I 
118TH CONGRESS 
1ST SESSION H. R. 3302 
To protect Moms and babies against climate change, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 15, 2023 
Ms. UNDERWOOD (for herself, Mr. AGUILAR, Mr. ALLRED, Ms. BARRAGA´N, 
Mrs. BEATTY, Mr. BISHOP of Georgia, Mr. BLUMENAUER, Ms. BLUNT 
ROCHESTER, Ms. BROWNLEY, Ms. BUDZINSKI, Ms. BUSH, Ms. CARAVEO, 
Mr. CARBAJAL, Mr. CARSON, Mr. CARTER
of Louisiana, Mrs. 
CHERFILUS-MCCORMICK, Ms. CLARKE of New York, Mr. CLEAVER, Mr. 
COHEN, Ms. CRAIG, Ms. CROCKETT, Mr. DAVIS of Illinois, Ms. DEAN of 
Pennsylvania, Ms. ESCOBAR, Mr. ESPAILLAT, Mr. EVANS, Mrs. 
FOUSHEE, Mr. GARAMENDI, Ms. GARCIA of Texas, Mr. GARCI´A of Illi-
nois, Mr. GREEN of Texas, Mrs. HAYES, Mr. HORSFORD, Mr. HUFFMAN, 
Mr. IVEY, Mr. JACKSON of Illinois, Ms. JACKSON LEE, Ms. JACOBS, Ms. 
JAYAPAL, Mr. JOHNSON
of Georgia, Ms. KAMLAGER-DOVE, Mr. 
KRISHNAMOORTHI, Ms. KUSTER, Ms. LEE of California, Mr. LIEU, Ms. 
LOFGREN, Mrs. MCBATH, Mrs. MCCLELLAN, Ms. MCCOLLUM, Mr. 
MCGOVERN, Mr. MEEKS, Ms. MENG, Mr. MFUME, Mr. MORELLE, Mr. 
MOULTON, Ms. MOORE of Wisconsin, Mr. MRVAN, Mr. MULLIN, Mrs. 
NAPOLITANO, Mr. NEGUSE, Ms. OCASIO-CORTEZ, Mr. PAPPAS, Mr. 
PAYNE, Mr. PHILLIPS, Ms. PORTER, Ms. PRESSLEY, Mr. RUPPERS-
BERGER, Ms. SALINAS, Ms. SCANLON, Mr. SCHIFF, Mr. SCHNEIDER, Ms. 
SCHOLTEN, Mr. DAVID SCOTT of Georgia, Ms. SEWELL, Mr. SMITH of 
Washington, Mr. SOTO, Ms. SPANBERGER, Ms. STANSBURY, Ms. STRICK-
LAND, Mrs. SYKES, Mr. TAKANO, Ms. TLAIB, Ms. TOKUDA, Mr. TONKO, 
Mrs. TORRES of California, Mrs. TRAHAN, Mr. TRONE, Mr. VARGAS, Mr. 
VEASEY, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Mrs. WATSON 
COLEMAN, Ms. WEXTON, Ms. WILLIAMS of Georgia, Mr. PASCRELL, Ms. 
DELBENE, and Mr. LYNCH) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce 
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A BILL 
To protect Moms and babies against climate change, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protecting Moms and 
Babies Against Climate Change Act’’. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) ADVERSE MATERNAL AND INFANT HEALTH 
OUTCOMES.—The term ‘‘adverse maternal and in-
fant health outcomes’’ includes the outcomes of 
preterm birth, low birth weight, stillbirth, infant or 
maternal mortality, and severe maternal morbidity. 
(2) INSTITUTION OF HIGHER EDUCATION.—The 
term ‘‘institution of higher education’’ has the 
meaning given such term in section 101 of the High-
er Education Act of 1965 (20 U.S.C. 1001). 
(3) MATERNAL MORTALITY.—The term ‘‘mater-
nal mortality’’ means a death occurring during or 
within a 1-year period after pregnancy, caused by 
pregnancy-related or childbirth complications, in-
cluding a suicide, overdose, or other death resulting 
from a mental health or substance use disorder at-
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tributed to or aggravated by pregnancy-related or 
childbirth complications. 
(4) 
MINORITY-SERVING
INSTITUTION.—The 
term ‘‘minority-serving institution’’ means an entity 
specified in any of paragraphs (1) through (7) of 
section 371(a) of the Higher Education Act of 1965 
(20 U.S.C. 1067q(a)). 
(5) PERINATAL HEALTH WORKER.—The term 
‘‘perinatal health worker’’ means a nonclinical health 
worker focused on maternal or perinatal health, such 
as a doula, community health worker, peer sup-
porter, lactation educator or counselor, nutritionist 
or dietitian, childbirth educator, social worker, home 
visitor, patient navigator or coordinator, or language 
interpreter. 
(6) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given such term in section 1707(g)(1) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)). 
(7) 
RISKS
ASSOCIATED
WITH
CLIMATE 
CHANGE.—The term ‘‘risks associated with climate 
change’’ includes risks associated with extreme heat, 
air pollution, extreme weather events, and other en-
vironmental issues associated with climate change 
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that can result in adverse maternal and infant 
health outcomes. 
(8) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(9) SEVERE MATERNAL MORBIDITY.—The term 
‘‘severe maternal morbidity’’ means a health condi-
tion, including mental health conditions and sub-
stance use disorders, attributed to or aggravated by 
pregnancy or childbirth that results in significant 
short-term or long-term consequences to the health 
of the individual who was pregnant. 
(10) STAKEHOLDER ORGANIZATION.—The term 
‘‘stakeholder organization’’ means— 
(A) a community-based organization with 
expertise in providing assistance to vulnerable 
individuals; 
(B) a nonprofit organization with expertise 
in— 
(i) maternal or infant health; or 
(ii) environmental or climate justice; 
and 
(C) a patient advocacy organization rep-
resenting vulnerable individuals. 
(11) VULNERABLE
INDIVIDUAL.—The term 
‘‘vulnerable individual’’ means— 
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(A) an individual who is pregnant; 
(B) an individual who was pregnant during 
any portion of the preceding 1-year period; and 
(C) an individual under 3 years of age. 
SEC. 3. GRANT PROGRAM TO PROTECT VULNERABLE 
MOTHERS 
AND 
BABIES 
FROM 
CLIMATE 
CHANGE RISKS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary shall es-
tablish a grant program to protect vulnerable individuals 
from risks associated with climate change. 
(b) GRANT AUTHORITY.—In carrying out the Pro-
gram, the Secretary may award, on a competitive basis, 
grants to 10 covered entities. 
(c) APPLICATIONS.—To be eligible for a grant under 
the Program, a covered entity shall submit to the Sec-
retary an application at such time, in such form, and con-
taining such information as the Secretary may require, 
which shall include, at a minimum, a description of the 
following: 
(1) Plans for the use of grant funds awarded 
under the Program and how patients and stake-
holder organizations were involved in the develop-
ment of such plans. 
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(2) How such grant funds will be targeted to 
geographic areas that have disproportionately high 
levels of risks associated with climate change for vul-
nerable individuals. 
(3) How such grant funds will be used to ad-
dress racial and ethnic disparities in— 
(A) adverse maternal and infant health 
outcomes; and 
(B) exposure to risks associated with cli-
mate change for vulnerable individuals. 
(4) Strategies to prevent an initiative assisted 
with such grant funds from causing— 
(A) adverse environmental impacts; 
(B) displacement of residents and busi-
nesses; 
(C) rent and housing price increases; or 
(D) disproportionate adverse impacts on 
racial and ethnic minority groups and other un-
derserved populations. 
(d) SELECTION OF GRANT RECIPIENTS.— 
(1) TIMING.—Not later than 270 days after the 
date of enactment of this Act, the Secretary shall se-
lect the recipients of grants under the Program. 
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(2) CONSULTATION.—In selecting covered enti-
ties for grants under the Program, the Secretary 
shall consult with— 
(A) representatives of stakeholder organi-
zations; 
(B) the Administrator of the Environ-
mental Protection Agency; 
(C) the Administrator of the National Oce-
anic and Atmospheric Administration; and 
(D) from the Department of Health and 
Human Services— 
(i) the Deputy Assistant Secretary for 
Minority Health; 
(ii) the Administrator of the Centers 
for Medicare & Medicaid Services; 
(iii) the Administrator of the Health 
Resources and Services Administration; 
(iv) the Director of the National Insti-
tutes of Health; and 
(v) the Director of the Centers for 
Disease Control and Prevention. 
(3) PRIORITY.—In selecting grantees under the 
Program, the Secretary shall give priority to covered 
entities that serve a county or locality— 
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(A) designated, or located in an area des-
ignated, as a nonattainment area pursuant to 
section 107 of the Clean Air Act (42 U.S.C. 
7407) for any air pollutant for which air quality 
criteria have been issued under section 108(a) 
of such Act (42 U.S.C. 7408(a)); 
(B) with a level of vulnerability of mod-
erate-to-high or higher, according to the Social 
Vulnerability Index of the Centers for Disease 
Control and Prevention, or a similar rating of 
social vulnerability according to related Federal 
mapping tools; 
(C) with temperatures that pose a risk to 
human health, as determined by the Secretary, 
in consultation with the Administrator of the 
National Oceanic and Atmospheric Administra-
tion and the Chair of the United States Global 
Change Research Program, based on the best 
available science; 
(D) with elevated rates of maternal mor-
tality, severe maternal morbidity, maternal 
health disparities, or other adverse perinatal or 
childbirth outcomes; 
(E) with a rating of very high or relatively 
high risk according to the National Risk Index 
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for Natural Hazards of the Federal Emergency 
Management Agency; or 
(F) with other climate-sensitive hazards 
with associations to adverse maternal or infant 
health outcomes, as determined by the Sec-
retary. 
(4) LIMITATION.—A recipient of grant funds 
under the Program may not use such grant funds to 
serve a county or locality that is served by any other 
recipient of a grant under the Program. 
(e) USE OF FUNDS.—A covered entity awarded grant 
funds under the Program may only use such grant funds 
for the following: 
(1) Initiatives to identify risks associated with 
climate change for vulnerable individuals and to pro-
vide services and support to such individuals that 
address such risks, which may include— 
(A) training for health care providers, 
perinatal health workers, and other employees 
in hospitals, birth centers, midwifery practices, 
and other health care practices that provide 
prenatal or labor and delivery services to vul-
nerable individuals on the identification of, and 
patient counseling relating to, risks associated 
with climate change for vulnerable individuals; 
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(B) hiring, training, or providing resources 
to perinatal health workers who can help iden-
tify risks associated with climate change for 
vulnerable individuals, provide patient coun-
seling about such risks, and carry out the dis-
tribution of relevant services and support; 
(C) enhancing the monitoring of risks as-
sociated with climate change for vulnerable in-
dividuals, including by— 
(i) collecting data on such risks in 
specific census tracts, neighborhoods, or 
other geographic areas; and 
(ii) sharing such data with local 
health care providers, perinatal health 
workers, and other employees in hospitals, 
birth centers, midwifery practices, and 
other health care practices that provide 
prenatal or labor and delivery services to 
local vulnerable individuals; and 
(D) providing vulnerable individuals— 
(i) air conditioning units, residential 
weatherization support, filtration systems, 
household appliances, or related items; 
(ii) direct financial assistance; and 
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(iii) services and support, including 
housing assistance, evacuation assistance, 
transportation assistance, access to cooling 
shelters, and mental health counseling, to 
prepare for or recover from extreme weath-
er events, which may include floods, hurri-
canes, wildfires, droughts, and related 
events. 
(2) Initiatives to mitigate levels of and exposure 
to risks associated with climate change for vulner-
able individuals, which shall be based on the best 
available science and which may include initiatives 
to— 
(A) develop, maintain, or expand urban or 
community forestry initiatives and tree canopy 
coverage initiatives; 
(B) improve infrastructure, such as build-
ings and paved surfaces; 
(C) develop or improve community out-
reach networks to provide culturally and lin-
guistically appropriate information and notifica-
tions about risks associated with climate change 
for vulnerable individuals; and 
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(D) provide enhanced services to racial and 
ethnic minority groups and other underserved 
populations. 
(f) LENGTH OF AWARD.—A grant under this section 
shall be disbursed over 4 fiscal years. 
(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance to a covered entity awarded 
a grant under the Program to support the development, 
implementation, and evaluation of activities funded with 
such grant. 
(h) REPORTS TO SECRETARY.— 
(1) ANNUAL
REPORT.—For each fiscal year 
during which a covered entity is disbursed grant 
funds under the Program, such covered entity shall 
submit to the Secretary a report that summarizes 
the activities carried out by such covered entity with 
such grant funds during such fiscal year, which shall 
include a description of the following: 
(A) The involvement of stakeholder organi-
zations in the implementation of initiatives as-
sisted with such grant funds. 
(B) Relevant health and environmental 
data, disaggregated, to the extent practicable, 
by race, ethnicity, primary language, socio-
economic status, geography, insurance type, 
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pregnancy status, and other relevant demo-
graphic information. 
(C) Qualitative feedback received from vul-
nerable individuals with respect to initiatives 
assisted with such grant funds. 
(D) Criteria used in selecting the geo-
graphic areas assisted with such grant funds. 
(E) Efforts to address racial and ethnic 
disparities in adverse maternal and infant 
health outcomes and in exposure to risks associ-
ated with climate change for vulnerable individ-
uals. 
(F) Any negative and unintended impacts 
of initiatives assisted with such grant funds, in-
cluding— 
(i) adverse environmental impacts; 
(ii) displacement of residents and 
businesses; 
(iii) rent and housing price increases; 
and 
(iv) disproportionate adverse impacts 
on racial and ethnic minority groups and 
other underserved populations. 
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(G) How the covered entity will address 
and prevent any impacts described in subpara-
graph (F). 
(2) PUBLICATION.—Not later than 30 days 
after the date on which a report is submitted under 
paragraph (1), the Secretary shall publish such re-
port on a public website of the Department of 
Health and Human Services. 
(i) REPORT TO CONGRESS.—Not later than the date 
that is 5 years after the date on which the Program is 
established, the Secretary shall submit to Congress and 
publish on a public website of the Department of Health 
and Human Services a report on the results of the Pro-
gram, including the following: 
(1) Summaries of the annual reports submitted 
under subsection (h). 
(2) Evaluations of the initiatives assisted with 
grant funds under the Program. 
(3) An assessment of the effectiveness of the 
Program in— 
(A) identifying risks associated with cli-
mate change for vulnerable individuals; 
(B) providing services and support to such 
individuals; 
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(C) mitigating levels of and exposure to 
such risks; and 
(D) addressing racial and ethnic disparities 
in adverse maternal and infant health outcomes 
and in exposure to such risks. 
(4) A description of how the Program could be 
expanded, including— 
(A) monitoring efforts or data collection 
that would be required to identify areas with 
high levels of risks associated with climate 
change for vulnerable individuals; 
(B) how such areas could be identified 
using the strategy developed under section 6; 
and 
(C) recommendations for additional fund-
ing. 
(j) DEFINITIONS.—In this section: 
(1) The term ‘‘covered entity’’ means a consor-
tium of organizations serving a county that— 
(A) shall include a community-based orga-
nization; and 
(B) may include— 
(i) another stakeholder organization; 
(ii) the government of such county; 
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(iii) the governments of one or more 
municipalities within such county; 
(iv) a State or local public health de-
partment or emergency management agen-
cy; 
(v) a local health care practice, which 
may include a licensed and accredited hos-
pital, birth center, midwifery practice, or 
other health care practice that provides 
prenatal or labor and delivery services to 
vulnerable individuals; 
(vi) an Indian tribe or Tribal organi-
zation (as such terms are defined in sec-
tion 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 
5304)); 
(vii) an Urban Indian organization (as 
defined in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603)); 
and 
(viii) an institution of higher edu-
cation. 
(2) The term ‘‘Program’’ means the grant pro-
gram under this section. 
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(k) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$100,000,000 for the period of fiscal years 2024 through 
2027. 
SEC. 4. GRANT PROGRAM FOR EDUCATION AND TRAINING 
AT HEALTH PROFESSION SCHOOLS. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary shall es-
tablish a grant program to provide funds to health profes-
sion schools to support the development and integration 
of education and training programs for identifying and ad-
dressing risks associated with climate change for vulner-
able individuals. 
(b) GRANT AUTHORITY.—In carrying out the Pro-
gram, the Secretary may award, on a competitive basis, 
grants to health profession schools. 
(c) APPLICATION.—To be eligible for a grant under 
the Program, 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 re-
quire, which shall include, at a minimum, a description 
of the following: 
(1) How such health profession school will en-
gage with vulnerable individuals, and stakeholder or-
ganizations representing such individuals, in devel-
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oping and implementing the education and training 
programs supported by grant funds awarded under 
the Program. 
(2) How such health profession school will en-
sure 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 vulnerable individuals. 
(d) USE
OF FUNDS.—A health profession school 
awarded a grant under the Program shall use the grant 
funds to develop, and integrate into the curriculum and 
continuing education of such health profession school, edu-
cation and training on each of the following: 
(1) Identifying risks associated with climate 
change for vulnerable individuals and individuals 
with the intent to become pregnant. 
(2) How risks associated with climate change 
affect vulnerable individuals and individuals with the 
intent to become pregnant. 
(3) Racial and ethnic disparities in exposure to, 
and the effects of, risks associated with climate 
change for vulnerable individuals and individuals 
with the intent to become pregnant. 
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(4) Patient counseling and mitigation strategies 
relating to risks associated with climate change for 
vulnerable individuals. 
(5) Relevant services and support for vulnerable 
individuals relating to risks associated with climate 
change and strategies for ensuring vulnerable indi-
viduals have access to such services and support. 
(6) Implicit and explicit bias, racism, and dis-
crimination. 
(7) Related topics identified by such health pro-
fession school based on the engagement of such 
health profession school with vulnerable individuals 
and stakeholder organizations representing such in-
dividuals. 
(e) PARTNERSHIPS.—In carrying out activities with 
grant funds, a health profession school awarded a grant 
under the Program may partner with one or more of the 
following: 
(1) A State or local public health department. 
(2) A health care professional membership or-
ganization. 
(3) A stakeholder organization. 
(4) A health profession school. 
(5) An institution of higher education. 
(f) REPORTS TO SECRETARY.— 
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(1) ANNUAL
REPORT.—For each fiscal year 
during which a health profession school is disbursed 
grant funds under the Program, such health profes-
sion 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 is disbursed 
grant funds under the Program, the health profes-
sion school shall submit to the Secretary a final re-
port that summarizes the activities carried out with 
such grant funds. 
(g) REPORT TO CONGRESS.—Not later than the date 
that is 6 years after the date on which the Program is 
established, the Secretary shall submit to Congress and 
publish on a 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 (f). 
(2) Recommendations to improve education and 
training programs at health profession schools with 
respect to identifying and addressing risks associ-
ated with climate change for vulnerable individuals. 
(h) DEFINITIONS.—In this section: 
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