II 117TH CONGRESS 1ST SESSION S. 423 To direct the Secretary of Health and Human Services to establish a grant program to protect vulnerable mothers and babies from climate change risks, and for other purposes. IN THE SENATE OF THE UNITED STATES FEBRUARY 24, 2021 Mr. MARKEY (for himself, Mr. MERKLEY, Mr. BLUMENTHAL, Mr. SANDERS, and Mr. BENNET) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To direct the Secretary of Health and Human Services to establish a grant program to protect vulnerable mothers and babies from climate change risks, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Protecting Moms and Babies Against Climate Change 5 Act’’. 6 (b) TABLE OF CONTENTS.—The table of contents for 7 this Act is as follows: 8 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 2 •S 423 IS Sec. 1. Short title; table of contents. Sec. 2. Grant program to protect vulnerable mothers and babies from climate change risks. Sec. 3. Grant program for education and training at health profession schools. Sec. 4. NIH Consortium on Birth and Climate Change Research. Sec. 5. Strategy for identifying climate change risk zones for vulnerable moth- ers and babies. Sec. 6. Definitions. SEC. 2. GRANT PROGRAM TO PROTECT VULNERABLE 1 MOTHERS AND BABIES FROM CLIMATE 2 CHANGE RISKS. 3 (a) IN GENERAL.—Not later than 180 days after the 4 date of the enactment of this Act, the Secretary of Health 5 and Human Services shall establish a grant program (in 6 this section referred to as the ‘‘Program’’) to protect vul- 7 nerable individuals from risks associated with climate 8 change. 9 (b) GRANT AUTHORITY.—In carrying out the Pro- 10 gram, the Secretary may award, on a competitive basis, 11 grants to 10 covered entities. 12 (c) APPLICATIONS.—To be eligible for a grant under 13 the Program, a covered entity shall submit to the Sec- 14 retary an application at such time, in such form, and con- 15 taining such information as the Secretary may require, 16 which shall include, at a minimum, a description of the 17 following: 18 (1) Plans for the use of grant funds awarded 19 under the Program and how patients and stake- 20 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 3 •S 423 IS holder organizations were involved in the develop- 1 ment of such plans. 2 (2) How such grant funds will be targeted to 3 geographic areas that have disproportionately high 4 levels of risks associated with climate change for vul- 5 nerable individuals. 6 (3) How such grant funds will be used to ad- 7 dress racial and ethnic disparities in— 8 (A) adverse maternal and infant health 9 outcomes; and 10 (B) exposure to risks associated with cli- 11 mate change for vulnerable individuals. 12 (4) Strategies to prevent an initiative assisted 13 with such grant funds from causing— 14 (A) adverse environmental impacts; 15 (B) displacement of residents and busi- 16 nesses; 17 (C) rent and housing price increases; or 18 (D) disproportionate adverse impacts on 19 racial and ethnic minority groups and other un- 20 derserved populations. 21 (d) SELECTION OF GRANT RECIPIENTS.— 22 (1) TIMING.—Not later than 270 days after the 23 date of the enactment of this Act, the Secretary 24 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 4 •S 423 IS shall select the recipients of grants under the Pro- 1 gram. 2 (2) CONSULTATION.—In selecting covered enti- 3 ties for grants under the Program, the Secretary 4 shall consult with— 5 (A) representatives of stakeholder organi- 6 zations; 7 (B) the Administrator of the Environ- 8 mental Protection Agency; 9 (C) the Administrator of the National Oce- 10 anic and Atmospheric Administration; and 11 (D) from the Department of Health and 12 Human Services— 13 (i) the Deputy Assistant Secretary for 14 Minority Health; 15 (ii) the Administrator of the Centers 16 for Medicare & Medicaid Services; 17 (iii) the Administrator of the Health 18 Resources and Services Administration; 19 (iv) the Director of the National Insti- 20 tutes of Health; and 21 (v) the Director of the Centers for 22 Disease Control and Prevention. 23 (3) PRIORITY.—In selecting a covered entity to 24 be awarded a grant under the Program, the Sec- 25 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 5 •S 423 IS retary shall give priority to covered entities that 1 serve a county— 2 (A) designated, or located in an area des- 3 ignated, as a nonattainment area pursuant to 4 section 107 of the Clean Air Act (42 U.S.C. 5 7407) for any air pollutant for which air quality 6 criteria have been issued under section 108(a) 7 of such Act (42 U.S.C. 7408(a)); 8 (B) with a level of vulnerability of mod- 9 erate-to-high or higher, according to the Social 10 Vulnerability Index of the Centers for Disease 11 Control and Prevention; or 12 (C) with temperatures that pose a risk to 13 human health, as determined by the Secretary, 14 in consultation with the Administrator of the 15 National Oceanic and Atmospheric Administra- 16 tion and the Chair of the United States Global 17 Change Research Program, based on the best 18 available science. 19 (4) LIMITATION.—A recipient of grant funds 20 under the Program may not use such grant funds to 21 serve a county that is served by any other recipient 22 of a grant under the Program. 23 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 6 •S 423 IS (e) USE OF FUNDS.—A covered entity awarded grant 1 funds under the Program may only use such grant funds 2 for the following: 3 (1) Initiatives to identify risks associated with 4 climate change for vulnerable individuals and to pro- 5 vide services and support to such individuals that 6 address such risks, which may include— 7 (A) training for health care providers, 8 doulas, and other employees in hospitals, birth 9 centers, midwifery practices, and other health 10 care practices that provide prenatal or labor 11 and delivery services to vulnerable individuals 12 on the identification of, and patient counseling 13 relating to, risks associated with climate change 14 for vulnerable individuals; 15 (B) hiring, training, or providing resources 16 to community health workers and perinatal 17 health workers who can help identify risks asso- 18 ciated with climate change for vulnerable indi- 19 viduals, provide patient counseling about such 20 risks, and carry out the distribution of relevant 21 services and support; 22 (C) enhancing the monitoring of risks as- 23 sociated with climate change for vulnerable in- 24 dividuals, including by— 25 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 7 •S 423 IS (i) collecting data on such risks in 1 specific census tracts, neighborhoods, or 2 other geographic areas; and 3 (ii) sharing such data with local 4 health care providers, doulas, and other 5 employees in hospitals, birth centers, mid- 6 wifery practices, and other health care 7 practices that provide prenatal or labor 8 and delivery services to local vulnerable in- 9 dividuals; and 10 (D) providing vulnerable individuals— 11 (i) air conditioning units, residential 12 weatherization support, filtration systems, 13 household appliances, or related items; 14 (ii) direct financial assistance; and 15 (iii) services and support, including 16 housing and transportation assistance, to 17 prepare for or recover from extreme weath- 18 er events, which may include floods, hurri- 19 canes, wildfires, droughts, and related 20 events. 21 (2) Initiatives to mitigate levels of and exposure 22 to risks associated with climate change for vulner- 23 able individuals, which shall be based on the best 24 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 8 •S 423 IS available science and which may include initiatives 1 to— 2 (A) develop, maintain, or expand urban or 3 community forestry initiatives and tree canopy 4 coverage initiatives; 5 (B) improve infrastructure, including 6 buildings and paved surfaces; 7 (C) develop or improve community out- 8 reach networks to provide culturally and lin- 9 guistically appropriate information and notifica- 10 tions about risks associated with climate change 11 for vulnerable individuals; and 12 (D) provide enhanced services to racial and 13 ethnic minority groups and other underserved 14 populations. 15 (f) LENGTH OF AWARD.—A grant under this section 16 shall be disbursed over 4 fiscal years. 17 (g) TECHNICAL ASSISTANCE.—The Secretary shall 18 provide technical assistance to a covered entity awarded 19 a grant under the Program to support the development, 20 implementation, and evaluation of activities funded with 21 such grant. 22 (h) REPORTS TO SECRETARY.— 23 (1) ANNUAL REPORT.—For each fiscal year 24 during which a covered entity is disbursed grant 25 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 9 •S 423 IS funds under the Program, such covered entity shall 1 submit to the Secretary a report that summarizes 2 the activities carried out by such covered entity with 3 such grant funds during such fiscal year, which shall 4 include a description of the following: 5 (A) The involvement of stakeholder organi- 6 zations in the implementation of initiatives as- 7 sisted with such grant funds. 8 (B) Relevant health and environmental 9 data, disaggregated, to the extent practicable, 10 by race, ethnicity, gender, and pregnancy sta- 11 tus. 12 (C) Qualitative feedback received from vul- 13 nerable individuals with respect to initiatives 14 assisted with such grant funds. 15 (D) Criteria used in selecting the geo- 16 graphic areas assisted with such grant funds. 17 (E) Efforts to address racial and ethnic 18 disparities in adverse maternal and infant 19 health outcomes and in exposure to risks associ- 20 ated with climate change for vulnerable individ- 21 uals. 22 (F) Any negative and unintended impacts 23 of initiatives assisted with such grant funds, in- 24 cluding— 25 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 10 •S 423 IS (i) adverse environmental impacts; 1 (ii) displacement of residents and 2 businesses; 3 (iii) rent and housing price increases; 4 and 5 (iv) disproportionate adverse impacts 6 on racial and ethnic minority groups and 7 other underserved populations. 8 (G) How the covered entity will address 9 and prevent any impacts described in subpara- 10 graph (F). 11 (2) PUBLICATION.—Not later than 30 days 12 after the date on which a report is submitted under 13 paragraph (1), the Secretary shall publish such re- 14 port on a public website of the Department of 15 Health and Human Services. 16 (i) REPORT TO CONGRESS.—Not later than the date 17 that is 5 years after the date on which the Program is 18 established, the Secretary shall submit to Congress and 19 publish on a public website of the Department of Health 20 and Human Services a report on the results of the Pro- 21 gram, including the following: 22 (1) Summaries of the annual reports submitted 23 under subsection (h). 24 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 11 •S 423 IS (2) Evaluations of the initiatives assisted with 1 grant funds under the Program. 2 (3) An assessment of the effectiveness of the 3 Program in— 4 (A) identifying risks associated with cli- 5 mate change for vulnerable individuals; 6 (B) providing services and support to such 7 individuals; 8 (C) mitigating levels of and exposure to 9 such risks; and 10 (D) addressing racial and ethnic disparities 11 in adverse maternal and infant health outcomes 12 and in exposure to such risks. 13 (4) A description of how the Program could be 14 expanded, including— 15 (A) monitoring efforts or data collection 16 that would be required to identify areas with 17 high levels of risks associated with climate 18 change for vulnerable individuals; 19 (B) how such areas could be identified 20 using the strategy developed under section 5; 21 and 22 (C) recommendations for additional fund- 23 ing. 24 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 12 •S 423 IS (j) COVERED ENTITY DEFINED.—In this section, the 1 term ‘‘covered entity’’ means a consortium of organiza- 2 tions serving a county that— 3 (1) shall include a community-based organiza- 4 tion; and 5 (2) may include— 6 (A) another stakeholder organization; 7 (B) the government of such county; 8 (C) the governments of one or more mu- 9 nicipalities within such county; 10 (D) a State or local public health depart- 11 ment or emergency management agency; 12 (E) a local health care practice, which may 13 include a licensed and accredited hospital, birth 14 center, midwifery practice, or other health care 15 practice that provides prenatal or labor and de- 16 livery services to vulnerable individuals; 17 (F) an Indian tribe or tribal organization 18 (as such terms are defined in section 4 of the 19 Indian Self-Determination and Education As- 20 sistance Act (25 U.S.C. 5304)); 21 (G) an Urban Indian organization (as de- 22 fined in section 4 of the Indian Health Care 23 Improvement Act (25 U.S.C. 1603)); and 24 (H) an institution of higher education. 25 VerDate Sep 11 2014 23:55 Mar 17, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S423.IS S423 kjohnson on DSK79L0C42PROD with BILLS 13 •S 423 IS (k) AUTHORIZATION OF APPROPRIATIONS.—There is 1 authorized to be appropriated to carry out this section 2 $100,000,000 for fiscal years 2021 through 2024. 3 SEC. 3. GRANT PROGRAM FOR EDUCATION AND TRAINING 4 AT HEALTH PROFESSION SCHOOLS. 5 (a) IN GENERAL.—Not later than 1 year after the 6 date of the enactment of this Act, the Secreta [Text truncated for display. Full text available on Congress.gov.]