(1) IN GENERAL.—Section 1610(a) of the Pub-
lic 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 pe-
riod at the end and inserting ‘‘; or’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(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 insert-
ing the following: 
‘‘(3) PRIORITY.—In awarding grants under this sub-
section, the Secretary shall give priority to applicants 
whose projects will include, by design, resilience against 
natural disasters, climate change mitigation, or other nec-
essary predisaster adaptations to ensure continuous health 
care access and combat health risks due to climate change, 
such as— 
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‘‘(A) installation of onsite distributed genera-
tion that combines energy-efficient devices, energy 
storage, and renewable energy in accordance with 
modern electrical safety standards for medical facili-
ties to allow the medical facility to access essential 
energy during power outages and optimize use of on-
site and offsite energy sources for emissions reduc-
tions; 
‘‘(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, stormwater drainage, 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 in-
creased risk of wildfire; 
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‘‘(D) green rooftops, walls, and indoor plant-
ings, particularly those that can provide publicly ac-
cessible temperature management and air quality 
improvements; 
‘‘(E) tree planting and other green infrastruc-
ture to create publicly accessible cool space to ad-
dress urban heat islands; 
‘‘(F) infrastructure upgrades that protect ac-
cess 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 in-
stalled using funds made available pursuant to para-
graph (4) or other funds; and 
‘‘(H) any other type of plan or project the Sec-
retary 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 sub-
section $100,000,000,000 for fiscal year 2024, to remain 
available until expended.’’. 
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(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 commu-
nity service obligation; and 
‘‘(M) reasonable assurance that the facil-
ity— 
‘‘(i) has a collective bargaining agree-
ment 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.’’. 
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(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 ap-
plication for a project submitted under part A or B shall 
deemed to be complete for purposes of section 3(d)(2) of 
the Granting Resources for Eliminating Emissions Now 
in Hospitals Act, and the application shall be deemed to 
have been submitted for purposes of consideration for a 
planning grant under that section.’’. 
SEC. 3. PLANNING AND EVALUATION GRANT PROGRAM. 
(a) DEFINITIONS.—In this section: 
(1) MEDICAL
FACILITY.—The term ‘‘medical 
facility’’ means a hospital, public health center, out-
patient medical facility, rehabilitation facility, facil-
ity 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 sustain-
ability and resiliency plan. 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
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