II 118TH CONGRESS 1ST SESSION S. 1601 To protect moms and babies against climate change, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 15, 2023 Mr. MARKEY (for himself, Mr. BOOKER, Mr. BLUMENTHAL, and Mr. SAND- ERS) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To protect moms and babies against 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 ‘‘Protecting Moms and 4 Babies Against Climate Change Act’’. 5 SEC. 2. DEFINITIONS. 6 In this Act: 7 (1) ADVERSE MATERNAL AND INFANT HEALTH 8 OUTCOMES.—The term ‘‘adverse maternal and in- 9 fant health outcomes’’ includes the outcomes of 10 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 1601 IS preterm birth, low birth weight, stillbirth, infant or 1 maternal mortality, and severe maternal morbidity. 2 (2) INSTITUTION OF HIGHER EDUCATION.—The 3 term ‘‘institution of higher education’’ has the 4 meaning given such term in section 101 of the High- 5 er Education Act of 1965 (20 U.S.C. 1001). 6 (3) MATERNAL MORTALITY.—The term ‘‘mater- 7 nal mortality’’ means a death occurring during or 8 within a 1-year period after pregnancy, caused by 9 pregnancy-related or childbirth complications, in- 10 cluding a suicide, overdose, or other death resulting 11 from a mental health or substance use disorder at- 12 tributed to or aggravated by pregnancy-related or 13 childbirth complications. 14 (4) MINORITY-SERVING INSTITUTION.—The 15 term ‘‘minority-serving institution’’ means an entity 16 specified in any of paragraphs (1) through (7) of 17 section 371(a) of the Higher Education Act of 1965 18 (20 U.S.C. 1067q(a)). 19 (5) PERINATAL HEALTH WORKER.—The term 20 ‘‘perinatal health worker’’ means a nonclinical health 21 worker focused on maternal or perinatal health, such 22 as a doula, community health worker, peer sup- 23 porter, lactation educator or counselor, nutritionist 24 or dietitian, childbirth educator, social worker, home 25 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 1601 IS visitor, patient navigator or coordinator, or language 1 interpreter. 2 (6) RACIAL AND ETHNIC MINORITY GROUP.— 3 The term ‘‘racial and ethnic minority group’’ has the 4 meaning given such term in section 1707(g) of the 5 Public Health Service Act (42 U.S.C. 300u–6(g)). 6 (7) RISKS ASSOCIATED WITH CLIMATE 7 CHANGE.—The term ‘‘risks associated with climate 8 change’’ includes risks associated with extreme heat, 9 air pollution, extreme weather events, and other en- 10 vironmental issues associated with climate change 11 that can result in adverse maternal and infant 12 health outcomes. 13 (8) SECRETARY.—The term ‘‘Secretary’’ means 14 the Secretary of Health and Human Services. 15 (9) SEVERE MATERNAL MORBIDITY.—The term 16 ‘‘severe maternal morbidity’’ means a health condi- 17 tion, including mental health conditions and sub- 18 stance use disorders, attributed to or aggravated by 19 pregnancy or childbirth that results in significant 20 short-term or long-term consequences to the health 21 of the individual who was pregnant. 22 (10) STAKEHOLDER ORGANIZATION.—The term 23 ‘‘stakeholder organization’’ means— 24 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 1601 IS (A) a community-based organization with 1 expertise in providing assistance to vulnerable 2 individuals; 3 (B) a nonprofit organization with expertise 4 in— 5 (i) maternal or infant health; or 6 (ii) environmental or climate justice; 7 and 8 (C) a patient advocacy organization rep- 9 resenting vulnerable individuals. 10 (11) VULNERABLE INDIVIDUAL.—The term 11 ‘‘vulnerable individual’’ means— 12 (A) an individual who is pregnant; 13 (B) an individual who was pregnant during 14 any portion of the preceding 1-year period; and 15 (C) an individual under 3 years of age. 16 SEC. 3. GRANT PROGRAM TO PROTECT VULNERABLE 17 MOTHERS AND BABIES FROM CLIMATE 18 CHANGE RISKS. 19 (a) IN GENERAL.—Not later than 180 days after the 20 date of enactment of this Act, the Secretary shall establish 21 a grant program to protect vulnerable individuals from 22 risks associated with climate change. 23 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 1601 IS (b) GRANT AUTHORITY.—In carrying out the Pro- 1 gram, the Secretary may award, on a competitive basis, 2 grants to 10 covered entities. 3 (c) APPLICATIONS.—To be eligible for a grant under 4 the Program, a covered entity shall submit to the Sec- 5 retary an application at such time, in such form, and con- 6 taining such information as the Secretary may require, 7 which shall include, at a minimum, a description of the 8 following: 9 (1) Plans for the use of grant funds awarded 10 under the Program and how patients and stake- 11 holder organizations were involved in the develop- 12 ment of such plans. 13 (2) How such grant funds will be targeted to 14 geographic areas that have disproportionately high 15 levels of risks associated with climate change for vul- 16 nerable individuals. 17 (3) How such grant funds will be used to ad- 18 dress racial and ethnic disparities in— 19 (A) adverse maternal and infant health 20 outcomes; and 21 (B) exposure to risks associated with cli- 22 mate change for vulnerable individuals. 23 (4) Strategies to prevent an initiative assisted 24 with such grant funds from causing— 25 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •S 1601 IS (A) adverse environmental impacts; 1 (B) displacement of residents and busi- 2 nesses; 3 (C) rent and housing price increases; or 4 (D) disproportionate adverse impacts on 5 racial and ethnic minority groups and other un- 6 derserved populations. 7 (d) SELECTION OF GRANT RECIPIENTS.— 8 (1) TIMING.—Not later than 270 days after the 9 date of enactment of this Act, the Secretary shall se- 10 lect the recipients of grants under the Program. 11 (2) CONSULTATION.—In selecting covered enti- 12 ties for grants under the Program, the Secretary 13 shall consult with— 14 (A) representatives of stakeholder organi- 15 zations; 16 (B) the Administrator of the Environ- 17 mental Protection Agency; 18 (C) the Administrator of the National Oce- 19 anic and Atmospheric Administration; and 20 (D) from the Department of Health and 21 Human Services— 22 (i) the Deputy Assistant Secretary for 23 Minority Health; 24 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •S 1601 IS (ii) the Administrator of the Centers 1 for Medicare & Medicaid Services; 2 (iii) the Administrator of the Health 3 Resources and Services Administration; 4 (iv) the Director of the National Insti- 5 tutes of Health; and 6 (v) the Director of the Centers for 7 Disease Control and Prevention. 8 (3) PRIORITY.—In selecting grantees under the 9 Program, the Secretary shall give priority to covered 10 entities that serve a county or locality— 11 (A) designated, or located in an area des- 12 ignated, as a nonattainment area pursuant to 13 section 107 of the Clean Air Act (42 U.S.C. 14 7407) for any air pollutant for which air quality 15 criteria have been issued under section 108(a) 16 of such Act (42 U.S.C. 7408(a)); 17 (B) with a level of vulnerability of mod- 18 erate-to-high or higher, according to the Social 19 Vulnerability Index of the Centers for Disease 20 Control and Prevention, or a similar rating of 21 social vulnerability according to related Federal 22 mapping tools; 23 (C) with temperatures that pose a risk to 24 human health, as determined by the Secretary, 25 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •S 1601 IS in consultation with the Administrator of the 1 National Oceanic and Atmospheric Administra- 2 tion and the Chair of the United States Global 3 Change Research Program, based on the best 4 available science; 5 (D) with elevated rates of maternal mor- 6 tality, severe maternal morbidity, maternal 7 health disparities, or other adverse perinatal or 8 childbirth outcomes; 9 (E) with a rating of very high or relatively 10 high risk according to the National Risk Index 11 for Natural Hazards of the Federal Emergency 12 Management Agency; or 13 (F) with other climate-sensitive hazards 14 with associations to adverse maternal or infant 15 health outcomes, as determined by the Sec- 16 retary. 17 (4) LIMITATION.—A recipient of grant funds 18 under the Program may not use such grant funds to 19 serve a county or locality that is served by any other 20 recipient of a grant under the Program. 21 (e) USE OF FUNDS.—A covered entity awarded grant 22 funds under the Program may only use such grant funds 23 for the following: 24 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •S 1601 IS (1) Initiatives to identify risks associated with 1 climate change for vulnerable individuals and to pro- 2 vide services and support to such individuals that 3 address such risks, which may include— 4 (A) training for health care providers, 5 perinatal health workers, and other employees 6 in hospitals, birth centers, midwifery practices, 7 and other health care practices that provide 8 prenatal or labor and delivery services to vul- 9 nerable individuals on the identification of, and 10 patient counseling relating to, risks associated 11 with climate change for vulnerable individuals; 12 (B) hiring, training, or providing resources 13 to perinatal health workers who can help iden- 14 tify risks associated with climate change for 15 vulnerable individuals, provide patient coun- 16 seling about such risks, and carry out the dis- 17 tribution of relevant services and support; 18 (C) enhancing the monitoring of risks as- 19 sociated with climate change for vulnerable in- 20 dividuals, including by— 21 (i) collecting data on such risks in 22 specific census tracts, neighborhoods, or 23 other geographic areas; and 24 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •S 1601 IS (ii) sharing such data with local 1 health care providers, perinatal health 2 workers, and other employees in hospitals, 3 birth centers, midwifery practices, and 4 other health care practices that provide 5 prenatal or labor and delivery services to 6 local vulnerable individuals; and 7 (D) providing vulnerable individuals— 8 (i) air conditioning units, residential 9 weatherization support, filtration systems, 10 household appliances, or related items; 11 (ii) direct financial assistance; and 12 (iii) services and support, including 13 housing assistance, evacuation assistance, 14 transportation assistance, access to cooling 15 shelters, and mental health counseling, to 16 prepare for or recover from extreme weath- 17 er events, which may include floods, hurri- 18 canes, wildfires, droughts, and related 19 events. 20 (2) Initiatives to mitigate levels of and exposure 21 to risks associated with climate change for vulner- 22 able individuals, which shall be based on the best 23 available science and which may include initiatives 24 to— 25 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •S 1601 IS (A) develop, maintain, or expand urban or 1 community forestry initiatives and tree canopy 2 coverage initiatives; 3 (B) improve infrastructure, such as build- 4 ings and paved surfaces; 5 (C) develop or improve community out- 6 reach networks to provide culturally and lin- 7 guistically appropriate information and notifica- 8 tions about risks associated with climate change 9 for vulnerable individuals; and 10 (D) provide enhanced services to racial and 11 ethnic minority groups and other underserved 12 populations. 13 (f) LENGTH OF AWARD.—A grant under this section 14 shall be disbursed over 4 fiscal years. 15 (g) TECHNICAL ASSISTANCE.—The Secretary shall 16 provide technical assistance to a covered entity awarded 17 a grant under the Program to support the development, 18 implementation, and evaluation of activities funded with 19 such grant. 20 (h) REPORTS TO SECRETARY.— 21 (1) ANNUAL REPORT.—For each fiscal year 22 during which a covered entity is disbursed grant 23 funds under the Program, such covered entity shall 24 submit to the Secretary a report that summarizes 25 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 12 •S 1601 IS the activities carried out by such covered entity with 1 such grant funds during such fiscal year, which shall 2 include a description of the following: 3 (A) The involvement of stakeholder organi- 4 zations in the implementation of initiatives as- 5 sisted with such grant funds. 6 (B) Relevant health and environmental 7 data, disaggregated, to the extent practicable, 8 by race, ethnicity, primary language, socio- 9 economic status, geography, insurance type, 10 pregnancy status, and other relevant demo- 11 graphic information. 12 (C) Qualitative feedback received from vul- 13 nerable individuals with respect to initiatives 14 assisted with such grant funds. 15 (D) Criteria used in selecting the geo- 16 graphic areas assisted with such grant funds. 17 (E) Efforts to address racial and ethnic 18 disparities in adverse maternal and infant 19 health outcomes and in exposure to risks associ- 20 ated with climate change for vulnerable individ- 21 uals. 22 (F) Any negative and unintended impacts 23 of initiatives assisted with such grant funds, in- 24 cluding— 25 VerDate Sep 11 2014 04:00 May 25, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1601.IS S1601 pbinns on DSKJLVW7X2PROD with $$_JOB 13 •S 1601 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 advers [Text truncated for display. 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