II 

113TH CONGRESS 

2D SESSION S. 2864 

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 SENATE OF THE UNITED STATES 

SEPTEMBER 18, 2014 

Mr. MARKEY (for himself, Mrs. BOXER, and Mr. WHITEHOUSE) 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 

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 Congress that the Federal Govern4 ment, in cooperation with international, State, tribal, and 

5 local governments, concerned public and private organiza6 tions, and citizens, should use all practicable means and 

7 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 limits the authority provided to 

3 or responsibility conferred on any Federal department or 

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

5 or authorizes any violation of any provision of any law (in6 cluding regulations), including any health, energy, envi7 ronmental, transportation, or any other law or regulation. 

8 SEC. 4. NATIONAL STRATEGIC ACTION PLAN. 

9 (a) REQUIREMENT.— 

10 (1) IN GENERAL.—The Secretary, not later 

11 than 2 years after the date of enactment of this Act, 

12 on the basis of the best available science, and in con13 sultation pursuant to paragraph (2), shall publish a 

14 strategic action plan to assist health professionals in 

15 preparing for and responding to the impacts of cli16 mate change on public health in the United States 

17 and other nations, particularly developing nations. 

18 (2) CONSULTATION.—In developing or making 

19 any revision to the national strategic action plan, the 

20 Secretary shall— 

21 (A) consult with the Director of the Cen22 ters for Disease Control and Prevention, the 

23 Administrator of the Environmental Protection 

24 Agency, the Director of the National Institutes 

25 of Health, the Secretary of Energy, other ap26 propriate Federal agencies, Indian tribes, State 


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1 and local governments, public health organiza2 tions, and scientists, and other interested stake3 holders; and 

4 (B) provide opportunity for public input. 

5 (b) CONTENTS.— 

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

7 through the Director of the Centers for Disease 

8 Control and Prevention, shall assist health profes9 sionals in preparing for and responding effectively 

10 and efficiently to the health effects of climate change 

11 through measures including— 

12 (A) developing, improving, integrating, and 

13 maintaining domestic and international disease 

14 surveillance systems and monitoring capacity to 

15 respond to health-related effects of climate 

16 change, including on topics addressing— 

17 (i) water, food, and vector-borne infec18 tious diseases and climate change; 

19 (ii) pulmonary effects, including re20 sponses to aeroallergens; 

21 (iii) cardiovascular effects, including 

22 impacts of temperature extremes; 

23 (iv) air pollution health effects, includ24 ing heightened sensitivity to air pollution; 

25 (v) hazardous algal blooms; 


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1 (vi) mental and behavioral health im2 pacts of climate change; 

3 (vii) the health of refugees, displaced 

4 persons, and vulnerable communities; 

5 (viii) the implications for communities 

6 vulnerable to health effects of climate 

7 change, as well as strategies for responding 

8 to climate change within these commu9 nities; and 

10 (ix) local and community-based health 

11 interventions for climate-related health im12 pacts; 

13 (B) creating tools for predicting and moni14 toring the public health effects of climate 

15 change on the international, national, regional, 

16 State, and local levels, and providing technical 

17 support to assist in their implementation; 

18 (C) developing public health communica19 tions strategies and interventions for extreme 

20 weather events and disaster response situations; 

21 (D) identifying and prioritizing commu22 nities and populations vulnerable to the health 

23 effects of climate change, and determining ac24 tions and communication strategies that should 

25 be taken to inform and protect these commuVerDate Sep 11 2014 00:08 Oct 01, 2014 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2864.IS S2864

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1 nities and populations from the health effects of 

2 climate change; 

3 (E) developing health communication, pub4 lic education, and outreach programs aimed at 

5 public health and health care professionals, and 

6 the general public, to promote preparedness and 

7 response strategies relating to climate change 

8 and public health, including the identification of 

9 greenhouse gas reduction behaviors that are 

10 health-promoting; 

11 (F) developing academic and regional cen12 ters of excellence devoted to— 

13 (i) researching relationships between 

14 climate change and health; 

15 (ii) expanding and training the public 

16 health workforce to strengthen the capacity 

17 of such workforce to respond to and pre18 pare for the health effects of climate 

19 change; 

20 (iii) creating and supporting academic 

21 fellowships focusing on the health effects 

22 of climate change; and 

23 (iv) training senior health ministry of24 ficials from developing nations to strength25 en the capacity of such nations to— 


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1 (I) prepare for and respond to 

2 the health effects of climate change; 

3 and 

4 (II) build an international net5 work of public health professionals 

6 with the necessary climate change 

7 knowledge base; 

8 (G) using techniques, including health im9 pact assessments, to assess various climate 

10 change public health preparedness and response 

11 strategies on international, national, State, re12 gional, tribal, and local levels, and make rec13 ommendations as to the strategies that best 

14 protect the public health; 

15 (H)(i) assisting in the development, imple16 mentation, and support of State, regional, trib17 al, and local preparedness, communication, and 

18 response plans (including with respect to the 

19 health departments of such entities) to antici20 pate and reduce the health threats of climate 

21 change; and 

22 (ii) acting through the Director of the Cen23 ters for Disease Control and Prevention or an 

24 appropriate Federal agency, pursuing collaboVerDate Sep 11 2014 00:08 Oct 01, 2014 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2864.IS S2864

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1 rative efforts to develop, integrate, and imple2 ment such plans; 

3 (I) acting through the Director of the Cen4 ters for Disease Control and Prevention or an 

5 appropriate Federal agency, creating a program 

6 to advance research as it relates to the effects 

7 of climate change on public health across Fed8 eral agencies, including research to— 

9 (i) identify and assess climate change 

10 health effects preparedness and response 

11 strategies; 

12 (ii) prioritize critical public health in13 frastructure projects related to potential 

14 climate change impacts that affect public 

15 health; and 

16 (iii) coordinate preparedness for cli17 mate change health impacts, including the 

18 development of modeling and forecasting 

19 tools; 

20 (J) providing technical assistance for the 

21 development, implementation, and support of 

22 preparedness and response plans to anticipate 

23 and reduce the health threats of climate change 

24 in developing nations; and 


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1 (K) carrying out other activities deter2 mined appropriate by the Secretary to plan for 

3 and respond to the impacts of climate change 

4 on public health. 

5 (c) REVISION.—The Secretary shall revise the na6 tional strategic action plan not later than July 1, 2017, 

7 and every 4 years thereafter, to reflect new information 

8 collected pursuant to implementation of the national stra9 tegic action plan and otherwise, including information 

10 on— 

11 (1) the status of critical environmental health 

12 parameters and related human health impacts; 

13 (2) the impacts of climate change on public 

14 health; and 

15 (3) advances in the development of strategies 

16 for preparing for and responding to the impacts of 

17 climate change on public health. 

18 (d) IMPLEMENTATION.— 

19 (1) IMPLEMENTATION THROUGH HHS.—The 

20 Secretary shall exercise the Secretary’s authority 

21 under this Act and other Federal statutes to achieve 

22 the goals and measures of the national strategic ac23 tion plan. 

24 (2) OTHER PUBLIC HEALTH PROGRAMS AND

25 INITIATIVES.—The Secretary and Federal officials of 


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1 other relevant Federal agencies shall administer 

2 public health programs and initiatives authorized by 

3 statutes other than this Act, subject to the require4 ments of such statutes, in a manner designed to 

5 achieve the goals of the national strategic action 

6 plan. 

7 (3) CDC.—In furtherance of the national stra8 tegic action plan, the Director of the Centers for 

9 Disease Control and Prevention shall— 

10 (A) conduct scientific research to assist 

11 health professionals in preparing for and re12 sponding to the impacts of climate change on 

13 public health; 

14 (B) provide funding for— 

15 (i) research on the health effects of 

16 climate change; and 

17 (ii) preparedness planning on the 

18 international, national, State, regional, and 

19 local levels to respond to or reduce the bur20 den of health effects of climate change; 

21 and 

22 (C) carry out other activities determined 

23 appropriate by the Director to prepare for and 

24 respond to the impacts of climate change on 

25 public health. 


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1 SEC. 5. ADVISORY BOARD. 

2 (a) ESTABLISHMENT.—The Secretary shall establish 

3 a permanent science advisory board comprised of not less 

4 than 10 and not more than 20 members. 

5 (b) APPOINTMENT OF MEMBERS.—The Secretary 

6 shall appoint the members of the science advisory board 

7 from among individuals who— 

8 (1) are recommended by the President of the 

9 National Academy of Sciences; and 

10 (2) have expertise in public health and human 

11 services, climate change, and other relevant dis12 ciplines. 

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

14 (1) provide scientific and technical advice and 

15 recommendations to the Secretary on the domestic 

16 and international impacts of climate change on pub17 lic health, populations and regions particularly vul18 nerable to the effects of climate change, and strate19 gies and mechanisms to prepare for and respond to 

20 the impacts of climate change on public health; and 

21 (2) advise the Secretary regarding the best 

22 science available for purposes of issuing the national 

23 strategic action plan. 

24 SEC. 6. REPORTS. 

25 (a) NEEDS ASSESSMENT.— 


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

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

3 of enactment of this Act, an agreement with the Na4 tional Research Council and the Institute of Medi5 cine to complete a report that— 

6 (A) assesses the needs for health profes7 sionals to prepare for and respond to climate 

8 change impacts on public health; and 

9 (B) recommends programs to meet those 

10 needs. 

11 (2) SUBMISSION.—The agreement under para12 graph (1) shall require the completed report to be 

13 submitted to Congress and the Secretary and made 

14 publicly available not later than 1 year after the 

15 date of the agreement. 

16 (b) CLIMATE CHANGE HEALTH PROTECTION AND

17 PROMOTION REPORTS.— 

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

19 enter into, not later than 6 months after the submis20 sion of the report under subsection (a)(2), an agree21 ment with the National Research Council and the 

22 Institute of Medicine, under which the National Re23 search Council and the Institute of Medicine will 

24 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 Congress and the Secretary and made publicly avail10 able not later than July 1, 2016, and every 4 years 

11 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 Congress that funds appropriated to carry out this Act 

19 should be used to supplement, and not replace, existing 

20 sources of funding for public health. 

Æ 


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