Green New Deal for Health Act



<html><body><pre>[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1229 Introduced in Senate (IS)]

&lt;DOC&gt;






118th CONGRESS
  1st Session
                                S. 1229

  To establish a Green New Deal for Health to prepare and empower the 
health care sector to protect the health and well-being of our workers, 
our communities, and our planet in the face of the climate crisis, and 
                          for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 20, 2023

  Mr. Markey (for himself, Mr. Merkley, Mr. Sanders, and Ms. Warren) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To establish a Green New Deal for Health to prepare and empower the 
health care sector to protect the health and well-being of our workers, 
our communities, and our planet in the face of the climate crisis, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Green New Deal for 
Health Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Findings and sense of Congress on health and climate change.
                 TITLE I--WHOLE-OF-GOVERNMENT APPROACH

Sec. 101. Definitions.
Sec. 102. Office of Climate Change and Health Equity; national 
                            strategic action plan.
Sec. 103. Advisory board.
Sec. 104. Climate change health protection and promotion reports.
Sec. 105. Authorization of appropriations.
           TITLE II--PROTECTING ESSENTIAL HEALTH CARE ACCESS

Sec. 201. Maintenance of health care access relating to hospital 
                            discontinuation of services or closure.
Sec. 202. Empowering community health in environmental justice 
                            communities.
       TITLE III--GREEN AND RESILIENT HEALTH CARE INFRASTRUCTURE

Sec. 301. Green Hill-Burton funds for climate-ready medical facilities.
Sec. 302. Planning and Evaluation Grant Program.
              TITLE IV--HEALTH CARE SECTOR DECARBONIZATION

Sec. 401. Office of Sustainability and Environmental Impact.
Sec. 402. Climate risk disclosure for medical supplies.
Sec. 403. Green health care manufacturing.
        TITLE V--A HEALTH WORKFORCE TO TACKLE THE CLIMATE CRISIS

Sec. 501. Education and training relating to health risks associated 
                            with climate change.
Sec. 502. Building a community health workforce for the climate crisis.
Sec. 503. Safeguarding essential health care workers.
           TITLE VI--SAFE, STRONG, AND RESILIENT COMMUNITIES

        Subtitle A--Empowering Resilient Community Mental Health

Sec. 601. Grants for resilient community mental health.
           Subtitle B--Understanding and Preventing Heat Risk

Sec. 611. Definitions.
Sec. 612. Study on extreme heat information and response.
Sec. 613. Financial assistance for research and resilience in 
                            addressing extreme heat risks.
Sec. 614. Authorization of appropriations.
             Subtitle C--Home Resiliency for Medical Needs

Sec. 621. Medicare coverage of medically necessary home resiliency 
                            services.
       TITLE VII--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH

Sec. 701. Research and innovation for climate and health.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Environmental justice community.--The term 
        ``environmental justice community'' means a community with 
        significant representation of communities of color, low-income 
        communities, or Tribal and Indigenous communities that 
        experiences, or is at risk of experiencing, higher or more 
        adverse human health or environmental effects.
            (2) Individual disproportionately affected by climate 
        change.--The term ``individual disproportionately affected by 
        climate change'' means an individual that may face elevated 
        mental and physical health risks due to climate change based on 
        2 or more of the following factors:
                    (A) Age under 5 years old or over 65 years old.
                    (B) Race and ethnicity, and experience of racial 
                bias.
                    (C) Sex, gender, and gender minority status.
                    (D) Being of reproductive age.
                    (E) Exposure to environmental health risks due to 
                living conditions or location, including current or 
                past experience of homelessness.
                    (F) Occupation or exposure to occupational hazards.
                    (G) Household income.
                    (H) Disability.
                    (I) Co-morbidities.
                    (J) Current or past exposure to personal or 
                systemic trauma, including natural disasters.
                    (K) Immigration status.
                    (L) Language isolation.
            (3) Medically underserved community.--The term ``medically 
        underserved community'' has the meaning given such term in 
        section 799B of the Public Health Service Act (42 U.S.C. 295p).

SEC. 3. FINDINGS AND SENSE OF CONGRESS ON HEALTH AND CLIMATE CHANGE.

    (a) Findings.--Congress finds that, according to the assessment of 
the United States Global Change Research Program entitled ``The Impacts 
of Climate Change on Human Health in the United States: A Scientific 
Assessment'' and dated 2016--
            (1) the impacts of human-induced climate change are 
        increasing nationwide;
            (2) rising greenhouse gas concentrations result in 
        increases in temperature, changes in precipitation, increases 
        in the frequency and intensity of some extreme weather events, 
        and rising sea levels;
            (3) the climate change impacts described in paragraph (2) 
        endanger our health by affecting--
                    (A) our access to care, food, and water sources;
                    (B) the air we breathe;
                    (C) the weather we experience; and
                    (D) our interactions with the built and natural 
                environments; and
            (4) as the climate continues to change, the risks to human 
        health continue to grow.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) climate change poses threats to the United States and 
        globally through its impacts on society, the economy, the 
        physical environment, and physical and mental health;
            (2) climate change health threats are growing in scale and 
        severity;
            (3) climate change disproportionately affects individuals 
        in the United States who are economically disadvantaged, belong 
        to communities of color, or have other social and health 
        vulnerabilities;
            (4) the health care sector accounts for 8.5 percent of 
        United States emissions, further worsening the overall health 
        impacts of climate change; and
            (5) the Federal Government, working with international, 
        State, Tribal, and local governments, nongovernmental 
        organizations, businesses, and individuals, should use all 
        practicable means and measures--
                    (A) to deploy a whole-of-government and whole-of-
                health approach to protect our collective health from 
                the impacts of climate change and to mitigate 
                environmental health impacts from health sector 
                operations;
                    (B) to build a just health care ecosystem where all 
                Americans have access to dignified, high-quality care 
                in their communities;
                    (C) to ensure the health care system is resilient 
                to extreme weather and can continue to provide care 
                before, during, and after crises;
                    (D) to lead the health sector to decarbonize its 
                facilities and operations in an equitable and just 
                manner;
                    (E) to empower a thriving health workforce with 
                good, high-wage union jobs and to recognize the value 
                of all of the essential workers that enable high-
                quality health care; and
                    (F) to invest in, empower, and build safe, strong, 
                and resilient communities.

                 TITLE I--WHOLE-OF-GOVERNMENT APPROACH

SEC. 101. DEFINITIONS.

    In this title:
            (1) Director.--The term ``Director'' means the Director of 
        the Office.
            (2) National strategic action plan.--The term ``national 
        strategic action plan'' means the national strategic action 
        plan published pursuant to section 102(b)(1).
            (3) Office.--The term ``Office'' means the Office of 
        Climate Change and Health Equity established by section 
        102(a)(1).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 102. OFFICE OF CLIMATE CHANGE AND HEALTH EQUITY; NATIONAL 
              STRATEGIC ACTION PLAN.

    (a) Office of Climate Change and Health Equity.--
            (1) Establishment.--
                    (A) In general.--There is established within the 
                Department of Health and Human Services the Office of 
                Climate Change and Health Equity.
                    (B) Purpose.--The purpose of the Office shall be to 
                facilitate a robust, Federal response to the impact of 
                climate change on the health of the American people and 
                the health care system.
                    (C) Director.--There is established the position of 
                Director of the Office, who--
                            (i) shall be the head of the Office; and
                            (ii) may report to the Assistant Secretary 
                        for Health.
            (2) Activities.--The duties of the Office shall be to 
        address priority health actions relating to the health impacts 
        of climate change, including by doing each of the following:
                    (A) Contribute to assessments of how climate change 
                is affecting the health of individuals living in the 
                United States.
                    (B) Understand the needs of the populations most 
                disproportionately affected by climate-related health 
                threats.
                    (C) Serve as a credible source of information on 
                the physical, mental, and behavioral health 
                consequences of climate change.
                    (D) Align Federal efforts to deploy climate-
                conscious human services and direct services to support 
                and protect populations composed of individuals 
                disproportionately affected by climate change.
                    (E) Create and distribute tools and resources to 
                support climate resilience for the health sector, 
                community-based organizations, and individuals.
                    (F) Create and distribute tools and resources to 
                support health sector efforts to track and decrease 
                greenhouse gas emissions.
                    (G) Lead efforts to reduce the carbon footprint and 
                environmental impacts of the health sector.
                    (H) Carry out other activities determined 
                appropriate by the Secretary.
    (b) National Strategic Action Plan.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary, on the basis of the best 
        available science, and in consultation pursuant to paragraph 
        (2), shall publish a national strategic action plan to 
        coordinate effective deployment of Federal efforts to ensure 
        that public health and health care systems are prepared for and 
        can respond to the impacts of climate change on health in the 
        United States.
            (2) Consultation.--In developing or making any revision to 
        the national strategic action plan, the Secretary shall--
                    (A) consult with the Director, the Administrator of 
                the Environmental Protection Agency, the Under 
                Secretary of Commerce for Oceans and Atmosphere, the 
                Administrator of the National Aeronautics and Space 
                Administration, the Director of the Indian Health 
                Service, the Secretary of Labor, the Secretary of 
                Defense, the Secretary of State, the Secretary of 
                Veterans Affairs, the National Environmental Justice 
                Advisory Council, the heads of other appropriate 
                Federal agencies, Tribal governments, and State and 
                local government officials; and
                    (B) provide meaningful opportunity for engagement, 
                comment, and consultation with relevant public 
                stakeholders, particularly representatives of 
                populations composed of individuals disproportionately 
                affected by climate change, environmental justice 
                communities, Tribal communities, health care providers, 
                public health organizations, and scientists.
            (3) National strategic action plan components.--The 
        national strategic action plan shall include an assessment of, 
        and strategies to improve, the health sector capacity of the 
        United States to address climate change, including--
                    (A) identifying, prioritizing, and engaging 
                communities and populations who are disproportionately 
                affected by exposures to climate hazards;
                    (B) addressing mental and physical health 
                disparities exacerbated by climate impacts to enhance 
                community health resilience;
                    (C) identifying the link between environmental 
                injustice and vulnerability to the impacts of climate 
                change and prioritizing those who have been harmed by 
                environmental and climate injustice;
                    (D) providing outreach and communication aimed at 
                public health and health care professionals and the 
                public to promote preparedness and response strategies;
                    (E) tracking and assessing programs across Federal 
                agencies to advance research related to the impacts of 
                climate change on health;
                    (F) identifying and assessing existing preparedness 
                and response strategies for the health impacts of 
                climate change;
                    (G) prioritizing critical public health and health 
                care infrastructure projects;
                    (H) providing modeling and forecasting tools of 
                climate change health impacts, including local impacts, 
                where feasible;
                    (I) establishing academic and regional centers of 
                excellence;
                    (J) recommending models for maintaining access to 
                health care during extreme weather;
                    (K) providing technical assistance and support for 
                preparedness and response plans for the health threats 
                of climate change in States, municipalities, 
                territories, Indian Tribes, and developing countries;
                    (L) addressing the impacts of fossil fuel pollution 
                and greenhouse gas emissions on the health of 
                individuals living in the United States;
                    (M) tracking health care sector contributions to 
                greenhouse gas emissions and identifying actions to 
                reduce those emissions;
                    (N) recommending new regulations or policies to 
                address identified gaps in the health system capacity 
                to effectively reduce emissions, reduce environmental 
                impact, and address climate change; and
                    (O) developing, improving, integrating, and 
                maintaining disease surveillance systems and monitoring 
                capacity to respond to health-related impacts of 
                climate change, including on topics addressing--
                            (i) water-, food-, and vector-borne 
                        infectious diseases and climate change;
                            (ii) pulmonary effects, including responses 
                        to aeroallergens, infectious agents, and toxic 
                        exposures;
                            (iii) cardiovascular effects, including 
                        impacts of temperature extremes;
                            (iv) air pollution health effects, 
                        including heightened sensitivity to air 
                        pollution such as wildfire smoke;
                            (v) reproductive health effects, including 
                        access to reproductive health care;
                            (vi) harmful algal blooms;
                            (vii) mental and behavioral health impacts 
                        of climate change;
                            (viii) the health of migrants, refugees, 
                        displaced persons, and communities composed of 
                        individuals disproportionately affected by 
                        climate change;
                            (ix) the implications for communities and 
                        populations vulnerable to the health effects of 
                        climate change, as well as strategies for 
                        responding to climate change within such 
                        communities;
                            (x) Tribal, local, and community-based 
                        health interventions for climate-related health 
                        impacts;
                            (xi) extreme heat and weather events;
                            (xii) decreased nutritional value of crops; 
                        and
                            (xiii) disruptions in access to routine and 
                        acute medical care, public health programs, and 
                        other supportive services for maintaining 
                        health.
    (c) Periodic Assessment and Revision.--Not later than 1 year after 
the date of first publication of the national strategic action plan, 
and annually thereafter, the Secretary shall periodically assess, and 
revise as necessary, the national strategic action plan, to reflect new 
information collected, including information on--
            (1) the status of and trends in critical environmental 
        health indicators and related human health impacts;
            (2) the trends in and impacts of climate change on public 
        health;
            (3) advances in the development of strategies for preparing 
        for and responding to the impacts of climate change on public 
        health; and
            (4) the effectiveness of the implementation of the national 
        strategic action plan in protecting against climate change 
        health threats.
    (d) Implementation.--
            (1) Implementation through hhs.--The Secretary shall 
        exercise the Secretary's authority under this title and other 
        Federal statutes to achieve the goals and measures of the 
        Office and the national strategic action plan.
            (2) Other public health programs and initiatives.--The 
        Secretary and Federal officials of other relevant Federal 
        agencies shall administer public health programs and 
        initiatives authorized by laws other than this title, subject 
        to the requirements of such laws, in a manner designed to 
        achieve the goals of the Office and the national strategic 
        action plan.
            (3) Health impact assessment.--
                    (A) In general.--Not later than 180 days after the 
                date of enactment of this Act, the Secretary shall 
                identify proposed and current laws, policies, and 
                programs that are of particular interest for their 
                impact in contributing to or alleviating health burdens 
                and the health impacts of climate change.
                    (B) Assessments.--Not later than 2 years after the 
                date of enactment of this Act, the head of each 
                relevant Federal agency shall--
                            (i) assess the impacts that the proposed 
                        and current laws, policies, and programs 
                        identified under subparagraph (A) under their 
                        jurisdiction have or may have on protection 
                        against the health threats of climate change; 
                        and
                            (ii) assist State, Tribal, local, and 
                        territorial governments in conducting such 
                        assessments.

SEC. 103. ADVISORY BOARD.

    (a) Establishment.--The Secretary shall, pursuant to chapter 10 of 
title 5, United States Code, establish a permanent science advisory 
board to be composed of not less than 10 and not more than 20 members.
    (b) Appointment of Members.--
            (1) In general.--The Secretary shall appoint the members of 
        the science advisory board from among individuals who--
                    (A) are recommended by the President of the 
                National Academy of Sciences or the President of the 
                National Academy of Medicine; and
                    (B) have expertise in essential public health and 
                health care services, including with respect to diverse 
                populations, climate change, environmental and climate 
                justice, and other relevant disciplines.
            (2) Requirement.--The Secretary shall ensure that the 
        science advisory board includes members with practical or lived 
        experience with relevant issues described in paragraph (1)(B).
    (c) Functions.--The science advisory board shall--
            (1) provide scientific and technical advice and 
        recommendations to the Secretary on the domestic and 
        international impacts of climate change on public health and 
        populations and regions disproportionately affected by climate 
        change, and strategies and mechanisms to prepare for and 
        respond to the impacts of climate change on public health;
            (2) advise the Secretary regarding the best science 
        available for purposes of issuing the national strategic action 
        plan and conducting the climate and health program; and
            (3) submit a report to Congress on its activities and 
        recommendations not later than 1 year after the date of 
        enactment of this Act and not later than every year thereafter.
    (d) Support.--The Secretary shall provide financial and 
administrative support to the board.

SEC. 104. CLIMATE CHANGE HEALTH PROTECTION AND PROMOTION REPORTS.

    (a) In General.--The Secretary shall offer to enter into an 
agreement, including the provision of such funding as may be necessary, 
with the National Academies of Sciences, Engineering, and Medicine, 
under which such National Academies will prepare periodic reports to 
aid public health and health care professionals in preparing for and 
responding to the adverse health effects of climate change that--
            (1) review scientific developments on health impacts and 
        health disparities of climate change;
            (2) evaluate the measurable impacts of activities 
        undertaken at the directive of the national strategic action 
        plan; and
            (3) recommend changes to the national strategic action plan 
        and climate and health program.
    (b) Submission.--The agreement under subsection (a) shall require a 
report to be submitted to Congress and the Secretary and made publicly 
available not later than 1 year after the first publication of the 
national strategic action plan, and every 4 years thereafter.

SEC. 105. AUTHORIZATION OF APPROPRIATIONS.

    (a) Office of Climate Change and Health Equity.--There is 
authorized to be appropriated to the Secretary to carry out section 
102(a) $10,000,000 for each of fiscal years 2024 through 2030.
    (b) National Strategic Action Plan.--There is authorized to be 
appropriated to the Secretary to carry out section 102(b) $2,000,000 
for fiscal year 2024, to remain available until expended.
    (c) Advisory Board.--There is authorized to be appropriated to the 
Secretary to carry out section 103(c) $500,000 for fiscal year 2024, to 
remain available until expended.

           TITLE II--PROTECTING ESSENTIAL HEALTH CARE ACCESS

SEC. 201. MAINTENANCE OF HEALTH CARE ACCESS RELATING TO HOSPITAL 
              DISCONTINUATION OF SERVICES OR CLOSURE.

    Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is 
amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (X), by striking ``and'' at the 
                end;
                    (B) in subparagraph (Y)(ii)(V), by striking the 
                period and inserting ``, and''; and
                    (C) by inserting after subparagraph (Y) the 
                following new subparagraph:
            ``(Z) beginning 60 days after the date of the enactment of 
        this subparagraph, in the case of a hospital, to comply with 
        the requirements of subsection (l) (relating to discontinuation 
        of services or closure).''; and
            (2) by adding at the end the following new subsection:
    ``(l) Requirements for Hospitals Relating to Discontinuation of 
Services or Closure.--
            ``(1) Requirements.--
                    ``(A) In general.--For purposes of subsection 
                (a)(1)(Z), except as provided in subparagraph (B), the 
                requirements described in this subsection are that a 
                hospital--
                            ``(i) notify the Secretary, in accordance 
                        with paragraph (2), not less than 90 days prior 
                        to the discontinuation of services or full 
                        hospital closure;
                            ``(ii) prohibit the discontinuation of 
                        essential services (as defined in paragraph 
                        (6)) during the notification period (as defined 
                        in such paragraph) unless there is a clear harm 
                        posed to patient or employee health or safety 
                        in the hospital continuing to furnish such 
                        services;
                            ``(iii) respond to any inquiries by the 
                        Secretary relating to the implementation of 
                        this subsection, including the determination of 
                        essential services under paragraph (6)(C); and
                            ``(iv) if applicable--
                                    ``(I) submit a mitigation plan and 
                                related information as described in 
                                paragraph (3); and
                                    ``(II) participate in the public 
                                comment and review process (including, 
                                if applicable, the alternative 
                                mitigation plan) described in paragraph 
                                (4).
                    ``(B) Application in case of catastrophic events.--
                In the case where a discontinuation of services or 
                closure of a hospital is due to an unforeseen 
                catastrophic event (as defined by the Secretary), the 
                requirements described in subparagraph (A) shall apply, 
                except--
                            ``(i) the hospital shall provide the 
                        notification under clause (i) of such 
                        subparagraph not later than 30 days after the 
                        catastrophic event or as soon as feasible as 
                        determined by the Secretary; and
                            ``(ii) clause (ii) of such subparagraph 
                        (relating to prohibiting the discontinuation of 
                        services) shall not apply.
            ``(2) Notification information.--For purposes of paragraph 
        (1)(A)(i), the notification under such paragraph shall include 
        the following information with respect to a hospital:
                    ``(A) Discontinuation of services.--In the case 
                where the hospital is discontinuing services (without 
                full hospital closure):
                            ``(i) The services that will be 
                        discontinued and number of hospital beds 
                        impacted.
                            ``(ii) The number of individuals furnished 
                        such services annually and a breakdown of the 
                        type of insurance used by such individuals for 
                        such services.
                            ``(iii) The number of impacted employees 
                        and what labor organization represents them 
                        (and the contact information for such 
                        organization).
                            ``(iv) The names and addresses of any 
                        organized health care coalitions and community 
                        groups that represent the communities impacted 
                        by the discontinuation of such services.
                            ``(v) Alternative providers of such 
                        services, including provider type, contact 
                        information, and distance and transportation 
                        time by car and public transit from the 
                        hospital.
                    ``(B) Full hospital closure.--In the case of full 
                hospital closure:
                            ``(i) Hospital ownership entities.
                            ``(ii) The full extent of services that 
                        will no longer be furnished by the hospital.
                            ``(iii) The number of individuals furnished 
                        services annually by the hospital, a 
                        description of the services furnished, and a 
                        breakdown of the type of insurance type used by 
                        such individuals for such services.
                            ``(iv) The number of impacted employees 
                        and, if applicable, what labor organizations 
                        represent them (and the contact information for 
                        each such organization).
                            ``(v) The names and addresses of any 
                        organized health care coalitions and community 
                        groups that represent the communities impacted 
                        by the closure.
                            ``(vi) Alternative providers, including 
                        provider type, contact information, and 
                        distance and transportation time by car and 
                        public transit from the hospital.
                            ``(vii) Steps taken prior to the decision 
                        to close in order to avoid closure.
                            ``(viii) Distribution of liquidation 
                        proceeds (cash or assets) or any payments (cash 
                        or assets) made to employees, owners, or 
                        contractors related to the closure.
            ``(3) Submission of mitigation plan and related information 
        for essential services.--
                    ``(A) Notification by secretary.--If the Secretary 
                determines that the discontinuation of services or 
                closure of an applicable hospital would negatively 
                impact access to essential services, the Secretary 
                shall notify the applicable hospital of such 
                determination.
                    ``(B) Submission of mitigation plan and related 
                information.--If an applicable hospital receives a 
                notification under subparagraph (A), the applicable 
                hospital shall, not later than 15 days after receiving 
                such notification, submit to the Secretary--
                            ``(i) a plan to--
                                    ``(I) preserve access to essential 
                                services for impacted communities 
                                through partnerships, commitments from 
                                surrounding facilities, transportation 
                                plan access, and preparation for surge 
                                response; and
                                    ``(II) support employees in 
                                transitioning to new positions within 
                                health care;
                            ``(ii) information on workforce and public 
                        engagement to ensure awareness of the 
                        discontinuation of services or closure; and
                            ``(iii) a description of potential 
                        alternatives to the discontinuation of services 
                        or closure that the hospital considered and an 
                        explanation of why those alternatives are not a 
                        viable option.
                    ``(C) Public availability.--The Secretary shall 
                make a mitigation plan and related information 
                submitted by an applicable hospital under this 
                paragraph available to the public on the internet 
                website of the Centers for Medicare & Medicaid 
                Services.
            ``(4) Public comment and review process; alternative 
        mitigation plan.--
                    ``(A) Public comment period.--
                            ``(i) In general.--The Secretary shall 
                        provide a public comment period of not less 
                        than 45 days with the opportunity to submit 
                        written comments regarding the impact of the 
                        potential discontinuation of services or 
                        closure of an applicable hospital.
                            ``(ii) Notice.--Notice of the opportunity 
                        to submit comments shall be published in the 
                        Federal Register and distributed to--
                                    ``(I) providers of services and 
                                suppliers that may be impacted by the 
                                discontinuation of services or closure 
                                of the applicable hospital;
                                    ``(II) any labor organization that 
                                represents any subdivision of employees 
                                of the applicable hospital;
                                    ``(III) organized health care 
                                coalitions and community groups that 
                                represent the communities impacted by 
                                the discontinuation of services or 
                                closure;
                                    ``(IV) the State health agency; and
                                    ``(V) the local department of 
                                public health.
                    ``(B) Alternative mitigation plan.--
                            ``(i) In general.--If, after reviewing the 
                        mitigation plan submitted by an applicable 
                        hospital under paragraph (3) and the comments 
                        submitted during the public comment period 
                        under subparagraph (A) with respect to the 
                        discontinuation of services or closure of the 
                        applicable hospital, the Secretary finds that 
                        the discontinuation of services or closure of 
                        the applicable hospital would have a 
                        significant impact on access to essential 
                        services, the Secretary shall work with the 
                        applicable hospital or other providers of 
                        services and suppliers in the area, as 
                        appropriate, to develop and implement an 
                        alternative plan to the plan submitted by the 
                        applicable hospital under paragraph (3) 
                        (referred to in this subsection as the 
                        `alternative mitigation plan') in order to 
                        ensure continued access to essential services, 
                        which may include an agreement to delay the 
                        discontinuation of services or closure of the 
                        applicable hospital until the alternative 
                        mitigation plan is complete.
                            ``(ii) Technical assistance.--An 
                        alternative mitigation plan under clause (i) 
                        may include technical assistance or information 
                        on available funding mechanisms to support the 
                        furnishing of essential services.
                            ``(iii) Collaboration.--The Secretary 
                        should, to the extent practicable, collaborate 
                        with State and municipal government officials 
                        in the development of an alternative mitigation 
                        plan under clause (i).
                            ``(iv) Public availability.--The Secretary 
                        shall make any information submitted and the 
                        alternative mitigation plan developed under 
                        this paragraph available to the public on the 
                        internet website of the Centers for Medicare & 
                        Medicaid Services.
                    ``(C) Implementation.--The Secretary shall 
                promulgate regulations to detail the required response 
                time by an applicable hospital and the speed of the 
                review process under this paragraph in order to ensure 
                that such process can be completed with respect to an 
                applicable hospital prior to the proposed service 
                discontinuation date or closure date of the applicable 
                hospital.
                    ``(D) Prohibition.--In the case where the Secretary 
                finds that a hospital has violated the requirements of 
                this subsection, the Secretary may prohibit the 
                hospital and any hospital under the same hospital 
                ownership entity from being eligible to enroll or 
                reenroll under the program under this title under 
                section 1866(j) until the earlier of--
                            ``(i) the date that is 3 years after the 
                        date on which the hospital discontinues 
                        services or closes;
                            ``(ii) the date on which the Secretary 
                        determines essential health services that were 
                        negatively impacted by the discontinuation or 
                        closure have been restored; or
                            ``(iii) such time as the Secretary is 
                        satisfied with the mitigation plan submitted by 
                        the hospital under paragraph (3) or the 
                        alternative mitigation plan under paragraph 
                        (4).
            ``(5) Annual reports.--The Secretary shall submit an annual 
        report to Congress on the discontinuation of services and full 
        closure of hospitals. Each report submitted under the preceding 
        sentence shall include--
                    ``(A) a description of trends in the 
                discontinuation of services and closures of hospitals, 
                including hospital ownership type, geographic location, 
                types of services furnished, demographic served, and 
                insurance type;
                    ``(B) an analysis of the impact of the 
                discontinuation of services and closures on health care 
                access and ability to meet surge demand due to 
                emergency (such as a pandemic or climate disaster);
                    ``(C) recommendations for such administrative or 
                legislative changes as the Secretary determines 
                appropriate to preserve access to essential services 
                nationwide.
            ``(6) Definitions.--In this subsection:
                    ``(A) Applicable hospital.--The term `applicable 
                hospital' means a hospital that submits a notification 
                under paragraph (1)(A)(i) of a discontinuation of 
                services or full hospital closure.
                    ``(B) Discontinuation.--The term `discontinuation' 
                may include any reduction or discontinuation of 
                services furnished by an applicable hospital, including 
                those that occur as part of a merger or acquisition 
                agreement.
                    ``(C) Essential services.--The term `essential 
                services' means, with respect to an applicable 
                hospital, services that are necessary for preserving 
                health care access (as determined by the Secretary), 
                including services for which the Secretary determines--
                            ``(i) there are no equivalent services 
                        available within the same travel time;
                            ``(ii) that loss of the services would 
                        result in meaningful reductions in surge 
                        capacity that will negatively impact access to 
                        services;
                            ``(iii) that loss of the services would 
                        limit health care access for specific 
                        demographics of individuals based on sex, 
                        sexuality, race, nationality, age, or 
                        disability status;
                            ``(iv) that loss of the services would have 
                        a meaningful impact on the ability of health 
                        systems to respond to impacts of climate 
                        change; or
                            ``(v) there is a health or health care-
                        related emergency declaration status applicable 
                        to the surrounding geographical area of the 
                        hospital on the date on which the hospital 
                        submits notification under paragraph (1)(A)(i) 
                        of a discontinuation of services or full 
                        hospital closure.
                    ``(D) Notification period.--The term `notification 
                period' means, with respect to an applicable hospital, 
                the period beginning on the date on which the hospital 
                submits notification under paragraph (1)(A)(i) of a 
                discontinuation of services or full hospital closure 
                and ending on the date of such discontinuation of 
                services or closure.
            ``(7) No preemption of state law.--Nothing in subsection 
        (a)(1)(Z) or this subsection shall be construed to limit any 
        rights or remedies under State or local law relating to 
        protecting access to essential services or reviewing proposed 
        hospital closures or reduction of services.''.

SEC. 202. EMPOWERING COMMUNITY HEALTH IN ENVIRONMENTAL JUSTICE 
              COMMUNITIES.

    Section 10503 of the Patient Protection and Affordable Care Act (42 
U.S.C. 254b-2) is amended--
            (1) in subsection (b)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (E), by striking 
                        ``and'' at the end; and
                            (ii) by adding at the end the following:
                    ``(G) $130,000,000,000 for the period of fiscal 
                years 2024 through 2028; and''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (G), by striking 
                        ``and'' at the end;
                            (ii) in subparagraph (H), by striking the 
                        period and inserting ``; and''; and
                            (iii) by adding at the end the following:
                                    ``(I) $2,000,000,000 for each of 
                                fiscals years 2024 through 2028.''; and
            (2) by adding at the end the following:
    ``(f) Environmental Justice Communities.--The Secretary shall 
ensure that not less than 50 percent of the amounts appropriated under 
subsection (b) on or after 2024 are awarded to entities for use with 
respect to projects or sites located in or serving environmental 
justice communities (as defined in section 2 of the Green New Deal for 
Health Act).
    ``(g) Prohibition.--No amounts made available under this section 
may be used for any activity that is subject to the reporting 
requirements set forth in section 203(a) of the Labor-Management 
Reporting and Disclosure Act of 1959 (29 U.S.C. 433(a)).''.

       TITLE III--GREEN AND RESILIENT HEALTH CARE INFRASTRUCTURE

SEC. 301. GREEN HILL-BURTON FUNDS FOR CLIMATE-READY MEDICAL FACILITIES.

    (a) Grants for Construction or Modernization Projects.--
            (1) In general.--Section 1610(a) of the Public Health 
        Service Act (42 U.S.C. 300r(a)) is amended--
                    (A) in paragraph (1)(A)--
                            (i) in clause (i), by striking ``, or'' and 
                        inserting a semicolon;
                            (ii) in clause (ii), by striking the period 
                        at the end and inserting ``; or''; and
                            (iii) by adding at the end the following:
                            ``(iii) increase capacity to provide 
                        essential health care and update medical 
                        facilities to become more resilient to climate 
                        disasters and public health crises to ensure 
                        access and availability of quality health care 
                        for communities in need.''; and
                    (B) by striking paragraph (3) and inserting the 
                following:
            ``(3) Priority.--In awarding grants under this subsection, 
        the Secretary shall give priority to applicants whose projects 
        will include, by design, resilience against natural disasters, 
        climate change mitigation, or other necessary predisaster 
        adaptations to ensure continuous health care access and combat 
        health risks due to climate change, such as--
                    ``(A) installation of onsite distributed generation 
                that combines energy-efficient devices, energy storage, 
                and renewable energy in accordance with modern 
                electrical safety standards for medical facilities to 
                allow the medical facility to access essential energy 
                during power outages and optimize use of onsite and 
                offsite energy sources for emissions reductions;
                    ``(B) improving air conditioning, monitoring, and 
                purifying through installation of high-efficiency heat 
                pumps that provide both cooling and heating, air 
                purifiers, air filtration systems, and air quality 
                monitoring systems integrated with energy systems and 
                energy efficiency considerations in preparation for 
                future natural hazards and public health crises, such 
                as wildfire, smog, extreme heat events, and pandemics;
                    ``(C) installation and maintenance of wetlands, 
                drainage ponds, and any other green infrastructure to 
                protect the medical facility from projected severe 
                effects with respect to extreme weather, natural 
                disasters, or climate-change-related events, including 
                sea-level rise, flooding, and increased risk of 
                wildfire;
                    ``(D) green rooftops, walls, and indoor plantings, 
                particularly those that can provide publicly accessible 
                temperature management and air quality improvements;
                    ``(E) tree planting and other green infrastructure 
                to create publicly accessible cool space to address 
                urban heat islands;
                    ``(F) infrastructure upgrades that protect access 
                routes to the medical facility, such as long-term 
                flood, wildfire, and other disaster mitigation for the 
                roads, sidewalks, and public transit infrastructure 
                that service the medical facility;
                    ``(G) the long-term maintenance of decarbonization 
                and zero-emissions infrastructure; and
                    ``(H) any other type of plan or project the 
                Secretary determines will increase the sustainability 
                and resiliency of a medical facility, protect patient 
                health and community access during extreme weather, and 
                advance environmental justice.
            ``(4) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this subsection 
        $100,000,000,000 for fiscal year 2024, to remain available 
        until expended.''.
            (2) Technical amendment.--Section 1610(b) of the Public 
        Health Service Act (42 U.S.C. 300r(b)) is amended by striking 
        paragraph (3).
    (b) Medical Facility Project Applications.--
            (1) In general.--Section 1621(b)(1) of the Public Health 
        Service Act (42 U.S.C. 300s-1(b)(1)) is amended--
                    (A) in subparagraph (J), by striking ``and'' at the 
                end;
                    (B) in subparagraph (K), by striking the period at 
                the end and inserting a semicolon; and
                    (C) by adding at the end the following:
                    ``(L) reasonable assurance that the facility will 
                have adequate staffing to fulfill the community service 
                obligation; and
                    ``(M) reasonable assurance that the facility--
                            ``(i) has a collective bargaining agreement 
                        with 1 or more labor organizations representing 
                        employees at the facility; or
                            ``(ii) has an explicit policy not to 
                        interfere with the rights of employees of the 
                        facility under section 7 of the National Labor 
                        Relations Act.''.
            (2) Application for planning grants.--Section 1621 of the 
        Public Health Service Act (42 U.S.C. 300s-1) is amended by 
        adding at the end the following:
    ``(c) Application for Planning Grants.--An application for a 
project submitted under part A or B shall deemed to be complete for 
purposes of section 302(d)(2) of the Green New Deal for Health Act, and 
the application shall be deemed to have been submitted for purposes of 
consideration for a planning grant under that section.''.

SEC. 302. PLANNING AND EVALUATION GRANT PROGRAM.

    (a) Definitions.--In this section:
            (1) Medical facility.--The term ``medical facility'' means 
        a hospital, public health center, outpatient medical facility, 
        rehabilitation facility, facility for long-term care, or other 
        facility (as may be designated by the Secretary) for the 
        provision of health care to ambulatory patients.
            (2) Proposed project.--The term ``proposed project'' means 
        a construction or modernization project proposed by an eligible 
        entity in a sustainability and resiliency plan.
            (3) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (4) Sustainability and resiliency plan.--The term 
        ``sustainability and resiliency plan'' means a plan, including 
        comprehensive preproject evaluation, for a construction or 
        modernization project that would, in order to protect patient 
        health and community access, enhance--
                    (A) the sustainability of a medical facility and 
                infrastructure surrounding the medical facility; and
                    (B) the resiliency of that medical facility and 
                infrastructure surrounding the medical facility to 
                climate change and public health crises.
    (b) Establishment.--The Secretary shall establish a grant program, 
to be known as the ``Planning and Evaluation Grant Program'', under 
which the Secretary shall make planning grants to eligible entities to 
develop sustainability and resiliency plans for medical facilities 
owned or operated by the eligible entity and infrastructure surrounding 
the medical facilities.
    (c) Eligible Entities.--To be eligible to receive a planning grant 
under subsection (b), an applicant shall be--
            (1) a State, Tribal government, or political subdivision of 
        a State or Tribal government, including any city, town, county, 
        borough, hospital district authority, or public or quasi-public 
        corporation; or
            (2) a nonprofit private entity.
    (d) Applications.--
            (1) In general.--Except as provided in paragraph (2), an 
        eligible entity seeking a planning grant under subsection (b) 
        shall submit to the Secretary an application at such time, in 
        such manner, and containing such information as the Secretary 
        may by regulation prescribe, including--
                    (A) a description of the proposed project;
                    (B) a summary and breakdown of the demographics of 
                the patient population served or potentially served by 
                the medical facility under the proposed project, 
                including information on--
                            (i) whether the medical facility is a 
                        facility for which a majority of the revenue 
                        the facility receives for patient care is from 
                        reimbursements for medical care furnished to 
                        Medicare and Medicaid beneficiaries under 
                        titles XVIII and XIX of the Social Security Act 
                        (42 U.S.C. 1395 et seq. and 1396 et seq.); and
                            (ii) other indications that individuals 
                        vulnerable to climate change are served or 
                        potentially served by the medical facility;
                    (C) a description of the ways in which the proposed 
                project--
                            (i) will carry out 1 or more activities 
                        described in subsection (g);
                            (ii) meet the needs of the community the 
                        medical facility serves, especially the needs 
                        of vulnerable populations; and
                            (iii) meet the sustainability and 
                        resiliency needs of the medical facility due to 
                        climate risks and hazards;
                    (D) a description of whether the community served 
                by the medical facility is an environmental justice 
                community;
                    (E) a description of the ways in which the planning 
                grant would be used to carry out 1 or more planning and 
                evaluation activities described in subsection (f);
                    (F) reasonable assurance that all laborers and 
                mechanics employed by contractors or subcontractors in 
                the performance of work on a project will be paid wages 
                at rates not less than those prevailing on similar work 
                in the locality as determined by the Secretary of Labor 
                in accordance with subchapter IV of chapter 31 of part 
                A of subtitle II of title 40, United States Code 
                (commonly referred to as the ``Davis-Bacon Act'') and 
                the Secretary of Labor shall have with respect to such 
                labor standards the authority and functions set forth 
                in Reorganization Plan Numbered 14 of 1950 (64 Stat. 
                1267; 5 U.S.C. App.) and section 3145 of title 40, 
                United States Code; and
                    (G) reasonable assurance that the facility--
                            (i) has a collective bargaining agreement 
                        with 1 or more labor organizations representing 
                        employees at the facility; or
                            (ii) has an explicit policy not to 
                        interfere with the rights of employees at the 
                        facility under section 7 of the National Labor 
                        Relations Act (29 U.S.C. 157).
            (2) Additional applications.--An application submitted 
        under part A or B of title XVI of the Public Health Service Act 
        (42 U.S.C. 300q et seq. and 42 U.S.C. 300r) shall be deemed to 
        be a complete application submitted for purposes of 
        consideration for a planning grant under subsection (b).
    (e) Selection.--The Secretary shall--
            (1) in coordination with the Secretary of Energy and the 
        Administrator of the Environmental Protection Agency, if 
        necessary, develop metrics to evaluate applications for 
        planning grants under subsection (b); and
            (2) give priority to applications that focus on improving a 
        medical facility--
                    (A) for which--
                            (i) a majority of the revenue the facility 
                        receives for patient care is from 
                        reimbursements for medical care furnished to 
                        Medicare and Medicaid beneficiaries under 
                        titles XVIII and XIX of the Social Security Act 
                        (42 U.S.C. 1395 et seq. and 1396 et seq.); or
                            (ii) a high proportion of patients is 
                        uninsured, as determined by the Secretary; and
                    (B) that is located in a neighborhood or serves a 
                patient population that--
                            (i) experiences low air quality;
                            (ii) lacks green space;
                            (iii) bears higher cumulative pollution 
                        burdens; or
                            (iv) is at disproportionate risk of 
                        experiencing the adverse effects of climate 
                        change.
    (f) Planning Activities.--Planning and evaluation activities 
carried out by an eligible entity using grant funds received under 
subsection (b) shall include 1 or more of the following:
            (1) Performing project planning, community outreach and 
        engagement, feasibility studies, and needs assessments of the 
        local community and patient populations.
            (2) Performing engineering and climate-risk assessments of 
        the medical facility infrastructure and the access routes to 
        the medical facility.
            (3) Providing management and operational assistance for 
        developing and receiving funding for the proposed project.
            (4) Other planning and evaluation activities and 
        assessments as the Secretary determines appropriate.
    (g) Proposed Projects.--Construction and modernization activities 
carried out by a proposed project under a sustainability and resiliency 
plan developed pursuant to a planning grant received under subsection 
(b) may include--
            (1) improvements to the infrastructure, buildings, and 
        grounds of the medical facility, including--
                    (A) installation of onsite distributed generation 
                that combines energy-efficient devices, energy storage, 
                and renewable energy in accordance with modern 
                electrical safety standards for medical facilities to 
                allow the medical facility to access essential energy 
                during power outages and optimize use of onsite and 
                offsite energy sources for emissions reductions; and
                    (B) improving air conditioning, monitoring, and 
                purifying through installation of high-efficiency heat 
                pumps that provide both cooling and heating, air 
                purifiers, air filtration systems, and air quality 
                monitoring systems integrated with energy systems and 
                energy efficiency considerations in preparation for 
                future natural hazards and public health crises such as 
                wildfire, smog, extreme heat events, and pandemics;
            (2) green infrastructure projects, such as--
                    (A) installation and maintenance of wetlands, 
                drainage ponds, and any other green infrastructure that 
                would protect the medical facility from projected 
                severe effects with respect to extreme weather, natural 
                disasters, or climate-change-related events, including 
                sea-level rise, flooding, and increased risk of 
                wildfire; and
                    (B) green rooftops, walls, and indoor plantings, 
                particularly those that can provide publicly accessible 
                temperature management and air quality improvements;
            (3) resiliency projects to secure local accessibility to 
        the medical facility by protecting the access routes to the 
        medical facility, such as--
                    (A) infrastructure upgrades that protect access 
                routes to the medical facility, such as long-term 
                flood, wildfire, and other disaster mitigation for the 
                roads, sidewalks, and public transit infrastructure 
                that service the medical facility; and
                    (B) the long-term maintenance of decarbonization 
                and zero-emissions infrastructure; and
            (4) any other type of activity the Secretary determines 
        will increase the sustainability and resiliency of a medical 
        facility and protect patient health and community access during 
        extreme weather.
    (h) Amount of Grant.--The total amount of a grant under subsection 
(b) shall not exceed $500,000.
    (i) Technical Assistance.--The Secretary, in coordination with the 
Secretary of Energy, the Administrator of the Environmental Protection 
Agency, and the Secretary of Transportation, if necessary, directly or 
through partnerships with States, Tribal governments, and nonprofit 
organizations, shall provide technical assistance to eligible entities 
interested in carrying out proposed projects that--
            (1) serve environmental justice communities or medically 
        underserved communities;
            (2) demonstrate a commitment to provide job training, 
        apprenticeship programs, and contracting opportunities to 
        residents and small businesses owned by residents of the 
        community that the medical facility serves;
            (3) identify and further community priority actions and 
        conduct robust community engagement; and
            (4) employ nature-based solutions that focus on protection, 
        restoration, or management of ecological systems to safeguard 
        public health, provide clean air and water, increase natural 
        hazard resilience, and sequester carbon.
    (j) Prohibition on Training Repayment.--As a condition of receiving 
a grant or technical assistance under this section, an eligible entity 
shall certify that the eligible entity does not use, and if the 
eligible entity contracts with any staffing agency or training 
provider, that such agency or provider does not use, any provision in 
employment agreements, job training agreements, or apprenticeship 
program agreements that would require an employee or training or 
apprenticeship program participant to pay a debt if the employee or 
training or apprenticeship program participant's employment or work 
relationship or training period with a specified employer or business 
entity is terminated.
    (k) Environmental Justice Communities.--The Secretary shall ensure 
that not less than 50 percent of grant funds awarded under subsection 
(b) are used for sustainability and resiliency plans for proposed 
projects located in environmental justice communities.
    (l) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary to carry out this section $5,000,000,000 
for fiscal year 2024, to remain available until expended.

              TITLE IV--HEALTH CARE SECTOR DECARBONIZATION

SEC. 401. OFFICE OF SUSTAINABILITY AND ENVIRONMENTAL IMPACT.

    (a) Establishment.--There is hereby established in the Centers for 
Medicare & Medicaid Services an Office of Sustainability and 
Environmental Impact (in this section referred to as the ``Office'') to 
prepare the health care system for the impacts of climate change by 
supporting health care decarbonization, sustainability, and 
environmental efforts and to ensure that the health care system 
minimizes and mitigates its climate harm while advancing patient health 
and safety.
    (b) Priority Goals.--The Office shall--
            (1) collaborate with the Office of Climate Change and 
        Health Equity, the Environmental Protection Agency, and other 
        interagency committees to support a whole-of-government and 
        whole-of-health approach to addressing the climate crisis;
            (2) develop and promulgate regulations that support 
        climate-informed care, support health care decarbonization and 
        sustainability, and mitigate the environmental impacts of the 
        health care system upon patients, communities, and health care 
        workers;
            (3) develop and promulgate regulations that support patient 
        access to, and coverage of, climate-informed health care 
        services to prevent and address the health impacts of climate 
        change;
            (4) conduct oversight of health care systems, their climate 
        emissions, and environmental harms and provide interagency 
        technical assistance in remediating such emissions and 
        environmental harms; and
            (5) issue ``Climate-Friendly'' health system designations 
        and accreditations that identify health systems that 
        demonstrate commitment to, and substantial evidence of, 
        reducing emissions and environmental harm while advancing 
        health care quality and patient and worker safety.
    (c) Director.--
            (1) In general.--The Office shall be headed by a Director, 
        to be known as the Director of Sustainability and Environmental 
        Impact, who shall be appointed by the Secretary of Health and 
        Human Services (in this section referred to as the 
        ``Secretary'').
            (2) Functions.--The Director shall--
                    (A) convene stakeholders (including key health care 
                stakeholders) for strategic planning towards the 
                priority goals of the Office;
                    (B) advise the Secretary and the Administrator of 
                the Centers for Medicare & Medicaid Services in matters 
                of sustainability and environmental impact and the role 
                of the Centers for Medicare & Medicaid Services in 
                sustainability and environmental impact;
                    (C) collaborate with academic experts and community 
                leaders to understand and establish best practices for 
                decarbonizing health care operations; and
                    (D) develop and evaluate the Office's strategy to 
                tackle health care decarbonization and sustainability 
                and mitigating environmental impacts within the Centers 
                for Medicare & Medicaid Services.
    (d) Report to Congress.--Not later than 2 years after the date of 
the enactment of this Act, and every 2 years thereafter, the Secretary 
shall submit to Congress a Health Care Sustainability and Environmental 
Impact Report, which shall be prepared by the Director of 
Sustainability and Environmental Impact, with appropriate assistance 
from other agencies in the executive branch of the Federal Government. 
Each such report shall include the following:
            (1) A summary of interagency collaboration.
            (2) A methodology to designate and accredit health systems 
        that achieve substantial reductions in emissions and 
        environmental harm as ``Climate-Friendly'' health systems.
            (3) An inventory of ``Climate-Friendly'' designated health 
        systems, their strategies, challenges, and best practices for 
        sustainability and mitigating environmental impact, and any 
        significant effects of these efforts on--
                    (A) quality of care;
                    (B) patient safety;
                    (C) safety of health care workers and health care 
                facility workers;
                    (D) health care costs; and
                    (E) environmental health and overall health of the 
                community served.
            (4) An analysis of the demographics and climate 
        vulnerability of patients and types of communities served by 
        ``Climate-Friendly'' health systems.
            (5) Recommendations for actions by health systems and for 
        Federal technical assistance and supportive resources for the 
        health system to achieve substantial reductions in emissions 
        and environmental harm in order to attain ``Climate-Friendly'' 
        designation.
            (6) A summary of oversight efforts of the Centers for 
        Medicare & Medicaid Services regarding emissions and 
        environmental impacts and payment and coverage impacts on 
        climate change preparedness, mitigation, and response.
            (7) Recommendations for such legislation and administration 
        action as the Secretary determines appropriate to regulate and 
        promote health care sustainability, decarbonization, and 
        mitigate environmental impact within the health care system.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $2,000,000 for each of fiscal 
years 2024 through 2033.

SEC. 402. CLIMATE RISK DISCLOSURE FOR MEDICAL SUPPLIES.

    Subchapter B of chapter V of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 351 et seq.) is amended by adding at the end the 
following:

``SEC. 524C. CLIMATE RISK DISCLOSURE FOR MEDICAL SUPPLIES.

    ``(a) Task Force.--
            ``(1) In general.--The Secretary, in coordination with the 
        Commissioner and the Administrator of the Environmental 
        Protection Agency, shall establish a task force for purposes of 
        developing a strategy to establish climate risk disclosure 
        policies for manufacturers of drugs (including biological 
        products) and devices.
            ``(2) Duties.--The task force established under paragraph 
        (1) shall--
                    ``(A) recommend a methodology for drug and device 
                manufacturers to calculate the emissions and climate 
                risk due to clinical use of the drug or device, 
                factoring in emissions from the manufacture, transport, 
                use, processing, reprocessing, and waste relating to 
                the drug or device;
                    ``(B) recommend a policy and process for mandatory 
                public disclosure of emissions and climate risk 
                relating to drugs and devices;
                    ``(C) recommend a policy for oversight of 
                disclosures to ensure accuracy and transparency of 
                emissions reporting as described in subparagraph (B), 
                and to ensure that patient safety and necessary access 
                is maintained;
                    ``(D) develop methods to disseminate information to 
                clinicians for low environmental impact options for 
                clinically equivalent treatment options;
                    ``(E) develop suggestions for the reduction of 
                emissions by drug and device manufacturers without 
                harming or risking patient safety; and
                    ``(F) provide technical assistance and establish 
                partnerships to facilitate lower emissions design and 
                manufacture of comparable drugs and comparable devices.
            ``(3) Membership.--The task force established under 
        paragraph (1) shall be composed of the following:
                    ``(A) 3 representatives of the Food and Drug 
                Administration, appointed by the Commissioner.
                    ``(B) 3 representatives of the Environmental 
                Protection Agency, appointed by the Administrator of 
                the Environmental Protection Agency.
                    ``(C) 3 representatives of the Office of Climate 
                Change and Health Equity of the Department of Health 
                and Human Services, appointed by the Secretary.
    ``(b) Regulations.--Not later than 1 year after the date of 
enactment of the Green New Deal for Health Act, the Secretary shall 
promulgate regulations to--
            ``(1) establish mandatory climate risk disclosure and 
        transparency policies for drugs and devices approved, licensed, 
        or cleared under section 505, 510(k), 513(f)(2), or 515 of this 
        Act or section 351 of the Public Health Service Act; and
            ``(2) incorporate climate risk into policies related to 
        transparency, labeling, and other regulatory policies related 
        to drugs and devices, based on the recommendations of the task 
        force described in subsection (a).
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $4,000,000 for fiscal year 2024, 
to remain available until expended.''.

SEC. 403. GREEN HEALTH CARE MANUFACTURING.

    (a) In General.--There is established a Federal interagency working 
group, to be known as the ``Council on Green Health Care 
Manufacturing'' (referred to in this section as the ``Council'').
    (b) Membership.--The membership of the Council shall consist of--
            (1) the Secretary of Health and Human Services (referred to 
        in this section as the ``Secretary''), who shall serve as the 
        Chair;
            (2) the Secretary of Energy;
            (3) the Secretary of Transportation;
            (4) the Secretary of Labor;
            (5) the Administrator of the Environmental Protection 
        Agency;
            (6) the Director of the Office of Climate Change and Health 
        Equity;
            (7) the Director of Sustainability and Environmental 
        Impact;
            (8) the Chair of the Council on Environmental Quality;
            (9) the United States Trade Representative; and
            (10) the heads of other Federal agencies, as determined 
        necessary by the Chair.
    (c) Duties.--
            (1) Assessment and report.--
                    (A) In general.--Not later than 1 year after the 
                date of enactment of this Act, the Council shall 
                conduct an assessment of global and domestic medical 
                supply chains, including an assessment of--
                            (i) the environmental and climate impacts 
                        of medical supply chains, including--
                                    (I) emissions from the production, 
                                transportation, and packaging of 
                                medical and pharmaceutical products;
                                    (II) chemical and other 
                                environmental pollution;
                                    (III) excessive energy consumption;
                                    (IV) negative externalities 
                                relating to waste; and
                                    (V) any other environmental or 
                                climate impacts the Council determines 
                                relevant;
                            (ii) labor conditions for workers in the 
                        United States and globally who produce medical 
                        and pharmaceutical products consumed by 
                        individuals residing in the United States, 
                        including the degree to which such workers--
                                    (I) are ensured a protected right 
                                to organize;
                                    (II) are provided adequate 
                                workplace safety protections; and
                                    (III) are adequately compensated;
                            (iii) efficiency and resiliency of 
                        processes under medical supply chains, 
                        including the ability of medical supply chains 
                        to adapt to sudden shifts in demand, including 
                        shifts in demand within discrete geographic 
                        regions;
                            (iv) the reliance of the United States on 
                        international supply chains for medical 
                        products, including information about which 
                        types of medical products are primarily 
                        manufactured outside of the United States, and 
                        where such products are manufactured; and
                            (v) human rights abuses in manufacturing of 
                        medical and pharmaceutical products and 
                        sourcing of those products, including abuses of 
                        indigenous rights and traditions.
                    (B) Report.--On completion of the assessment 
                conducted under subparagraph (A), the Council shall 
                submit to Congress and make publicly available a 
                report, to be known as the ``Green Health Care 
                Manufacturing Report'', that describes the findings of 
                the assessment.
            (2) Recommendations.--
                    (A) In general.--Based on the findings of the 
                assessment conducted under paragraph (1)(A), the 
                Council shall develop recommendations for regulations 
                that would support a medical supply chain that is--
                            (i) sustainable;
                            (ii) free of greenhouse gas emissions; and
                            (iii) based in the United States.
                    (B) Inclusions.--The proposed regulations under 
                subparagraph (A) shall--
                            (i) support good labor conditions, worker 
                        protections, and employee rights to organize 
                        and collectively bargain; and
                            (ii) ensure the global trade 
                        competitiveness of the United States, including 
                        by considering the comparative carbon intensity 
                        of domestic and internationally manufactured 
                        pharmaceuticals and medical products.
            (3) Grant program.--Based on the findings of the assessment 
        conducted under paragraph (1)(A), the Council shall develop 
        recommendations for a grant program to be carried out by the 
        Secretary under which the Secretary would make grants for 
        medical manufacturing to support the development and 
        establishment of sustainable and zero-emission medical supply 
        chains based in the United States.
    (d) Regulations.--
            (1) In general.--Not later than 1 year after the date of 
        enactment of this Act, the Secretary shall develop and 
        promulgate regulations to support a medical supply chain that 
        is--
                    (A) sustainable;
                    (B) free of greenhouse gas emissions; and
                    (C) based in the United States.
            (2) Requirement.--The Secretary shall develop the 
        regulations under paragraph (1) based on the recommendations 
        for regulations developed by the Council under subsection 
        (c)(2).
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as are necessary.

        TITLE V--A HEALTH WORKFORCE TO TACKLE THE CLIMATE CRISIS

SEC. 501. EDUCATION AND TRAINING RELATING TO HEALTH RISKS ASSOCIATED 
              WITH CLIMATE CHANGE.

    Part D of title VII of the Public Health Service Act (42 U.S.C. 294 
et seq.) is amended by inserting after section 757 the following:

``SEC. 758. EDUCATION AND TRAINING RELATING TO HEALTH RISKS ASSOCIATED 
              WITH CLIMATE CHANGE.

    ``(a) In General.--Not later than 1 year after the date of the 
enactment of the Green New Deal for Health Act, the Secretary shall 
establish a competitive grant program to award grants to health 
professions schools to support the development and integration into 
such schools of education and training programs for identifying, 
treating, and mitigating mental and physical health risks associated 
with climate change for whole populations and for individuals 
disproportionately affected by climate change.
    ``(b) Application.--To be eligible for a grant under this section, 
a health profession school shall submit to the Secretary an application 
at such time, in such form, and containing such information as the 
Secretary may require, which shall include, at a minimum, a description 
of the following:
            ``(1) How the health profession school will engage with 
        frontline communities to climate change or environmental 
        justice communities, and stakeholder organizations representing 
        such communities, in developing and implementing the education 
        and training programs supported by the grant.
            ``(2) How the health profession school will engage with 
        individuals disproportionately affected by climate change, and 
        stakeholder organizations representing such individuals, in 
        developing and implementing the education and training programs 
        supported by the grant.
            ``(3) How the health profession school will ensure that 
        such education and training programs will address racial and 
        ethnic disparities in exposure to, and the effects of, risks 
        associated with climate change for individuals vulnerable to 
        climate change.
            ``(4) How the health profession school will build inclusive 
        career opportunities and pathways to build up and expand the 
        health care workforce ready to address the health burdens of 
        climate change.
    ``(c) Use of Funds.--A health profession school awarded a grant 
under this section shall use the grant funds to develop, and integrate 
into the curriculum and continuing education of such health profession 
school, education and training on each of the following:
            ``(1) Identifying risks associated with climate change for 
        individuals disproportionately affected by climate change, with 
        consideration of co-morbidities and socioeconomic risk factors.
            ``(2) Identifying risks to reproductive health associated 
        with climate change for individuals disproportionately affected 
        by climate change.
            ``(3) How risks and combinations of risks associated with 
        climate change affect individuals disproportionately affected 
        by climate change and individuals with the intent to become 
        pregnant.
            ``(4) Racial and ethnic disparities in exposure to, and the 
        effects of, risks associated with climate change for 
        individuals disproportionately affected by climate change and 
        individuals with the intent to become pregnant.
            ``(5) Patient counseling and mitigation strategies relating 
        to risks associated with climate change for both mental and 
        physical health for individuals disproportionately affected by 
        climate change.
            ``(6) Relevant services and support for individuals 
        disproportionately affected by climate change relating to risks 
        associated with climate change and strategies for ensuring that 
        such individuals have access to such services and support.
            ``(7) Implicit and explicit bias, racism, and 
        discrimination.
            ``(8) Related topics identified by such health profession 
        school based on the engagement of such health profession school 
        with individuals vulnerable to climate change and stakeholder 
        organizations representing such individuals.
    ``(d) Partnerships.--In carrying out activities with grant funds, a 
health profession school awarded a grant under this section may partner 
with one or more of the following:
            ``(1) A State, local, or Tribal public health department.
            ``(2) A labor union organization representing workers in 
        health care settings.
            ``(3) A health care professional membership association.
            ``(4) A patient advocacy organization.
            ``(5) A community health center or organization.
            ``(6) A health profession school or other institution of 
        higher education, which may be a health profession school.
            ``(7) A public school or school district.
    ``(e) Technical Assistance.--The Secretary shall provide technical 
assistance to health profession schools and partnership organizations 
to assist application planning and preparation for schools and 
partnerships that train individuals from, and that serve, medically 
underserved communities.
    ``(f) Reports to Secretary.--
            ``(1) Annual report.--For each fiscal year during which a 
        health profession school receives grant funds under this 
        section, such health profession school shall submit to the 
        Secretary a report that describes the activities carried out 
        with such grant funds during such fiscal year.
            ``(2) Final report.--Not later than the date that is 1 year 
        after the end of the last fiscal year during which a health 
        profession school receives grant funds under this section, the 
        health profession school shall submit to the Secretary a final 
        report that summarizes the activities carried out with such 
        grant funds.
    ``(g) Report to Congress.--Not later than 6 years after the date on 
which the program is established under subsection (a), the Secretary 
shall submit to Congress and publish on the public website of the 
Department of Health and Human Services a report that includes the 
following:
            ``(1) A summary of the reports submitted under subsection 
        (e).
            ``(2) Recommendations to improve education and training 
        programs at health profession schools with respect to 
        identifying and addressing risks associated with climate change 
        for individuals vulnerable to climate change.
    ``(h) Definitions.--In this section:
            ``(1) Environmental justice community.--The term 
        `environmental justice community' has the meaning given such 
        term in section 2 of the Green New Deal for Health Act.
            ``(2) Health profession school.--The term `health 
        profession school' means an accredited--
                    ``(A) medical school;
                    ``(B) school of nursing;
                    ``(C) midwifery program or other evidence-based 
                birth care training program;
                    ``(D) physician assistant education program;
                    ``(E) school of psychiatry, psychology, counseling, 
                or social work;
                    ``(F) career and technical education health 
                sciences program;
                    ``(G) public health program;
                    ``(H) community health worker training program;
                    ``(I) teaching hospital;
                    ``(J) residency or fellowship program; or
                    ``(K) other school or program determined 
                appropriate by the Secretary.
            ``(3) Individual disproportionately affected by climate 
        change.--The term `individual disproportionately affected by 
        climate change' means an individual that may face elevated 
        mental and physical health risks due to climate change based on 
        2 or more of the following factors:
                    ``(A) Age under 5 years old or over 65 years old.
                    ``(B) Race and ethnicity, and experience of racial 
                bias.
                    ``(C) Sex, gender, and gender minority status.
                    ``(D) Being of reproductive age.
                    ``(E) Exposure to environmental health risks due to 
                living conditions or location, including current or 
                past experience of homelessness.
                    ``(F) Occupation or exposure to occupational 
                hazards.
                    ``(G) Household income.
                    ``(H) Disability.
                    ``(I) Co-morbidities.
                    ``(J) Current or past exposure to personal or 
                systemic trauma, including natural disasters.
                    ``(K) Immigration status.
                    ``(L) Language isolation.
            ``(4) Medically underserved community.--The term `medically 
        underserved community' has the meaning given such term in 
        section 799B.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $9,000,000,000 for fiscal year 
2024, to remain available until expended.''.

SEC. 502. BUILDING A COMMUNITY HEALTH WORKFORCE FOR THE CLIMATE CRISIS.

    Section 399V of the Public Health Service Act (42 U.S.C. 280g-11) 
is amended--
            (1) in subsection (b)--
                    (A) by redesignating the paragraphs (2) through (6) 
                as paragraphs (4) through (8), respectively;
                    (B) by inserting after paragraph (1) the following:
            ``(2) build career paths for community health workers by--
                    ``(A) establishing accessible, inclusive, low-cost 
                or no-cost training, credentialing, or apprenticeship 
                opportunities for community health workers to acquire 
                skills and expertise concerning health risks caused by 
                climate change and environmental hazards;
                    ``(B) establishing accessible, inclusive, low-cost 
                or no-cost educational, training, credentialing, or 
                apprenticeship opportunities for entry into the 
                community health worker profession; or
                    ``(C) expanding career advancement opportunities 
                and career pathways, including scholarships for 
                advanced or specialized training;
            ``(3) expand the community health workforce by establishing 
        permanent community health worker positions that pay, at 
        minimum, the prevailing wage for such workers, through long-
        term, stable funding, in order to staff the medical needs of a 
        community sufficiently while ensuring reasonable workloads for 
        individual workers;'';
                    (C) in paragraph (4) (as so redesignated)--
                            (i) in subparagraph (A)(i), by inserting 
                        ``and linguistically isolated populations'' 
                        before the semicolon; and
                            (ii) in subparagraph (B)--
                                    (I) in clause (i), by striking 
                                ``and'' after the semicolon;
                                    (II) by redesignating clause (ii) 
                                as clause (iii); and
                                    (III) by inserting after clause (i) 
                                the following:
                            ``(ii) connecting population groups at 
                        disproportionate risk for specific health 
                        threats and effects from environmental hazards, 
                        climate change, and extreme weather, such as 
                        increased heat-related illnesses and injuries, 
                        degraded air and water quality, vector-borne 
                        illnesses, mental and behavioral health 
                        effects, and food, water, and nutrient 
                        insecurity to available resources; and'';
                    (D) in paragraph (7) (as so redesignated), by 
                striking ``and'' after the semicolon;
                    (E) in paragraph (8) (as so redesignated), by 
                striking the period at the end and inserting a 
                semicolon; and
                    (F) by adding at the end the following:
            ``(9) support community health workers in educating, 
        guiding, and providing home visitation services regarding the 
        assessment and mitigation of the health risks of climate 
        change, including geography-specific and condition-specific 
        risks and environmental health hazards and the cumulative 
        health impacts of such risks and hazards; and
            ``(10) provide outreach and communication to promote 
        preparedness and response strategies to climate change and 
        extreme weather.'';
            (2) in subsection (d)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (D), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (E), by adding ``or'' 
                        after the semicolon; and
                            (iii) by adding at the end the following:
                    ``(F) environmental justice communities (as defined 
                in section 2 of the Green New Deal for Health Act);'';
                    (B) in paragraph (3), by inserting ``and experience 
                training community health workers'' before the 
                semicolon;
                    (C) in paragraph (4), by striking ``and'' at the 
                end;
                    (D) in paragraph (5), by striking the period at the 
                end and inserting ``; and''; and
                    (E) by adding at the end the following:
            ``(6) have a documented collective bargaining agreement 
        with 1 or more labor organizations representing employees of 
        the applicant or have an explicit policy not to interfere with 
        the rights of employees of the applicant under section 7 of the 
        National Labor Relations Act.'';
            (3) by redesignating subsections (e) through (j) as 
        subsections (f) through (k), respectively;
            (4) by inserting after subsection (d) the following:
    ``(e) Workforce Expansion.--The Secretary, in consultation with the 
Secretary of Labor, shall develop a plan to expand the community health 
workforce by 150,000 workers by 2028 through the creation of career 
pathways, full-time positions, and training opportunities described in 
subsection (b).'';
            (5) in subsection (j) (as so redesignated), by striking 
        ``$50,000,000 for each of fiscal years 2023 through 2027'' and 
        inserting ``$10,000,000,000 for each of fiscal years 2024 
        through 2033''; and
            (6) in paragraph (1) of subsection (k) (as so 
        redesignated)--
                    (A) by inserting ``a nonprofit community health 
                organization, a nonprofit community health worker 
                association,'' after ``a public health department,''; 
                and
                    (B) by striking ``((as defined'' and inserting 
                ``(as defined''.

SEC. 503. SAFEGUARDING ESSENTIAL HEALTH CARE WORKERS.

    The Public Health Service Act is amended by inserting after section 
319D-1 (42 U.S.C. 247d-4b) the following:

``SEC. 319D-2. EMERGENCY GRANTS TO SAFEGUARD ESSENTIAL HEALTH CARE 
              WORKERS.

    ``(a) Definitions.--In this section:
            ``(1) Emergency or disaster.--The term `emergency or 
        disaster' means--
                    ``(A) a major disaster declared by the President 
                under section 401 of the Robert T. Stafford Disaster 
                Relief and Emergency Assistance Act;
                    ``(B) an emergency declared by the President under 
                section 501 of the Robert T. Stafford Disaster Relief 
                and Emergency Assistance Act;
                    ``(C) a national emergency declared by the 
                President under the National Emergencies Act;
                    ``(D) a public health emergency declared under 
                section 319; and
                    ``(E) a State or local emergency or disaster, as 
                declared by the applicable State or local government.
            ``(2) Eligible health care worker.--The term `eligible 
        health care worker' means an essential health care worker whose 
        work cannot be conducted remotely.
            ``(3) Essential health care worker.--The term `essential 
        health care worker' means--
                    ``(A) a health care provider, including a direct 
                care worker (as defined in section 799B);
                    ``(B) a medical technologist;
                    ``(C) a public health worker;
                    ``(D) an orderly (as defined in the 2010 Standard 
                Occupational Classifications of the Department of Labor 
                under the code for Orderlies (31-1015));
                    ``(E) an environmental service, janitorial, or 
                custodial worker in a health care setting; and
                    ``(F) any other professional role that the 
                Secretary determines is essential to the care of 
                patients or the maintenance of public health.
    ``(b) Grants.--
            ``(1) In general.--The Secretary may make grants to public 
        or private nonprofit health care facilities and home health 
        agencies for use in accordance with paragraph (2).
            ``(2) Use of funds.--
                    ``(A) Hazardous duty compensation.--
                            ``(i) In general.--The recipient of a grant 
                        under paragraph (1) shall use the grant funds 
                        to provide hazardous duty compensation to 
                        eligible health care workers for work performed 
                        during the period of an emergency or disaster 
                        in cases in which the Secretary determines 
                        that--
                                    ``(I) the performance of the work 
                                by the eligible health care worker for 
                                the applicable health care facility or 
                                home health agency is hazardous; or
                                    ``(II) the commute of the eligible 
                                health care worker is hazardous.
                            ``(ii) Requirement.--
                                    ``(I) In general.--Subject to 
                                subclause (II), the amount of hazardous 
                                duty compensation under clause (i) 
                                shall be not more than $13 per hour, 
                                which shall be in addition to the wages 
                                or remuneration the eligible health 
                                care worker otherwise receives for the 
                                work.
                                    ``(II) Maximum amount.--The total 
                                amount of hazardous duty compensation 
                                received by any 1 eligible health care 
                                worker under this subparagraph may not 
                                exceed $25,000 per year.
                    ``(B) Additional uses.--The recipient of a grant 
                under paragraph (1) may use the grant funds to provide 
                safety measures to safeguard and protect eligible 
                health care workers from hazards due to the applicable 
                emergency or disaster, including alternative transit 
                options, personal protective equipment, and other 
                safety measures.
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be 
necessary.''.

           TITLE VI--SAFE, STRONG, AND RESILIENT COMMUNITIES

        Subtitle A--Empowering Resilient Community Mental Health

SEC. 601. GRANTS FOR RESILIENT COMMUNITY MENTAL HEALTH.

     Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by inserting after section 317V the following:

``SEC. 317W. GRANT PROGRAM FOR COMMUNITY WELLNESS AND RESILIENCE 
              PROGRAMS.

    ``(a) Grants.--
            ``(1) Program grants.--
                    ``(A) Awards.--The Secretary, in coordination with 
                the Assistant Secretary for Mental Health and Substance 
                Use and the Administrator of the Health Resources and 
                Services Administration, shall carry out a program of 
                awarding grants to eligible entities, on a competitive 
                basis, for the purpose of establishing, operating, or 
                expanding community mental wellness and resilience 
                programs.
                    ``(B) Amount.--An eligible entity awarded a grant 
                under subparagraph (A) may receive not more than 
                $300,000 per year for not more than 4 years.
            ``(2) Planning grants.--
                    ``(A) Awards.--The Secretary, in coordination with 
                the Assistant Secretary for Mental Health and Substance 
                Use and the Administrator of the Health Resources and 
                Services Administration, shall award grants to 
                entities--
                            ``(i) to organize a resilience coordinating 
                        network that meets the requirements of 
                        subsection (c)(2);
                            ``(ii) to perform assessments of need with 
                        respect to community mental wellness and 
                        resilience; and
                            ``(iii) to prepare an application for a 
                        grant under paragraph (1).
                    ``(B) Amount.--The amount of a grant under 
                subparagraph (A), with respect to any resilience 
                coordinating network to be organized for applying for a 
                grant under paragraph (1), shall not exceed $100,000.
    ``(b) Program Requirements.--A community mental wellness and 
resilience program funded pursuant to a grant under subsection (a)(1) 
shall take a public health approach to mental health to strengthen the 
entire community's psychological and emotional wellness and resilience, 
including by--
            ``(1) collecting and analyzing information from residents 
        as well as quantitative data to identify--
                    ``(A) protective factors that enhance and sustain 
                the community's capacity for mental wellness and 
                resilience; and
                    ``(B) risk factors that undermine such capacity;
            ``(2) strengthening such protective factors and addressing 
        such risk factors;
            ``(3) building awareness, skills, tools, curricula, and 
        leadership in the community to--
                    ``(A) facilitate using a public health approach to 
                mental health; and
                    ``(B) heal mental health and psychosocial problems 
                among all adults and youth; and
            ``(4) developing, implementing, and continually evaluating 
        and improving a comprehensive strategic plan for carrying out 
        the activities described in paragraphs (1), (2) and (3) that 
        includes utilizing developmentally, linguistically, and 
        culturally appropriate evidence-based, evidence-informed, 
        promising-best, or indigenous practices for--
                    ``(A) engaging community members in building social 
                connections across cultural, geographic, and economic 
                boundaries;
                    ``(B) enhancing local economic and environmental 
                conditions and environmental resilience, including with 
                respect to the built environment;
                    ``(C) becoming trauma-informed and learning simple 
                self-administrable mental wellness and resilience 
                skills;
                    ``(D) engaging in community activities and mutual 
                aid networks that strengthen mental wellness and 
                resilience;
                    ``(E) partaking in nonclinical group and community-
                minded recovery and healing programs;
                    ``(F) embedding trauma-informed climate education 
                and mental resilience curricula and programming into 
                schools for students, workers, and the broader 
                community; and
                    ``(G) other activities to promote mental wellness 
                and resilience, manage climate anxiety, and heal 
                individual and community traumas.
    ``(c) Eligible Entities.--
            ``(1) In general.--To be eligible to receive a grant under 
        subsection (a)(1), an applicant shall be a nonprofit or 
        community organization that has--
                    ``(A) organized a resilience coordinating network 
                that meets the requirements of paragraph (2); and
                    ``(B) been approved by such resilience coordinating 
                network to serve as its fiscal sponsor.
            ``(2) Resilience coordinating networks described.--A 
        resilience coordinating network organized under paragraph 
        (1)(A) shall be composed of 1 or more representatives of 
        entities from not fewer than 8 of the following categories:
                    ``(A) Grassroots groups, neighborhood associations, 
                and volunteer civic organizations.
                    ``(B) Elementary and secondary schools, 
                institutions of higher education including community 
                colleges, job-training programs, and other education or 
                training agencies or organizations.
                    ``(C) Youth after-school and summer programs.
                    ``(D) Family and early childhood education 
                programs.
                    ``(E) Faith and spirituality organizations.
                    ``(F) Senior care organizations.
                    ``(G) Climate change mitigation and adaptation, and 
                environmental conservation, groups and organizations.
                    ``(H) Social and environmental justice groups and 
                organizations.
                    ``(I) Disaster preparedness and response groups and 
                organizations.
                    ``(J) Local labor organizations.
                    ``(K) Businesses and business associations.
                    ``(L) Agencies and organizations involved with 
                community safety.
                    ``(M) Social work, mental health, behavioral 
                health, substance use, physical health, and public 
                health professionals; public health agencies and 
                institutions; and mental health, behavioral health, 
                social work, and other professionals, groups, 
                organizations, agencies, and institutions in the health 
                and human services fields.
                    ``(N) The general public, including individuals who 
                have experienced mental health or psychosocial problems 
                who can represent and engage with populations relevant 
                to the community.
    ``(d) Report.--
            ``(1) Submission.--Not later than December 31, 2028, the 
        Secretary shall submit a report to the Congress on the results 
        of the grants under subsection (a)(1).
            ``(2) Contents.--Such report shall include a summary of the 
        best practices used by grantees in establishing, operating, or 
        expanding community mental wellness and resilience programs.
    ``(e) Technical Assistance.--The Secretary shall provide technical 
assistance--
            ``(1) to assist eligible entities in developing 
        applications for grants under paragraph (1) or (2) of 
        subsection (a); and
            ``(2) to enable the sharing of best practices learned from 
        successful resilience coordinating networks.
    ``(f) Definitions.--In this section:
            ``(1) The term `community' means people, groups, and 
        organizations that reside in or work within a specific 
        geographic area, such as a city, neighborhood, subdivision, 
        urban, suburban, or rural locale.
            ``(2) The term `community trauma' means a blow to the basic 
        fabric of social life that damages the bonds attaching people 
        together, impairs their prevailing sense of community, 
        undermines their fundamental sense of safety, justice, equity, 
        and security, and heightens individual and collective fears and 
        feelings of vulnerability.
            ``(3) The term `mental wellness' means a state of well-
        being in which an individual can--
                    ``(A) realize their own potential;
                    ``(B) constructively cope with the stresses of 
                life;
                    ``(C) work productively and fruitfully; and
                    ``(D) make a contribution to their community.
            ``(4) The term `protective factors' means strengths, 
        skills, resources, and characteristics that--
                    ``(A) are associated with a lower likelihood of 
                negative outcomes of adversities; or
                    ``(B) reduce the impact on people of toxic stresses 
                or a traumatic experience.
            ``(5) The term `psychosocial problem' means the ways in 
        which an individual's mental health or behavioral health 
        problem disturbs others such as children, families, 
        communities, or society.
            ``(6) The term `public health approach to mental health' 
        means methods that--
                    ``(A) take a population-level approach to promote 
                mental wellness and resilience to prevent problems 
                before they emerge and heal them when they do appear, 
                not merely treating individuals one at a time after 
                symptoms of pathology appear; and
                    ``(B) address mental health and psychosocial 
                problems by--
                            ``(i) identifying and strengthening 
                        existing protective factors, and forming new 
                        ones, that buffer people from and enhance their 
                        capacity for psychological and emotional 
                        resilience; and
                            ``(ii) taking a holistic systems 
                        perspective that recognizes that most mental 
                        health and psychosocial problems result from 
                        numerous interrelated personal, family, social, 
                        economic, and environmental factors that 
                        require multipronged community-based 
                        interventions.
            ``(7) The term `resilience' means that people develop 
        cognitive, psychological, emotional capabilities and social 
        connections that enable them to calm their body, mind, 
        emotions, and behaviors during toxic stresses or traumatic 
        experiences in ways that enable them to--
                    ``(A) respond without negative consequences for 
                themselves or others; and
                    ``(B) use the experiences as catalysts to develop a 
                constructive new sense of meaning, purpose, and hope.
            ``(8) The term `Secretary' means the Secretary, acting 
        through the Director of the Centers for Disease Control and 
        Prevention.
            ``(9) The term `toxic stress' means exposure to persistent 
        overwhelming traumatic and stressful situations.
    ``(g) Funding.--
            ``(1) Authorization of appropriations.--To carry out this 
        section, there is authorized to be appropriated $100,000,000 
        for each of fiscal years 2024 through 2028.
            ``(2) Rural communities.--The Secretary shall award not 
        less than 20 percent of the amounts made available under 
        paragraph (1) for grants under paragraphs (1) and (2) of 
        subsection (a) to eligible entities that are establishing, 
        operating, or expanding community mental wellness and 
        resilience programs that are located in or serve a rural area 
        (as defined in section 520 of the Housing Act of 1949 (42 
        U.S.C. 1490)).
            ``(3) Environmental justice communities.--The Secretary 
        shall award not less than 20 percent of the amounts made 
        available under paragraph (1) for grants under paragraphs (1) 
        and (2) of subsection (a) to eligible entities that are 
        establishing, operating, or expanding community mental wellness 
        and resilience programs that serve environmental justice 
        communities (as defined in section 2 of the Green New Deal for 
        Health Act).''.

           Subtitle B--Understanding and Preventing Heat Risk

SEC. 611. DEFINITIONS.

    In this subtitle:
            (1) Extreme heat.--The term ``extreme heat'' means heat 
        that substantially exceeds local climatological norms in terms 
        of any combination of the following:
                    (A) Duration of an individual heat event.
                    (B) Intensity.
                    (C) Season length.
                    (D) Frequency.
            (2) Heat.--The term ``heat'' means any combination of the 
        atmospheric parameters associated with modulating human thermal 
        regulation, such as air temperature, humidity, solar exposure, 
        and wind speed.
            (3) Heat event.--The term ``heat event'' means an 
        occurrence of extreme heat that may have heat-health 
        implications.
            (4) Heat-health.--The term ``heat-health'' means mental and 
        physical health effects to humans from heat or the risk of such 
        effects.
            (5) Planning.--The term ``planning'' means activities 
        performed across time scales (including days, weeks, months, 
        years, and decades) with scenario-based, probabilistic or 
        deterministic information to identify and take actions to 
        proactively mitigate heat-health risks from increased 
        frequency, duration, and intensity of heat waves and increased 
        ambient temperature.
            (6) Preparedness.--The term ``preparedness'' means 
        activities performed across time scales (including days, weeks, 
        months, years, and decades) with probabilistic or deterministic 
        information to manage risk in advance of a heat event and 
        increased ambient temperature.
            (7) Tribal government.--The term ``Tribal government'' 
        means the recognized governing body of any Indian or Alaska 
        Native tribe, band, nation, pueblo, village, community, 
        component band, or component reservation, individually 
        identified (including parenthetically) in the list published 
        most recently as of the date of enactment of this Act pursuant 
        to section 104 of the Federally Recognized Indian Tribe List 
        Act of 1994 (25 U.S.C. 5131).
            (8) Vulnerable populations.--The term ``vulnerable 
        populations'' means populations that face health, financial, 
        educational, or housing disparities that would render them more 
        susceptible to the negative impacts of extreme heat.

SEC. 612. STUDY ON EXTREME HEAT INFORMATION AND RESPONSE.

    (a) Study.--
            (1) In general.--Not later than 120 days after the date of 
        the enactment of this Act, the Under Secretary of Commerce for 
        Oceans and Atmosphere, in consultation with representatives 
        from the Department of Health and Human Services as the 
        Secretary of Health and Human Services considers appropriate, 
        shall seek to enter into an agreement with the National 
        Academies of Sciences, Engineering, and Medicine to conduct a 
        study on extreme heat information and response, to be completed 
        not later than 2 years after the date of the enactment of this 
        Act.
            (2) Elements.--The study described in paragraph (1) shall--
                    (A) identify the policy, research, operations, 
                communications, and data gaps affecting heat-health 
                planning, preparedness, response, resilience, and 
                adaptation, and impacts to vulnerable populations;
                    (B) provide recommendations for addressing gaps 
                identified under subparagraph (A);
                    (C) provide recommendations, in addition to the 
                recommendations provided under subparagraph (B), which 
                may include strategies for--
                            (i) communicating warnings to and promoting 
                        resilience of populations vulnerable to extreme 
                        heat;
                            (ii) distributing extreme heat warnings, 
                        including to individuals with limited English 
                        proficiency and individuals who may have other 
                        established barriers to such information;
                            (iii) designing warnings described in 
                        clause (ii) to convey the urgency and severity 
                        of heat events and achieve behavior changes 
                        that reduce the mortality and morbidity of 
                        extreme heat effects;
                            (iv) understanding compound and cascading 
                        risks to inform development and implementation 
                        of heat-health risk reduction interventions; 
                        and
                            (v) promoting community resilience and 
                        addressing specific decision support service 
                        needs of vulnerable populations; and
                    (D) consider the effectiveness of country- or 
                local-level heat awareness and communication tools, 
                preparedness plans, or mitigation.
            (3) Development of definitions.--In conducting the study 
        described in paragraph (1), the National Academies of Sciences, 
        Engineering, and Medicine shall work with heat and health 
        experts to identify consistent and agreed-upon definitions for 
        heat events, heat waves, and other relevant terms.
    (b) Report.--Not later than 90 days after completion of the study 
described in subsection (a)(1), the Under Secretary of Commerce for 
Oceans and Atmosphere shall--
            (1) make available to the public on an internet website of 
        the National Oceanic and Atmospheric Administration a report on 
        the findings and conclusions of the study; and
            (2) submit the report to--
                    (A) the Committee on Commerce, Science, and 
                Transportation of the Senate;
                    (B) the Committee on Health, Education, Labor, and 
                Pensions of the Senate;
                    (C) the Committee on Science, Space, and Technology 
                of the House of Representatives;
                    (D) the Committee on Energy and Commerce of the 
                House of Representatives; and
                    (E) the Committee on Education and the Workforce of 
                the House of Representatives.

SEC. 613. FINANCIAL ASSISTANCE FOR RESEARCH AND RESILIENCE IN 
              ADDRESSING EXTREME HEAT RISKS.

    (a) Establishment of Program.--Subject to the availability of 
appropriations, not later than 1 year after the date of the enactment 
of this Act, the Under Secretary of Commerce for Oceans and Atmosphere 
shall establish and administer a community heat resilience program to 
provide financial assistance to eligible entities to carry out projects 
described in subsection (e) to ameliorate the mental and physical human 
health impacts of extreme heat events.
    (b) Purpose.--The purpose of the financial assistance provided 
under this section is to further scientific research regarding extreme 
heat and fund efforts to educate communities about extreme heat.
    (c) Forms of Assistance.--Financial assistance provided under this 
section may be in the form of contracts, grants, or cooperative 
agreements.
    (d) Eligible Entities.--Entities eligible to receive financial 
assistance under this section to carry out projects described in 
subsection (e) include--
            (1) nonprofit entities;
            (2) academic institutions;
            (3) States;
            (4) Tribal governments;
            (5) local governments; and
            (6) political subdivisions of States, Tribal governments, 
        and local governments.
    (e) Eligible Projects.--Projects described in this subsection 
include projects--
            (1) to expand public awareness of heat risks;
            (2) to conduct heat mapping campaigns;
            (3) to conduct scientific research to assess gaps and 
        priorities regarding the risks of extreme heat in communities;
            (4) to communicate risks to isolated communities; and
            (5) to educate such communities about how to respond to 
        extreme heat events.
    (f) Priorities.--In selecting eligible entities to receive 
financial assistance under this section, the Under Secretary of 
Commerce for Oceans and Atmosphere shall prioritize entities that will 
carry out projects that provide benefits for historically disadvantaged 
communities and communities found to have the greatest risk or highest 
incidence of heat-related illnesses and mortalities.

SEC. 614. AUTHORIZATION OF APPROPRIATIONS.

    (a) Study on Extreme Heat Information and Response.--There is 
authorized to be appropriated to the National Oceanic and Atmospheric 
Administration to contract with the National Academies of Sciences, 
Engineering, and Medicine to carry out section 612 $500,000 for each of 
fiscal years 2024 through 2026.
    (b) Financial Assistance To Address Extreme Heat.--There is 
authorized to be appropriated to the National Oceanic and Atmospheric 
Administration to carry out section 613 $30,000,000 for each of fiscal 
years 2024 through 2028.

             Subtitle C--Home Resiliency for Medical Needs

SEC. 621. MEDICARE COVERAGE OF MEDICALLY NECESSARY HOME RESILIENCY 
              SERVICES.

    (a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended--
            (1) in subsection (s)(2)--
                    (A) in subparagraph (II), by striking ``and'' at 
                the end;
                    (B) in subparagraph (JJ), by inserting ``and'' at 
                the end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(KK) in the case of an individual who is medically at 
        risk in the event of a climate or man-made disaster (as 
        determined by the Secretary in accordance with subsection 
        (nnn)), home resiliency services (as defined in such 
        subsection);''; and
            (2) by adding at the end the following new subsection:
    ``(nnn) Home Resiliency Services; Determination of Individuals 
Medically at Risk.--
            ``(1) Home resiliency services.--The term `home resiliency 
        services' means items and services--
                    ``(A) furnished on or after January 1, 2024, to an 
                individual described in subsection (s)(2)(KK); and
                    ``(B) that the Secretary determines are medically 
                necessary for such individual in the case of a climate 
                or man-made disaster, such as a heat pump for an 
                individual vulnerable to extreme temperatures, solar 
                batteries for an individual reliant on electrical 
                medical equipment (including home mechanical 
                ventilators), and energy-efficient cold storage for 
                heat-sensitive medical supplies.
            ``(2) Determination of individuals medically at risk.--For 
        purposes of subsection (s)(2)(KK) and this subsection, the 
        Secretary, in consultation with the Office of Climate Change 
        and Health Equity, the National Institutes of Health, the 
        Centers of Medicare & Medicaid Services, and the National 
        Oceanic and Atmospheric Administration, shall establish a 
        process to determine the conditions under which an individual 
        would be determined to be medically at risk in the event of a 
        disaster or climate hazards, including extreme heat, extreme 
        cold, flooding, and loss of power. Such a process shall 
        consider--
                    ``(A) geography-specific climate risks and regional 
                preparedness for different climate risks;
                    ``(B) the regional history of disaster or climate 
                hazards and infrastructure failure in the preceding 20 
                years or the forward-looking predicted risk of disaster 
                or climate hazards and infrastructure failure in the 
                next 20 years;
                    ``(C) medical reliance on equipment, 
                pharmaceuticals, mobility aids, and other supplies that 
                are sensitive to exposure to extreme temperatures, poor 
                air quality, flooding and water damage, or dependent on 
                electrical power; and
                    ``(D) chronic medical conditions, disabilities, and 
                co-morbidities that increase patient vulnerability 
                during disaster.''.
    (b) Payment.--Section 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) is amended--
            (1) by striking ``and'' before ``(HH)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``and (II) with respect to home resiliency services 
        described in section 1861(s)(2)(KK), the amount paid shall be 
        an amount equal to 100 percent of the lesser of the actual 
        charge for the services or the amount determined under a fee 
        schedule established by the Secretary''. 

       TITLE VII--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH

SEC. 701. RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by adding at the end the following:

        ``PART W--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH

``SEC. 399OO. NATIONAL CLIMATE AND HEALTH RESEARCH AND INNOVATION 
              INITIATIVE.

    ``(a) Establishment.--The President shall establish and implement 
an initiative, to be known as the `National Climate and Health Research 
and Innovation Initiative' (referred to in this part as the 
`Initiative'), to be carried out by the Secretary, acting through the 
Assistant Secretary for Health.
    ``(b) Purpose.--The purpose of the Initiative is to develop the 
tools, research, innovations, and understanding of climate change and 
health needed to prevent, treat, and mitigate the health harms of 
climate change in order to protect the collective health and well-being 
of the people of the United States.
    ``(c) Activities.--In carrying out the Initiative, the President, 
acting through the Office of Climate Change and Health Equity, the 
Interagency Committee, and such agency heads as the President considers 
appropriate, shall carry out activities that include the following:
            ``(1) Supporting research to understand, predict, and 
        prevent the health burdens of climate change and improve the 
        ability to treat health harms due to climate change, 
        including--
                    ``(A) research to understand and predict the 
                impacts of climate change on both physical and mental 
                health, including disproportionate impacts based on 
                race, ethnicity, language, gender, sex, pregnancy 
                status, disability, age, location, occupation, and 
                immigration status;
                    ``(B) research into, and mitigation of, adverse 
                mental and physical health effects of historical and 
                ongoing environmental racism and the subsequent 
                combined health risk of climate change and 
                environmental pollution;
                    ``(C) research to model and predict occupational 
                hazards that will occur or intensify due to climate 
                change;
                    ``(D) development of medical education curricula 
                relating to the clinical hazards of, and interventions 
                for, climate-change-based health burdens;
                    ``(E) research to address climate-related housing 
                and community development issues, including the impact 
                of, and mitigation strategies for, challenges such as 
                isolation, low-quality housing, housing precarity, and 
                homelessness, and the vulnerabilities and the mental 
                and physical health risks those challenges present; and
                    ``(F) research to study the social and economic 
                factors and policies that create healthy, resilient 
                communities prepared to adapt to the challenges posed 
                by climate change.
            ``(2) Supporting research and development of sustainable 
        and equitable health care operations and clinical practices 
        that reduce greenhouse gas emissions, climate risk, and 
        environmental health hazards, including--
                    ``(A) research into effective models of health care 
                delivery--
                            ``(i) to mitigate the impact of long-
                        standing climate change and environmental 
                        hazards on health; and
                            ``(ii) in preparation for, and in response 
                        to, climate disasters;
                    ``(B) research to model and predict the necessary 
                health care capacity surplus required to absorb both 
                acute and chronic surges in health care demand due to 
                climate-generated health burden, with attention to 
                geographical climate risks and patient demographic 
                health care needs;
                    ``(C) the development of methods to reduce health 
                sector environmental pollution;
                    ``(D) research into, and mitigation of, the 
                environmental impacts of hazardous substances used in 
                health care and the health care supply chain, including 
                the placement of facilities that use hazardous 
                substances and the proximity of those facilities to 
                historically marginalized communities;
                    ``(E)(i) research and development of innovations 
                that shift the lifecycle of medical supplies and 
                devices from single use to sustainable, circular 
                economies, including low-environmental impact 
                sterilization techniques; and
                    ``(ii) support of public-private partnerships that 
                enable scientific translation of those innovations;
                    ``(F) the development of clinically equivalent and 
                improved, low-climate-footprint interventions and 
                pharmaceuticals and the study of the environmental 
                impacts of those interventions and pharmaceuticals to 
                enable high-quality, environmentally conscious clinical 
                decision making; and
                    ``(G) conducting and supporting research, 
                development, demonstration, and commercial application 
                of renewable energy technologies and strategies to meet 
                the energy demand and energy security needs of 
                infrastructure critical to health care.
    ``(d) Termination.--The Initiative shall terminate on December 31, 
2033.

``SEC. 399OO-1. INTERAGENCY COORDINATION.

    ``(a) In General.--Not later than 1 year after the date of 
enactment of the Green New Deal for Health Act, the President shall 
establish an interagency committee (referred to in this part as the 
`Interagency Committee'), to coordinate the Initiative, as appropriate, 
among the departments, offices, and agencies described in subsection 
(b)(1).
    ``(b) Membership.--
            ``(1) In general.--The membership of the Interagency 
        Committee shall consist of--
                    ``(A) 3 representatives of the Department of Health 
                and Human Services, which shall include--
                            ``(i) 1 representative of the Office of 
                        Climate Change and Health Equity; and
                            ``(ii) 1 representative of the National 
                        Institutes of Health;
                    ``(B) 1 representative of the Office of Science and 
                Technology Policy;
                    ``(C) 1 representative of the National Science 
                Foundation;
                    ``(D) 1 representative of the Environmental 
                Protection Agency;
                    ``(E) 1 representative of the Department of Energy;
                    ``(F) 1 representative of the Department of Housing 
                and Urban Development; and
                    ``(G) 1 representative of the Department of Labor.
            ``(2) Co-chairs.--The Interagency Committee shall be co-
        chaired by the representatives described in subparagraphs 
        (A)(i) and (B) of paragraph (1).
    ``(c) Meetings.--The Interagency Committee shall meet not less 
frequently than quarterly.
    ``(d) Duties.--The Interagency Committee shall--
            ``(1) provide for interagency coordination of the 
        activities of the Initiative;
            ``(2) develop a plan that describes how the departments, 
        offices, and agencies described in subsection (b)(1) will 
        collectively carry out the activities described in section 
        399OO(c), including--
                    ``(A) a description of how each department, office, 
                and agency will execute a subset of the activities 
                described in that section; and
                    ``(B) a description of collaborations across the 
                departments, offices, and agencies;
            ``(3) annually submit to Congress a report describing the 
        progress of the Initiative, activities of the Interagency 
        Committee, and policy recommendations that derive from the 
        results of the Initiative; and
            ``(4) as part of the President's annual budget request to 
        Congress, propose an annually coordinated interagency budget 
        for the Initiative to the Office of Management and Budget that 
        is intended to ensure that the balance of funding across the 
        Initiative is sufficient to meet the goals and priorities 
        established for the Initiative.

``SEC. 399OO-2. ADVISORY COUNCIL.

    ``(a) In General.--The Secretary shall establish an advisory 
council (referred to in this section as the `Advisory Council') to 
advise and provide recommendations to the Initiative.
    ``(b) Membership.--
            ``(1) In general.--The membership of the Advisory Council 
        shall consist of--
                    ``(A) the members of the Interagency Committee; and
                    ``(B) the non-Federal members appointed under 
                paragraph (2).
            ``(2) Appointed members.--The Secretary shall appoint the 
        following non-Federal members of the Advisory Council:
                    ``(A) Not more than 4 members who are 
                representatives of research institutions, academic 
                institutions, or medical industry entities.
                    ``(B) Not fewer than 1 member who is a 
                representative of a critical access hospital (as 
                defined in section 1861(mm)(1) of the Social Security 
                Act).
                    ``(C) Not fewer than 1 member who is a 
                representative of a hospital that receives 
                disproportionate share payments under section 
                1886(d)(5)(F) of the Social Security Act.
                    ``(D) Not fewer than 1 member who is a 
                representative of a community health center receiving 
                funding under section 330.
                    ``(E) Not fewer than 1 member who is a 
                representative of an Indian Health Service facility 
                operated by an Indian tribe or tribal organization (as 
                defined in section 4 of the Indian Health Care 
                Improvement Act).
                    ``(F) Not fewer than 1 member who is a 
                representative of a State, local, or Tribal department 
                of public health.
                    ``(G) Not fewer than 4 members who--
                            ``(i) are representatives of labor 
                        organizations representing health care workers; 
                        and
                            ``(ii) collectively represent a diversity 
                        of health care professions, such as workers in 
                        environmental services, direct care workers, 
                        nurses, and physicians.
                    ``(H) Not fewer than 4 members who are 
                representatives of community-based patient advocacy or 
                public health advocacy organizations, each of which are 
                from different geographic regions of the United States.
            ``(3) Diverse representation.--The Secretary shall ensure 
        that the membership of the Advisory Council reflects the 
        diversity of the patient populations that are geographically 
        and demographically representative of the United States, 
        especially frontline populations and populations that are 
        subject to negative disparate outcomes in health.
            ``(4) Duties.--The Advisory Council shall advise the 
        President and the Secretary on matters relating to the 
        Initiative, including recommendations related to--
                    ``(A) the research and innovation needs of 
                frontline communities, environmental justice 
                communities (as defined in section 2 of the Green New 
                Deal for Health Act), medically underserved communities 
                (as defined in section 799B), and individuals 
                vulnerable to climate change;
                    ``(B) the current gaps and challenges in the 
                scientific understanding of the health impacts of 
                climate change and the impact of health care on 
                climate;
                    ``(C) emerging research and innovation needs from 
                clinical practice;
                    ``(D) whether issues of health disparities are 
                adequately addressed by the Initiative;
                    ``(E) the balance of activities and funding across 
                the Initiative;
                    ``(F) bottlenecks in translating research findings 
                into clinical advances, mitigation strategies, and 
                workplace safety; and
                    ``(G) accountability and ethical use of research 
                funds.
            ``(5) Meetings.--The Advisory Council shall meet not less 
        frequently than annually, and such meetings shall be open to 
        the public.
            ``(6) Termination.--The Advisory Council shall terminate on 
        December 31, 2033.

``SEC. 399OO-3. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated to carry out section 399OO 
$5,000,000,000 for each of fiscal years 2024 through 2033.''.
                                 &lt;all&gt;
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