II 116TH CONGRESS 1ST SESSION S. 523 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. IN THE SENATE OF THE UNITED STATES FEBRUARY 14, 2019 Mr. MARKEY (for himself, Mr. SCHATZ, Mr. WHITEHOUSE, Ms. WARREN, Mr. MERKLEY, and Ms. KLOBUCHAR) 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 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. 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. 3 This Act may be cited as the ‘‘Climate Change Health 4 Protection and Promotion Act of 2019’’. 5 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 2 •S 523 IS SEC. 2. SENSE OF CONGRESS ON PUBLIC HEALTH AND CLI- 1 MATE CHANGE. 2 (a) FINDINGS.—The U.S. Global Change Research 3 Program Climate and Health Assessment states that— 4 (1) the impacts of human-induced climate 5 change are increasing nationwide; 6 (2) rising greenhouse gas concentrations result 7 in increases in temperature, changes in precipitation, 8 increases in the frequency and intensity of some ex- 9 treme weather events, and rising sea levels; 10 (3) these climate change impacts endanger our 11 health by affecting our food and water sources, the 12 air we breathe, the weather we experience, and our 13 interactions with the built and natural environments; 14 and 15 (4) as the climate continues to change, the risks 16 to human health continue to grow. 17 (b) SENSE OF CONGRESS.—It is the sense of Con- 18 gress that— 19 (1) climate change is real; 20 (2) human activity significantly contributes to 21 climate change; 22 (3) climate change negatively impacts health; 23 (4) climate change disproportionately impacts 24 communities of color and low-income communities; 25 and 26 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 3 •S 523 IS (5) the Federal Government, in cooperation 1 with international, State, tribal, and local govern- 2 ments, concerned public, private and Native Amer- 3 ican organizations, and citizens, should use all prac- 4 ticable means and measures— 5 (A) to assist the efforts of public health 6 and health care professionals, first responders, 7 health care systems, States, the District of Co- 8 lumbia, territories, municipalities, and Native 9 American and local communities to incorporate 10 measures to prepare public health and health 11 care systems to respond to the impacts of cli- 12 mate change; 13 (B) to ensure— 14 (i) that the Nation’s public health and 15 health care professionals have sufficient in- 16 formation to prepare for and respond to 17 the adverse health impacts of climate 18 change; 19 (ii) the application of scientific re- 20 search in advancing understanding of— 21 (I) the health impacts of climate 22 change; and 23 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 4 •S 523 IS (II) strategies to prepare for and 1 respond to the health impacts of cli- 2 mate change; 3 (iii) the identification of communities 4 and populations vulnerable to the health 5 impacts of climate change, including in- 6 fants, children, pregnant women, the elder- 7 ly, individuals with disabilities or pre-exist- 8 ing illnesses, low-income populations, and 9 unhoused individuals, and the development 10 of strategic response plans to be carried 11 out by public health and health care pro- 12 fessionals for those communities; 13 (iv) the improvement of health status 14 and health equity through efforts to pre- 15 pare for and respond to climate change; 16 and 17 (v) the inclusion of health impacts in 18 the development of climate change re- 19 sponses; 20 (C) to encourage further research, inter- 21 disciplinary partnership, and collaboration 22 among stakeholders in order to— 23 (i) understand and monitor the health 24 impacts of climate change; 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 5 •S 523 IS (ii) improve public health knowledge 1 and response strategies to climate change; 2 (iii) identify actions and policies that 3 are beneficial to health and that mitigate 4 climate health impacts; and 5 (iv) develop strategies to address 6 water-, food-, and vector-borne infectious 7 diseases and other public health emer- 8 gencies; 9 (D) to enhance preparedness activities, and 10 health care and public health infrastructure, re- 11 lating to climate change and health; 12 (E) to encourage each and every commu- 13 nity to learn about the impacts of climate 14 change on health; and 15 (F) to assist the efforts of developing na- 16 tions to incorporate measures to prepare public 17 health and health care systems to respond to 18 the impacts of climate change. 19 SEC. 3. RELATIONSHIP TO OTHER LAWS. 20 Nothing in this Act limits the authority provided to 21 or responsibility conferred on any Federal department or 22 agency by any provision of any law (including regulations) 23 or authorizes any violation of any provision of any law (in- 24 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 6 •S 523 IS cluding regulations), including any health, energy, envi- 1 ronmental, transportation, or any other law or regulation. 2 SEC. 4. NATIONAL STRATEGIC ACTION PLAN AND PRO- 3 GRAM. 4 (a) REQUIREMENT.— 5 (1) IN GENERAL.—The Secretary of Health and 6 Human Services (referred to in this Act as the ‘‘Sec- 7 retary’’), on the basis of the best available science, 8 and in consultation pursuant to paragraph (2), shall 9 publish a strategic action plan and establish a pro- 10 gram to ensure the public health and health care 11 systems are prepared for and can respond to the im- 12 pacts of climate change on health in the United 13 States and other nations. 14 (2) CONSULTATION.—In developing or making 15 any revision to the national strategic action plan and 16 program, the Secretary shall— 17 (A) consult with the Director of the Cen- 18 ters for Disease Control and Prevention, the 19 Administrator of the Environmental Protection 20 Agency, the Director of the National Institutes 21 of Health, the Undersecretary of Commerce for 22 Oceans & Atmosphere, the Administrator of the 23 National Aeronautics and Space Administra- 24 tion, the Director of the Indian Health Service, 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 7 •S 523 IS the Secretary of Defense, the Secretary of 1 State, the Secretary of Veterans Affairs, other 2 appropriate Federal agencies, Indian tribes, 3 State and local governments, public health or- 4 ganizations, scientists, representatives of at-risk 5 populations, and other interested stakeholders; 6 and 7 (B) provide opportunity for public input 8 and consultation with Indian tribes and Native 9 American organizations. 10 (b) ACTIVITIES.— 11 (1) NATIONAL STRATEGIC ACTION PLAN.— 12 (A) IN GENERAL.—Not later than 2 years 13 after the date of enactment of this Act, the Sec- 14 retary, acting through the Director of the Cen- 15 ters for Disease Control and Prevention, and in 16 collaboration with other Federal agencies as ap- 17 propriate, shall, on the basis of the best avail- 18 able science, and in consultation with the enti- 19 ties described in subsection (a)(2)(A), publish a 20 national strategic action plan under subpara- 21 graph (B) to guide the climate and health pro- 22 gram and assist public health and health care 23 professionals in preparing for and responding to 24 the impacts of climate change on public health 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 8 •S 523 IS in the United States and other nations, particu- 1 larly developing nations. 2 (B) NATIONAL STRATEGIC ACTION PLAN 3 COMPONENTS.—The national strategic plan 4 shall include an assessment of the health sys- 5 tem capacity of the United States to address 6 climate change including— 7 (i) identifying and prioritizing commu- 8 nities and populations vulnerable to the 9 health impacts of climate change; 10 (ii) providing outreach and commu- 11 nication aimed at public health and health 12 care professionals and the public to pro- 13 mote preparedness and response strategies; 14 (iii) providing for programs across 15 Federal agencies to advance research re- 16 lated to the impacts of climate change on 17 health; 18 (iv) identifying and assessing existing 19 preparedness and response strategies for 20 the health impacts of climate change; 21 (v) prioritizing critical public health 22 and health care infrastructure projects; 23 (vi) providing modeling and fore- 24 casting tools of climate change health im- 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 9 •S 523 IS pacts, including local impacts, where fea- 1 sible; 2 (vii) establishing academic and re- 3 gional centers of excellence; 4 (viii) providing technical assistance 5 and support for preparedness and response 6 plans for the health threats of climate 7 change in States, municipalities, terri- 8 tories, Indian tribes, and developing na- 9 tions; and 10 (ix) developing, improving, inte- 11 grating, and maintaining domestic and 12 international disease surveillance systems 13 and monitoring capacity to respond to 14 health-related impacts of climate change, 15 including on topics addressing— 16 (I) water-, food-, and vector- 17 borne infectious diseases and climate 18 change; 19 (II) pulmonary effects, including 20 responses to aeroallergens and toxic 21 exposures; 22 (III) cardiovascular effects, in- 23 cluding impacts of temperature ex- 24 tremes; 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 10 •S 523 IS (IV) air pollution health effects, 1 including heightened sensitivity to air 2 pollution; 3 (V) harmful algal blooms; 4 (VI) mental and behavioral 5 health impacts of climate change; 6 (VII) the health of migrants, ref- 7 ugees, displaced persons, and vulner- 8 able communities; 9 (VIII) the implications for com- 10 munities and populations vulnerable 11 to the health effects of climate 12 change, as well as strategies for re- 13 sponding to climate change within 14 these communities; 15 (IX) tribal, local, and commu- 16 nity-based health interventions for cli- 17 mate-related health impacts; 18 (X) extreme heat and weather 19 events, including drought; 20 (XI) decreased nutritional value 21 of crops; and 22 (XII) disruptions in access to 23 routine and acute medical care. 24 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 11 •S 523 IS (2) CLIMATE AND HEALTH PROGRAM.—The 1 Secretary, acting through the Director of the Cen- 2 ters for Disease Control and Prevention, and in col- 3 laboration with other Federal agencies, as appro- 4 priate, shall ensure that the climate and health pro- 5 gram established under this section addresses pri- 6 ority health actions including the following: 7 (A) Serve as a credible source of informa- 8 tion on the physical, mental, and behavioral 9 health consequences of climate change for the 10 United States population and globally. 11 (B) Track data on environmental condi- 12 tions, disease risks, and disease occurrence re- 13 lated to climate change. 14 (C) Expand capacity for modeling and 15 forecasting health effects that may be climate- 16 related. 17 (D) Enhance the science base to better un- 18 derstand the relationship between climate 19 change and health outcomes. 20 (E) Identify locations and population 21 groups at greatest risk for specific health 22 threats and effects, such as increased heat 23 stress, degraded air and water quality, food or 24 water-related infections, vector-borne illnesses, 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 12 •S 523 IS pulmonary and cardiovascular effects, mental 1 and behavioral health effects and food, water, 2 and nutrient insecurity. 3 (F) Communicate the health-related as- 4 pects of climate change, including risks and as- 5 sociated costs and ways to reduce them, to the 6 public, decisionmakers, public health profes- 7 sionals, and health care providers. 8 (G) Develop partnerships with other gov- 9 ernment agencies, the private sector, non- 10 governmental organizations, universities, and 11 international organizations to more effectively 12 address domestic and global health aspects of 13 climate change. 14 (H) Provide leadership to State and local 15 governments, community leaders, health care 16 professionals, nongovernmental organizations, 17 environmental justice networks, faith-based 18 communities, the private sector and the public, 19 domestically and internationally, regarding 20 health protection from climate change effects. 21 (I) Develop and implement preparedness 22 and response plans for health threats such as 23 heat waves, severe weather events, and infec- 24 tious diseases. 25 VerDate Sep 11 2014 01:08 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S523.IS S523 pbinns on DSK79D2C42PROD with BILLS 13 •S 523 IS (J) Provide technical advice and support to 1 State and local health departments, the private 2 sector, and others in developing and imple- 3 menting national and global preparedness meas- 4 ures related to the health effects of climate 5 change. 6 (K) Promote workforce development by 7 helping to ensure the training of a new genera- 8 tion of competent, experienced public health 9 and health care professionals to respond to the 10 health threats posed by climate change. 11 (c) PERIODIC ASSESSMENT AND REVIS [Text truncated for display. 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