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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public">
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<dublinCore>
<dc:title>116 S523 IS: Climate Change Health Protection and Promotion Act of 2019</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2019-02-14</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<form>
<distribution-code display="yes">II</distribution-code>
<congress>116th CONGRESS</congress><session>1st Session</session>
<legis-num>S. 523</legis-num>
<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
<action>
<action-date date="20190214">February 14, 2019</action-date>
<action-desc><sponsor name-id="S369">Mr. Markey</sponsor> (for himself, <cosponsor name-id="S353">Mr. Schatz</cosponsor>, <cosponsor name-id="S316">Mr. Whitehouse</cosponsor>, <cosponsor name-id="S366">Ms. Warren</cosponsor>, <cosponsor name-id="S322">Mr. Merkley</cosponsor>, and <cosponsor name-id="S311">Ms. Klobuchar</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc>
</action>
<legis-type>A BILL</legis-type>
<official-title>To direct the Secretary of Health and Human Services to develop a national strategic action plan and program to assist health professionals and systems in preparing for and responding to the public health effects of climate change, and for other purposes.</official-title>
</form> 
<legis-body display-enacting-clause="yes-display-enacting-clause" id="H9892C9D58D4A46EBA7E7CA0DAFA3E13E"> 
<section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Climate Change Health Protection and Promotion Act of 2019</short-title></quote>.</text> </section> <section id="idaeda94feee4546b185555555851977e5"><enum>2.</enum><header>Sense of congress on public health and climate change</header> <subsection id="id8833a76fa3fa4a518e9eba0a139b9d77"><enum>(a)</enum><header>Findings</header><text>The U.S. Global Change Research Program Climate and Health Assessment states that—</text> 
<paragraph id="id7c5cf7c5c2a24c6b8ad03009d636c3cb"><enum>(1)</enum><text>the impacts of human-induced climate change are increasing nationwide;</text> </paragraph> <paragraph id="id9592f32b01d4487d938bf66b26724e6d"><enum>(2)</enum><text>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;</text> </paragraph>
<paragraph id="id0414208edce24cb096634afc643ef16a"><enum>(3)</enum><text>these climate change impacts endanger our health by affecting our food and water sources, the air we breathe, the weather we experience, and our interactions with the built and natural environments; and</text> </paragraph> <paragraph id="id7e9f7526728f4c43a0ec1c6d6977f5ea"><enum>(4)</enum><text>as the climate continues to change, the risks to human health continue to grow.</text> </paragraph></subsection>
<subsection id="idd44ee76bdf75415a95944d7336b12f01"><enum>(b)</enum><header>Sense of Congress</header><text>It is the sense of Congress that—</text> <paragraph id="id700f244522f841ea9ac6487314853fbb"><enum>(1)</enum><text>climate change is real;</text> </paragraph>
<paragraph id="id81be28cc71434d14a87b35f5ae4eb7bf"><enum>(2)</enum><text>human activity significantly contributes to climate change;</text> </paragraph> <paragraph id="id0d746a9e0bd4483fa1631a637045ae79"><enum>(3)</enum><text>climate change negatively impacts health;</text> </paragraph>
<paragraph commented="no" id="id4f8b072b723d453bb197807c1694113e"><enum>(4)</enum><text>climate change disproportionately impacts communities of color and low-income communities; and</text> </paragraph> <paragraph commented="no" id="id312EC5E4CC004121B531E65B87AE195D"><enum>(5)</enum><text>the Federal Government, in cooperation with international, State, tribal, and local governments, concerned public, private and Native American organizations, and citizens, should use all practicable means and measures—</text> 
<subparagraph id="idedd701f6dde84ce7bd42f2e26f0ca97f"><enum>(A)</enum><text>to assist the efforts of public health and health care professionals, first responders, health care systems, States, the District of Columbia, territories, municipalities, and Native American and local communities to incorporate measures to prepare public health and health care systems to respond to the impacts of climate change;</text> </subparagraph> <subparagraph id="id321709c8f0d6462f8be5878343aee4d6"><enum>(B)</enum><text>to ensure—</text> 
<clause id="id9542c88865fe401bb8fb520d7757f743"><enum>(i)</enum><text>that the Nation’s public health and health care professionals have sufficient information to prepare for and respond to the adverse health impacts of climate change;</text> </clause> <clause id="ida4a611e2aed744c58e6c21f55d55a5ca"><enum>(ii)</enum><text>the application of scientific research in advancing understanding of—</text> 
<subclause id="id42a112fa810540808c23b7d5550166e9"><enum>(I)</enum><text>the health impacts of climate change; and</text> </subclause> <subclause id="id9bdda57876824d22a278edc67097ea35"><enum>(II)</enum><text>strategies to prepare for and respond to the health impacts of climate change;</text> </subclause></clause>
<clause id="id64a0804166e3428a92f4cadfbbd930b8"><enum>(iii)</enum><text>the identification of communities and populations vulnerable to the health impacts of climate change, including infants, children, pregnant women, the elderly, individuals with disabilities or pre-existing illnesses, low-income populations, and unhoused individuals, and the development of strategic response plans to be carried out by public health and health care professionals for those communities;</text> </clause> <clause id="idfacd42e6429643f0af2ed0ba5b4fd19f"><enum>(iv)</enum><text>the improvement of health status and health equity through efforts to prepare for and respond to climate change; and</text> </clause>
<clause id="id1ff6868877bc4bfda4f62f433b31cbb2"><enum>(v)</enum><text>the inclusion of health impacts in the development of climate change responses;</text> </clause></subparagraph> <subparagraph id="idc2ccd8574c464537821efa6758f977d7"><enum>(C)</enum><text>to encourage further research, interdisciplinary partnership, and collaboration among stakeholders in order to—</text> 
<clause id="id5c551b1d03b54b6891e0ff21f990097a"><enum>(i)</enum><text>understand and monitor the health impacts of climate change;</text> </clause> <clause id="id651650b6ea234463a1db30873fa655d9"><enum>(ii)</enum><text>improve public health knowledge and response strategies to climate change;</text> </clause>
<clause id="id0eaf86f39adf432b98fdc9e29ebca701"><enum>(iii)</enum><text>identify actions and policies that are beneficial to health and that mitigate climate health impacts; and</text> </clause> <clause id="id6565A5A03E98468BBF3A12590278599B"><enum>(iv)</enum><text>develop strategies to address water-, food-, and vector-borne infectious diseases and other public health emergencies;</text> </clause></subparagraph>
<subparagraph id="id7a0396dee5c54041a020c93b12bf6d60"><enum>(D)</enum><text>to enhance preparedness activities, and health care and public health infrastructure, relating to climate change and health;</text> </subparagraph> <subparagraph id="idb31e5a6d69864e6da117dea4b36cb7be"><enum>(E)</enum><text>to encourage each and every community to learn about the impacts of climate change on health; and</text> </subparagraph>
<subparagraph id="id7b4db0ea5c604bbb90b95cc0fa8fb28c"><enum>(F)</enum><text>to assist the efforts of developing nations to incorporate measures to prepare public health and health care systems to respond to the impacts of climate change.</text> </subparagraph></paragraph></subsection></section> <section id="idfbdf0f3cab4e4cdf8de3d2321ee62c6b"><enum>3.</enum><header>Relationship to other laws</header><text display-inline="no-display-inline">Nothing in this Act limits the authority provided to or responsibility conferred on any Federal department or agency by any provision of any law (including regulations) or authorizes any violation of any provision of any law (including regulations), including any health, energy, environmental, transportation, or any other law or regulation.</text> </section>
<section id="id93344d531098443389ca6970377cfc75"><enum>4.</enum><header>National strategic action plan and program</header> 
<subsection id="id0a39e7a622f046368495bc7d1f93f13b"><enum>(a)</enum><header>Requirement</header> 
<paragraph id="ideccbfc03a76f46fcbd804b57b6f11d4a"><enum>(1)</enum><header>In general</header><text>The Secretary of Health and Human Services (referred to in this Act as the <quote>Secretary</quote>), on the basis of the best available science, and in consultation pursuant to paragraph (2), shall publish a strategic action plan and establish a program to ensure the public health and health care systems are prepared for and can respond to the impacts of climate change on health in the United States and other nations.</text> </paragraph> <paragraph id="ide3fc136a06544223b88d31e69615a587"><enum>(2)</enum><header>Consultation</header><text>In developing or making any revision to the national strategic action plan and program, the Secretary shall—</text> 
<subparagraph id="id36abe075b4b04fa094e92388f44b5756"><enum>(A)</enum><text>consult with the Director of the Centers for Disease Control and Prevention, the Administrator of the Environmental Protection Agency, the Director of the National Institutes of Health, the Undersecretary of Commerce for Oceans &amp; Atmosphere, the Administrator of the National Aeronautics and Space Administration, the Director of the Indian Health Service, the Secretary of Defense, the Secretary of State, the Secretary of Veterans Affairs, other appropriate Federal agencies, Indian tribes, State and local governments, public health organizations, scientists, representatives of at-risk populations, and other interested stakeholders; and</text> </subparagraph> <subparagraph id="id965da8fcfad1469396f6848e93d3830d"><enum>(B)</enum><text>provide opportunity for public input and consultation with Indian tribes and Native American organizations.</text> </subparagraph></paragraph></subsection>
<subsection id="id653fb5e0dd894bd689e496dc62031737"><enum>(b)</enum><header>Activities</header> 
<paragraph id="id4724a13760724b4e82167be40f588dab"><enum>(1)</enum><header>National strategic action plan</header> 
<subparagraph id="idDF4238BE235E49F69A15AB5E51449487"><enum>(A)</enum><header>In general</header><text>Not later than 2 years after the date of enactment of this Act, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, and in collaboration with other Federal agencies as appropriate, shall, on the basis of the best available science, and in consultation with the entities described in subsection (a)(2)(A), publish a national strategic action plan under subparagraph (B) to guide the climate and health program and assist public health and health care professionals in preparing for and responding to the impacts of climate change on public health in the United States and other nations, particularly developing nations.</text> </subparagraph> <subparagraph commented="no" id="id2de212274b2d45b6a81a85a94bf8c254"><enum>(B)</enum><header>National strategic action plan components</header><text>The national strategic plan shall include an assessment of the health system capacity of the United States to address climate change including—</text> 
<clause id="id9210c8ad926b45d59a10a687921b593b"><enum>(i)</enum><text>identifying and prioritizing communities and populations vulnerable to the health impacts of climate change;</text> </clause> <clause id="id1c44ad029e9342d6ab56564ba54e24ee"><enum>(ii)</enum><text>providing outreach and communication aimed at public health and health care professionals and the public to promote preparedness and response strategies;</text> </clause>
<clause id="idcd924668d81b4017bef9b1aec836f923"><enum>(iii)</enum><text>providing for programs across Federal agencies to advance research related to the impacts of climate change on health;</text> </clause> <clause id="id0eb1b3ea28754004bc5153fe3230358f"><enum>(iv)</enum><text>identifying and assessing existing preparedness and response strategies for the health impacts of climate change;</text> </clause>
<clause id="id02b8f01d672e47bfbcab553fb0affc2a"><enum>(v)</enum><text>prioritizing critical public health and health care infrastructure projects;</text> </clause> <clause id="id27c05b7bf1ec493d91b29ba77c228819"><enum>(vi)</enum><text>providing modeling and forecasting tools of climate change health impacts, including local impacts, where feasible;</text> </clause>
<clause id="idfa7b78f8bcbe47e0991b8f515afa7f90"><enum>(vii)</enum><text>establishing academic and regional centers of excellence;</text> </clause> <clause id="id7c93c760603541fcbbb69fd53ca13e7b"><enum>(viii)</enum><text>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 nations; and</text> </clause>
<clause id="id2984390b3b6f48ff84b9d088149b7ab2"><enum>(ix)</enum><text>developing, improving, integrating, and maintaining domestic and international disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change, including on topics addressing—</text> <subclause id="id2501c09402fc403e92213f1e217148db"><enum>(I)</enum><text>water-, food-, and vector-borne infectious diseases and climate change;</text> </subclause>
<subclause id="id7153280a0e434b04b05e795117442a87"><enum>(II)</enum><text>pulmonary effects, including responses to aeroallergens and toxic exposures;</text> </subclause> <subclause id="id268dc9f7e54344d39518e1e12c3af979"><enum>(III)</enum><text>cardiovascular effects, including impacts of temperature extremes;</text> </subclause>
<subclause id="id2723dfc92bec4e01b09762f27eab786f"><enum>(IV)</enum><text>air pollution health effects, including heightened sensitivity to air pollution;</text> </subclause> <subclause id="id29ce7887640d470daa4e7b0e07f558a0"><enum>(V)</enum><text>harmful algal blooms;</text> </subclause>
<subclause id="idf7b9908004d64d1e93d29a7ceab94072"><enum>(VI)</enum><text>mental and behavioral health impacts of climate change;</text> </subclause> <subclause id="id086d18865431468f8b2c0833aacd18a9"><enum>(VII)</enum><text>the health of migrants, refugees, displaced persons, and vulnerable communities;</text> </subclause>
<subclause id="ida52409e116f54db982ca6441223200a2"><enum>(VIII)</enum><text>the implications for communities and populations vulnerable to the health effects of climate change, as well as strategies for responding to climate change within these communities;</text> </subclause> <subclause id="id0beb037a08dd46748cc7fc4a72a3859e"><enum>(IX)</enum><text>tribal, local, and community-based health interventions for climate-related health impacts;</text> </subclause>
<subclause id="idfcbe5b0783e0482496dfcf37e946dde8"><enum>(X)</enum><text>extreme heat and weather events, including drought;</text> </subclause> <subclause id="idF5910D672EA249D9A4A0367B4DAD0571"><enum>(XI)</enum><text>decreased nutritional value of crops; and</text> </subclause>
<subclause id="id8485FE660CD14428A903A865E5BE7D07"><enum>(XII)</enum><text>disruptions in access to routine and acute medical care.</text> </subclause></clause></subparagraph></paragraph> <paragraph id="id53d21a24d795428e9cda62b30f464313"><enum>(2)</enum><header>Climate and health program</header><text>The Secretary, acting through the Director of the Centers for Disease Control and Prevention, and in collaboration with other Federal agencies, as appropriate, shall ensure that the climate and health program established under this section addresses priority health actions including the following:</text> 
<subparagraph id="id666937b5c7414775ac2d458b6229d5bc"><enum>(A)</enum><text>Serve as a credible source of information on the physical, mental, and behavioral health consequences of climate change for the United States population and globally.</text> </subparagraph> <subparagraph id="ida30270182bd248dcacd3c1d0a5609555"><enum>(B)</enum><text>Track data on environmental conditions, disease risks, and disease occurrence related to climate change.</text> </subparagraph>
<subparagraph id="id7829f944441e4da2a72668ffa956dded"><enum>(C)</enum><text>Expand capacity for modeling and forecasting health effects that may be climate-related.</text> </subparagraph> <subparagraph id="idbdb6f5ff4a0d441cbb97bba92ce9fb1d"><enum>(D)</enum><text>Enhance the science base to better understand the relationship between climate change and health outcomes.</text> </subparagraph>
<subparagraph id="id29faf1d89d3a4b1898cd854864658eb2"><enum>(E)</enum><text>Identify locations and population groups at greatest risk for specific health threats and effects, such as increased heat stress, degraded air and water quality, food or water-related infections, vector-borne illnesses, pulmonary and cardiovascular effects, mental and behavioral health effects and food, water, and nutrient insecurity.</text> </subparagraph> <subparagraph id="idd7d56922242648cba25b1886248a2022"><enum>(F)</enum><text>Communicate the health-related aspects of climate change, including risks and associated costs and ways to reduce them, to the public, decisionmakers, public health professionals, and health care providers.</text> </subparagraph>
<subparagraph id="idbeedb9cba7a1441099b085150e35827a"><enum>(G)</enum><text>Develop partnerships with other government agencies, the private sector, nongovernmental organizations, universities, and international organizations to more effectively address domestic and global health aspects of climate change.</text> </subparagraph> <subparagraph id="id699f76879fbd4a0b993cf3d5dffac400"><enum>(H)</enum><text>Provide leadership to State and local governments, community leaders, health care professionals, nongovernmental organizations, environmental justice networks, faith-based communities, the private sector and the public, domestically and internationally, regarding health protection from climate change effects.</text> </subparagraph>
<subparagraph id="id3ead405a1c9a4d8cac51284c59aaefa7"><enum>(I)</enum><text>Develop and implement preparedness and response plans for health threats such as heat waves, severe weather events, and infectious diseases.</text> </subparagraph> <subparagraph id="idd000032c68c44362916368932f5cf7d1"><enum>(J)</enum><text>Provide technical advice and support to State and local health departments, the private sector, and others in developing and implementing national and global preparedness measures related to the health effects of climate change.</text> </subparagraph>
<subparagraph id="id8c8800286951470e8f1a1367ccb5f6e7"><enum>(K)</enum><text>Promote workforce development by helping to ensure the training of a new generation of competent, experienced public health and health care professionals to respond to the health threats posed by climate change.</text> </subparagraph></paragraph></subsection> <subsection id="idb0f3370e8c7a40c09d62b52f0a789c12"><enum>(c)</enum><header>Periodic assessment and revision</header><text>Not later than 4 years after the date of enactment of this Act, and every 4 years thereafter, the Secretary shall periodically assess, and revise as necessary, the national strategic action plan under subsection (b)(1) and the climate and health program under subsection (b)(2), to reflect new information collected pursuant to the implementation of the national strategic action plan and program and otherwise, including information on—</text> 
<paragraph id="ida3181b01920e4f28bed24b9a118064e9"><enum>(1)</enum><text>the status of critical environmental health indicators and related human health impacts;</text> </paragraph> <paragraph id="id12d8165bd40b4187beeaaf0ac47a7311"><enum>(2)</enum><text>the impacts of climate change on public health; and</text> </paragraph>
<paragraph id="idda80d60d380243b3967a8b2ca4291198"><enum>(3)</enum><text>advances in the development of strategies for preparing for and responding to the impacts of climate change on public health.</text> </paragraph></subsection> <subsection id="id50acbd329f914f5a81ec93e41c196215"><enum>(d)</enum><header>Implementation</header> <paragraph id="id848e663e83394e73a949adbdb87640bf"><enum>(1)</enum><header>Implementation through HHS</header><text>The Secretary shall exercise the Secretary’s authority under this Act and other Federal statutes to achieve the goals and measures of the national strategic action plan and climate and health program.</text> </paragraph>
<paragraph id="iddd237702a9f540589a8f31bdbcc34df5"><enum>(2)</enum><header>Other public health programs and initiatives</header><text>The Secretary and Federal officials of other relevant Federal agencies shall administer public health programs and initiatives authorized by laws other than this Act, subject to the requirements of such laws, in a manner designed to achieve the goals of the national strategic action plan and climate and health program.</text> </paragraph></subsection></section> <section id="idf5f579dab1004674be2aba7535f95768"><enum>5.</enum><header>Advisory board</header> <subsection id="id04f6e59557ad456db9a5302c436a6123"><enum>(a)</enum><header>Establishment</header><text>The Secretary shall, pursuant to the Federal Advisory Committee Act (5 U.S.C. App.), establish a permanent science advisory board to be comprised of not less than 10 and not more than 20 members.</text> </subsection>
<subsection id="id0ddeb855733249179ebd11a320038c25"><enum>(b)</enum><header>Appointment of members</header><text>The Secretary shall appoint the members of the science advisory board from among individuals who—</text> <paragraph id="id884b356fbe9d49f096bed0c6ef7cc8a8"><enum>(1)</enum><text>are recommended by the President of the National Academy of Sciences and the President of the National Academy of Medicine; and</text> </paragraph>
<paragraph id="id5e6c992969714ed08ca4cd32751d7b24"><enum>(2)</enum><text>have expertise in essential public health and health care services, including those related to vulnerable populations, climate change, and other relevant disciplines.</text> </paragraph><continuation-text continuation-text-level="subsection">The Secretary shall ensure that the science advisory board includes members with practical or lived experience with relevant issues.</continuation-text></subsection> <subsection id="idcd93a28de0044e71bd97c53a67201e80"><enum>(c)</enum><header>Functions</header><text>The science advisory board shall—</text> 
<paragraph id="ide940cb0750d94c4b9403fc58bf583f07"><enum>(1)</enum><text>provide scientific and technical advice and recommendations to the Secretary on the domestic and international impacts of climate change on public health, populations and regions particularly vulnerable to the effects of climate change, and strategies and mechanisms to prepare for and respond to the impacts of climate change on public health; and</text> </paragraph> <paragraph id="id51e78dcfb86a4a0498dd3afee841330d"><enum>(2)</enum><text>advise the Secretary regarding the best science available for purposes of issuing the national strategic action plan and conducting the climate and health program.</text> </paragraph></subsection></section>
<section id="idc6cac21feb694e08aa456334dc658a9d"><enum>6.</enum><header>Climate change health protection and promotion reports</header> 
<subsection id="id931e629acb154b8b836ec66de52bd7f6"><enum>(a)</enum><header>In general</header><text>The Secretary shall offer to enter into an agreement 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—</text> <paragraph id="id65894dac9b7346508c925784d2c4cd4a"><enum>(1)</enum><text>review scientific developments on health impacts of climate change; and</text> </paragraph>
<paragraph id="id067409b360f0483486494cfb98e0e75b"><enum>(2)</enum><text>recommend changes to the national strategic action plan and climate and health program.</text> </paragraph></subsection> <subsection id="idbf12cf26728941aab7ca6c1aa4ce896f"><enum>(b)</enum><header>Submission</header><text>The agreement under subsection (a) shall require a report to be submitted to Congress and the Secretary and made publicly available not later than 2 years after the date of enactment of this Act, and every 4 years thereafter.</text></subsection></section>
</legis-body>
</bill> 


