I 116TH CONGRESS 1ST SESSION H. R. 1243 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 HOUSE OF REPRESENTATIVES FEBRUARY 14, 2019 Mr. CARTWRIGHT (for himself, Mr. RASKIN, Mr. ENGEL, Mr. KHANNA, Ms. PINGREE, Mr. POCAN, Ms. JAYAPAL, Mr. HUFFMAN, Ms. WILD, Mr. COHEN, Ms. MATSUI, Mr. SCHNEIDER, Mr. CARBAJAL, Mr. LIPINSKI, Mr. CASTEN of Illinois, Ms. MCCOLLUM, Mr. TONKO, Mr. GRIJALVA, Mr. ROUDA, Mr. GREEN of Texas, and Ms. NORTON) introduced the following bill; which was referred to the Committee on Energy and Commerce 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 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 1243 IH SEC. 2. SENSE OF CONGRESS ON PUBLIC HEALTH AND CLI- 1 MATE CHANGE. 2 (a) FINDINGS.—The United States Global Change 3 Research Program Climate and Health Assessment states 4 that— 5 (1) the impacts of human-induced climate 6 change are increasing nationwide; 7 (2) rising greenhouse gas concentrations result 8 in increases in temperature, changes in precipitation, 9 increases in the frequency and intensity of some ex- 10 treme weather events, and rising sea levels; 11 (3) these climate change impacts endanger our 12 health by affecting our food and water sources, the 13 air we breathe, the weather we experience, and our 14 interactions with the built and natural environments; 15 and 16 (4) as the climate continues to change, the risks 17 to human health continue to grow. 18 (b) SENSE OF CONGRESS.—It is the sense of Con- 19 gress that— 20 (1) climate change is real; 21 (2) human activity significantly contributes to 22 climate change; 23 (3) climate change negatively impacts health; 24 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 1243 IH (4) climate change disproportionately impacts 1 communities of color and low-income communities; 2 and 3 (5) the Federal Government, in cooperation 4 with international, State, Tribal, and local govern- 5 ments, concerned public, private, and Native Amer- 6 ican organizations, and citizens, should use all prac- 7 ticable means and measures— 8 (A) to assist the efforts of public health 9 and health care professionals, first responders, 10 health care systems, States, the District of Co- 11 lumbia, territories, municipalities, and Native 12 American and local communities to incorporate 13 measures to prepare public health and health 14 care systems to respond to the impacts of cli- 15 mate change; 16 (B) to ensure— 17 (i) that the Nation’s public health and 18 health care professionals have sufficient in- 19 formation to prepare for and respond to 20 the adverse health impacts of climate 21 change; 22 (ii) the application of scientific re- 23 search in advancing understanding of— 24 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 1243 IH (I) the health impacts of climate 1 change; and 2 (II) strategies to prepare for and 3 respond to the health impacts of cli- 4 mate change; 5 (iii) the identification of communities 6 and populations vulnerable to the health 7 impacts of climate change, including in- 8 fants, children, pregnant women, the elder- 9 ly, individuals with disabilities or pre- 10 existing illnesses, low-income populations, 11 and unhoused individuals, and the develop- 12 ment of strategic response plans to be car- 13 ried out by public health and health care 14 professionals for those communities; 15 (iv) the improvement of health status 16 and health equity through efforts to pre- 17 pare for and respond to climate change; 18 and 19 (v) the inclusion of health impacts in 20 the development of climate change re- 21 sponses; 22 (C) to encourage further research, inter- 23 disciplinary partnership, and collaboration 24 among stakeholders in order to— 25 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 1243 IH (i) understand and monitor the health 1 impacts of climate change; 2 (ii) improve public health knowledge 3 and response strategies to climate change; 4 (iii) identify actions and policies that 5 are beneficial to health and that mitigate 6 climate health impacts; and 7 (iv) develop strategies to address 8 water-, food-, and vector-borne infectious 9 diseases and other public health emer- 10 gencies; 11 (D) to enhance preparedness activities, and 12 health care and public health infrastructure, re- 13 lating to climate change and health; 14 (E) to encourage each and every commu- 15 nity to learn about the impacts of climate 16 change on health; and 17 (F) to assist the efforts of developing na- 18 tions to incorporate measures to prepare public 19 health and health care systems to respond to 20 the impacts of climate change. 21 SEC. 3. RELATIONSHIP TO OTHER LAWS. 22 Nothing in this Act limits the authority provided to 23 or responsibility conferred on any Federal department or 24 agency by any provision of any law (including regulations) 25 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 1243 IH or authorizes any violation of any provision of any law (in- 1 cluding regulations), including any health, energy, envi- 2 ronmental, transportation, or any other law or regulation. 3 SEC. 4. NATIONAL STRATEGIC ACTION PLAN AND PRO- 4 GRAM. 5 (a) REQUIREMENT.— 6 (1) IN GENERAL.—The Secretary of Health and 7 Human Services (referred to in this Act as the ‘‘Sec- 8 retary’’), on the basis of the best available science, 9 and in consultation pursuant to paragraph (2), shall 10 publish a strategic action plan and establish a pro- 11 gram to ensure the public health and health care 12 systems are prepared for and can respond to the im- 13 pacts of climate change on health in the United 14 States and other nations. 15 (2) CONSULTATION.—In developing or making 16 any revision to the national strategic action plan and 17 program, the Secretary shall— 18 (A) consult with the Director of the Cen- 19 ters for Disease Control and Prevention, the 20 Administrator of the Environmental Protection 21 Agency, the Director of the National Institutes 22 of Health, the Under Secretary of Commerce 23 for Oceans and Atmosphere, the Administrator 24 of the National Aeronautics and Space Admin- 25 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 1243 IH istration, the Director of the Indian Health 1 Service, the Secretary of Defense, the Secretary 2 of State, the Secretary of Veterans Affairs, 3 other appropriate Federal agencies, Indian 4 Tribes, State and local governments, public 5 health organizations, scientists, representatives 6 of at-risk populations, and other interested 7 stakeholders; and 8 (B) provide opportunity for public input 9 and consultation with Indian tribes and Native 10 American organizations. 11 (b) ACTIVITIES.— 12 (1) NATIONAL STRATEGIC ACTION PLAN.—Not 13 later than 2 years after the date of enactment of 14 this Act, the Secretary, acting through the Director 15 of the Centers for Disease Control and Prevention, 16 and in collaboration with other Federal agencies as 17 appropriate, shall, on the basis of the best available 18 science, and in consultation with the entities de- 19 scribed in subsection (a)(2), publish a national stra- 20 tegic action plan under paragraph (2) to guide the 21 climate and health program and assist public health 22 and health care professionals in preparing for and 23 responding to the impacts of climate change on pub- 24 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 1243 IH lic health in the United States and other nations, 1 particularly developing nations. 2 (2) ASSESSMENT OF HEALTH SYSTEM CAPAC- 3 ITY.—The national strategic action plan shall in- 4 clude an assessment of the health system capacity of 5 the United States to address climate change includ- 6 ing— 7 (A) identifying and prioritizing commu- 8 nities and populations vulnerable to the health 9 impacts of climate change; 10 (B) providing outreach and communication 11 aimed at public health and health care profes- 12 sionals and the public to promote preparedness 13 and response strategies; 14 (C) providing for programs across Federal 15 agencies to advance research related to the im- 16 pacts of climate change on health; 17 (D) identifying and assessing existing pre- 18 paredness and response strategies for the health 19 impacts of climate change; 20 (E) prioritizing critical public health and 21 health care infrastructure projects; 22 (F) providing modeling and forecasting 23 tools of climate change health impacts, includ- 24 ing local impacts where possible; 25 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 1243 IH (G) establishing academic and regional 1 centers of excellence; 2 (H) providing technical assistance and sup- 3 port for preparedness and response plans for 4 the health threats of climate change in States, 5 municipalities, territories, Indian Tribes, and 6 developing nations; and 7 (I) developing, improving, integrating, and 8 maintaining domestic and international disease 9 surveillance systems and monitoring capacity to 10 respond to health-related impacts of climate 11 change, including on topics addressing— 12 (i) water-, food-, and vector-borne in- 13 fectious diseases and climate change; 14 (ii) pulmonary effects, including re- 15 sponses to aeroallergens and toxic expo- 16 sures; 17 (iii) cardiovascular effects, including 18 impacts of temperature extremes; 19 (iv) air pollution health effects, includ- 20 ing heightened sensitivity to air pollution; 21 (v) harmful algal blooms; 22 (vi) mental and behavioral health im- 23 pacts of climate change; 24 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 1243 IH (vii) the health of migrants, refugees, 1 displaced persons, and vulnerable commu- 2 nities; 3 (viii) the implications for communities 4 and populations vulnerable to the health 5 effects of climate change, as well as strate- 6 gies for responding to climate change with- 7 in these communities; 8 (ix) Tribal, local, and community- 9 based health interventions for climate-re- 10 lated health impacts; 11 (x) extreme heat and weather events, 12 including drought; 13 (xi) decreased nutritional value of 14 crops; and 15 (xii) disruptions in access to routine 16 and acute medical care. 17 (3) CLIMATE AND HEALTH PROGRAM.—The 18 Secretary, acting through the Director of the Cen- 19 ters for Disease Control and Prevention, and in col- 20 laboration with other Federal agencies, as appro- 21 priate, shall ensure that the climate and health pro- 22 gram established under this section addresses pri- 23 ority health actions including the following: 24 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 11 •HR 1243 IH (A) Serve as a credible source of informa- 1 tion on the physical, mental, and behavioral 2 health consequences of climate change for the 3 United States population and globally. 4 (B) Track data on environmental condi- 5 tions, disease risks, and disease occurrence re- 6 lated to climate change. 7 (C) Expand capacity for modeling and 8 forecasting health effects that may be climate- 9 related. 10 (D) Enhance the science base to better un- 11 derstand the relationship between climate 12 change and health outcomes. 13 (E) Identify locations and population 14 groups at greatest risk for specific health 15 threats and effects, such as increased heat 16 stress, degraded air and water quality, food- or 17 water-related infections, vector-borne illnesses, 18 pulmonary and cardiovascular effects, mental 19 and behavioral health effects, and food, water, 20 and nutrient insecurity. 21 (F) Communicate the health-related as- 22 pects of climate change, including risks and as- 23 sociated costs and ways to reduce them, to the 24 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 12 •HR 1243 IH public, decisionmakers, public health profes- 1 sionals, and health care providers. 2 (G) Develop partnerships with other gov- 3 ernment agencies, the private sector, non- 4 governmental organizations, universities, and 5 international organizations to more effectively 6 address domestic and global health aspects of 7 climate change. 8 (H) Provide leadership to State and local 9 governments, community leaders, health care 10 professionals, nongovernmental organizations, 11 environmental justice networks, faith-based 12 communities, the private sector, and the public, 13 domestically and internationally, regarding 14 health protection from climate change effects. 15 (I) Develop and implement preparedness 16 and response plans for health threats such as 17 heat waves, severe weather events, and infec- 18 tious diseases. 19 (J) Provide technical advice and support to 20 State and local health departments, the private 21 sector, and others in developing and imple- 22 menting national and global preparedness meas- 23 ures related to the health effects of climate 24 change. 25 VerDate Sep 11 2014 23:24 Feb 27, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H1243.IH H1243 pamtmann on DSKBFK8HB2PROD with BILLS 13 •HR 1243 IH (K) Promote workforce development by 1 helping to ensure the training of a new genera [Text truncated for display. 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