination with the Secretary of Energy, the Adminis5 trator of the Environmental Protection Agency, and the 

6 Secretary of Transportation, if necessary, directly or 

7 through partnerships with States, Tribal governments, 

8 and nonprofit organizations, shall provide technical assist9 ance to eligible entities interested in carrying out proposed 

10 projects that— 

11 (1) serve environmental justice communities or 

12 medically underserved communities; 

13 (2) demonstrate a commitment to provide job 

14 training, apprenticeship programs, and contracting 

15 opportunities to residents and small businesses 

16 owned by residents of the community that the med17 ical facility serves; 

18 (3) identify and further community priority ac19 tions and conduct robust community engagement; 

20 and 

21 (4) employ nature-based solutions that focus on 

22 protection, restoration, or management of ecological 

23 systems to safeguard public health, provide clean air 

24 and water, increase natural hazard resilience, and 

25 sequester carbon. 


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1 (j) PROHIBITION ON TRAINING REPAYMENT.—As a 

2 condition of receiving a grant or technical assistance under 

3 this section, an eligible entity shall certify that the eligible 

4 entity does not use, and if the eligible entity contracts with 

5 any staffing agency or training provider, that such agency 

6 or provider does not use, any provision in employment 

7 agreements, job training agreements, or apprenticeship 

8 program agreements that would require an employee or 

9 training or apprenticeship program participant to pay a 

10 debt if the employee or training or apprenticeship program 

11 participant’s employment or work relationship or training 

12 period with a specified employer or business entity is ter13 minated. 

14 (k) ENVIRONMENTAL JUSTICE COMMUNITIES.—The 

15 Secretary shall ensure that not less than 50 percent of 

16 grant funds awarded under subsection (b) are used for 

17 sustainability and resiliency plans for proposed projects lo18 cated in environmental justice communities. 

19 (l) AUTHORIZATION OF APPROPRIATIONS.—There is 

20 authorized to be appropriated to the Secretary to carry 

21 out this section $5,000,000,000 for fiscal year 2024, to 

22 remain available until expended. 

Æ 


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