[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1601 Introduced in Senate (IS)]
<DOC>
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. Sanders)
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 Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protecting Moms and Babies Against
Climate Change Act''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Adverse maternal and infant health outcomes.--The term
``adverse maternal and infant health outcomes'' includes the
outcomes of preterm birth, low birth weight, stillbirth, infant
or maternal mortality, and severe maternal morbidity.
(2) Institution of higher education.--The term
``institution of higher education'' has the meaning given such
term in section 101 of the Higher Education Act of 1965 (20
U.S.C. 1001).
(3) Maternal mortality.--The term ``maternal mortality''
means a death occurring during or within a 1-year period after
pregnancy, caused by pregnancy-related or childbirth
complications, including a suicide, overdose, or other death
resulting from a mental health or substance use disorder
attributed to or aggravated by pregnancy-related or childbirth
complications.
(4) Minority-serving institution.--The term ``minority-
serving institution'' means an entity specified in any of
paragraphs (1) through (7) of section 371(a) of the Higher
Education Act of 1965 (20 U.S.C. 1067q(a)).
(5) Perinatal health worker.--The term ``perinatal health
worker'' means a nonclinical health worker focused on maternal
or perinatal health, such as a doula, community health worker,
peer supporter, lactation educator or counselor, nutritionist
or dietitian, childbirth educator, social worker, home visitor,
patient navigator or coordinator, or language interpreter.
(6) Racial and ethnic minority group.--The term ``racial
and ethnic minority group'' has the meaning given such term in
section 1707(g) of the Public Health Service Act (42 U.S.C.
300u-6(g)).
(7) Risks associated with climate change.--The term ``risks
associated with climate change'' includes risks associated with
extreme heat, air pollution, extreme weather events, and other
environmental issues associated with climate change that can
result in adverse maternal and infant health outcomes.
(8) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(9) Severe maternal morbidity.--The term ``severe maternal
morbidity'' means a health condition, including mental health
conditions and substance use disorders, attributed to or
aggravated by pregnancy or childbirth that results in
significant short-term or long-term consequences to the health
of the individual who was pregnant.
(10) Stakeholder organization.--The term ``stakeholder
organization'' means--
(A) a community-based organization with expertise
in providing assistance to vulnerable individuals;
(B) a nonprofit organization with expertise in--
(i) maternal or infant health; or
(ii) environmental or climate justice; and
(C) a patient advocacy organization representing
vulnerable individuals.
(11) Vulnerable individual.--The term ``vulnerable
individual'' means--
(A) an individual who is pregnant;
(B) an individual who was pregnant during any
portion of the preceding 1-year period; and
(C) an individual under 3 years of age.
SEC. 3. GRANT PROGRAM TO PROTECT VULNERABLE MOTHERS AND BABIES FROM
CLIMATE CHANGE RISKS.
(a) In General.--Not later than 180 days after the date of
enactment of this Act, the Secretary shall establish a grant program to
protect vulnerable individuals from risks associated with climate
change.
(b) Grant Authority.--In carrying out the Program, the Secretary
may award, on a competitive basis, grants to 10 covered entities.
(c) Applications.--To be eligible for a grant under the Program, a
covered entity shall submit to the Secretary an application at such
time, in such form, and containing such information as the Secretary
may require, which shall include, at a minimum, a description of the
following:
(1) Plans for the use of grant funds awarded under the
Program and how patients and stakeholder organizations were
involved in the development of such plans.
(2) How such grant funds will be targeted to geographic
areas that have disproportionately high levels of risks
associated with climate change for vulnerable individuals.
(3) How such grant funds will be used to address racial and
ethnic disparities in--
(A) adverse maternal and infant health outcomes;
and
(B) exposure to risks associated with climate
change for vulnerable individuals.
(4) Strategies to prevent an initiative assisted with such
grant funds from causing--
(A) adverse environmental impacts;
(B) displacement of residents and businesses;
(C) rent and housing price increases; or
(D) disproportionate adverse impacts on racial and
ethnic minority groups and other underserved
populations.
(d) Selection of Grant Recipients.--
(1) Timing.--Not later than 270 days after the date of
enactment of this Act, the Secretary shall select the
recipients of grants under the Program.
(2) Consultation.--In selecting covered entities for grants
under the Program, the Secretary shall consult with--
(A) representatives of stakeholder organizations;
(B) the Administrator of the Environmental
Protection Agency;
(C) the Administrator of the National Oceanic and
Atmospheric Administration; and
(D) from the Department of Health and Human
Services--
(i) the Deputy Assistant Secretary for
Minority Health;
(ii) the Administrator of the Centers for
Medicare & Medicaid Services;
(iii) the Administrator of the Health
Resources and Services Administration;
(iv) the Director of the National
Institutes of Health; and
(v) the Director of the Centers for Disease
Control and Prevention.
(3) Priority.--In selecting grantees under the Program, the
Secretary shall give priority to covered entities that serve a
county or locality--
(A) designated, or located in an area designated,
as a nonattainment area pursuant to section 107 of the
Clean Air Act (42 U.S.C. 7407) for any air pollutant
for which air quality criteria have been issued under
section 108(a) of such Act (42 U.S.C. 7408(a));
(B) with a level of vulnerability of moderate-to-
high or higher, according to the Social Vulnerability
Index of the Centers for Disease Control and
Prevention, or a similar rating of social vulnerability
according to related Federal mapping tools;
(C) with temperatures that pose a risk to human
health, as determined by the Secretary, in consultation
with the Administrator of the National Oceanic and
Atmospheric Administration and the Chair of the United
States Global Change Research Program, based on the
best available science;
(D) with elevated rates of maternal mortality,
severe maternal morbidity, maternal health disparities,
or other adverse perinatal or childbirth outcomes;
(E) with a rating of very high or relatively high
risk according to the National Risk Index for Natural
Hazards of the Federal Emergency Management Agency; or
(F) with other climate-sensitive hazards with
associations to adverse maternal or infant health
outcomes, as determined by the Secretary.
(4) Limitation.--A recipient of grant funds under the
Program may not use such grant funds to serve a county or
locality that is served by any other recipient of a grant under
the Program.
(e) Use of Funds.--A covered entity awarded grant funds under the
Program may only use such grant funds for the following:
(1) Initiatives to identify risks associated with climate
change for vulnerable individuals and to provide services and
support to such individuals that address such risks, which may
include--
(A) training for health care providers, perinatal
health workers, and other employees in hospitals, birth
centers, midwifery practices, and other health care
practices that provide prenatal or labor and delivery
services to vulnerable individuals on the
identification of, and patient counseling relating to,
risks associated with climate change for vulnerable
individuals;
(B) hiring, training, or providing resources to
perinatal health workers who can help identify risks
associated with climate change for vulnerable
individuals, provide patient counseling about such
risks, and carry out the distribution of relevant
services and support;
(C) enhancing the monitoring of risks associated
with climate change for vulnerable individuals,
including by--
(i) collecting data on such risks in
specific census tracts, neighborhoods, or other
geographic areas; and
(ii) sharing such data with local health
care providers, perinatal health workers, and
other employees in hospitals, birth centers,
midwifery practices, and other health care
practices that provide prenatal or labor and
delivery services to local vulnerable
individuals; and
(D) providing vulnerable individuals--
(i) air conditioning units, residential
weatherization support, filtration systems,
household appliances, or related items;
(ii) direct financial assistance; and
(iii) services and support, including
housing assistance, evacuation assistance,
transportation assistance, access to cooling
shelters, and mental health counseling, to
prepare for or recover from extreme weather
events, which may include floods, hurricanes,
wildfires, droughts, and related events.
(2) Initiatives to mitigate levels of and exposure to risks
associated with climate change for vulnerable individuals,
which shall be based on the best available science and which
may include initiatives to--
(A) develop, maintain, or expand urban or community
forestry initiatives and tree canopy coverage
initiatives;
(B) improve infrastructure, such as buildings and
paved surfaces;
(C) develop or improve community outreach networks
to provide culturally and linguistically appropriate
information and notifications about risks associated
with climate change for vulnerable individuals; and
(D) provide enhanced services to racial and ethnic
minority groups and other underserved populations.
(f) Length of Award.--A grant under this section shall be disbursed
over 4 fiscal years.
(g) Technical Assistance.--The Secretary shall provide technical
assistance to a covered entity awarded a grant under the Program to
support the development, implementation, and evaluation of activities
funded with such grant.
(h) Reports to Secretary.--
(1) Annual report.--For each fiscal year during which a
covered entity is disbursed grant funds under the Program, such
covered entity shall submit to the Secretary a report that
summarizes the activities carried out by such covered entity
with such grant funds during such fiscal year, which shall
include a description of the following:
(A) The involvement of stakeholder organizations in
the implementation of initiatives assisted with such
grant funds.
(B) Relevant health and environmental data,
disaggregated, to the extent practicable, by race,
ethnicity, primary language, socioeconomic status,
geography, insurance type, pregnancy status, and other
relevant demographic information.
(C) Qualitative feedback received from vulnerable
individuals with respect to initiatives assisted with
such grant funds.
(D) Criteria used in selecting the geographic areas
assisted with such grant funds.
(E) Efforts to address racial and ethnic
disparities in adverse maternal and infant health
outcomes and in exposure to risks associated with
climate change for vulnerable individuals.
(F) Any negative and unintended impacts of
initiatives assisted with such grant funds, including--
(i) adverse environmental impacts;
(ii) displacement of residents and
businesses;
(iii) rent and housing price increases; and
(iv) disproportionate adverse impacts on
racial and ethnic minority groups and other
underserved populations.
(G) How the covered entity will address and prevent
any impacts described in subparagraph (F).
(2) Publication.--Not later than 30 days after the date on
which a report is submitted under paragraph (1), the Secretary
shall publish such report on a public website of the Department
of Health and Human Services.
(i) Report to Congress.--Not later than the date that is 5 years
after the date on which the Program is established, the Secretary shall
submit to Congress and publish on a public website of the Department of
Health and Human Services a report on the results of the Program,
including the following:
(1) Summaries of the annual reports submitted under
subsection (h).
(2) Evaluations of the initiatives assisted with grant
funds under the Program.
(3) An assessment of the effectiveness of the Program in--
(A) identifying risks associated with climate
change for vulnerable individuals;
(B) providing services and support to such
individuals;
(C) mitigating levels of and exposure to such
risks; and
(D) addressing racial and ethnic disparities in
adverse maternal and infant health outcomes and in
exposure to such risks.
(4) A description of how the Program could be expanded,
including--
(A) monitoring efforts or data collection that
would be required to identify areas with high levels of
risks associated with climate change for vulnerable
individuals;
(B) how such areas could be identified using the
strategy developed under section 6; and
(C) recommendations for additional funding.
(j) Definitions.--In this section:
(1) The term ``covered entity'' means a consortium of
organizations serving a county that--
(A) shall include a community-based organization;
and
(B) may include--
(i) another stakeholder organization;
(ii) the government of such county;
(iii) the governments of 1 or more
municipalities within such county;
(iv) a State or local public health
department or emergency management agency;
(v) a local health care practice, which may
include a licensed and accredited hospital,
birth center, midwifery practice, or other
health care practice that provides prenatal or
labor and delivery services to vulnerable
individuals;
(vi) an Indian tribe or Tribal organization
(as such terms are defined in section 4 of the
Indian Self-Determination and Education
Assistance Act (25 U.S.C. 5304));
(vii) an Urban Indian organization (as
defined in section 4 of the Indian Health Care
Improvement Act (25 U.S.C. 1603)); and
(viii) an institution of higher education.
(2) The term ``Program'' means the grant program under this
section.
(k) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $100,000,000 for the period of
fiscal years 2024 through 2027.
SEC. 4. GRANT PROGRAM FOR EDUCATION AND TRAINING AT HEALTH PROFESSION
SCHOOLS.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Secretary shall establish a grant program to provide
funds to health profession schools to support the development and
integration of education and training programs for identifying and
addressing risks associated with climate change for vulnerable
individuals.
(b) Grant Authority.--In carrying out the Program, the Secretary
may award, on a competitive basis, grants to health profession schools.
(c) Application.--To be eligible for a grant under the Program, a
health profession school shall submit to the Secretary an application
at such time, in such form, and containing such information as the
Secretary may require, which shall include, at a minimum, a description
of the following:
(1) How such health profession school will engage with
vulnerable individuals, and stakeholder organizations
representing such individuals, in developing and implementing
the education and training programs supported by grant funds
awarded under the Program.
(2) How such health profession school will ensure that such
education and training programs will address racial and ethnic
disparities in exposure to, and the effects of, risks
associated with climate change for vulnerable individuals.
(d) Use of Funds.--A health profession school awarded a grant under
the Program shall use the grant funds to develop, and integrate into
the curriculum and continuing education of such health profession
school, education and training on each of the following:
(1) Identifying risks associated with climate change for
vulnerable individuals and individuals with the intent to
become pregnant.
(2) How risks associated with climate change affect
vulnerable individuals and individuals with the intent to
become pregnant.
(3) Racial and ethnic disparities in exposure to, and the
effects of, risks associated with climate change for vulnerable
individuals and individuals with the intent to become pregnant.
(4) Patient counseling and mitigation strategies relating
to risks associated with climate change for vulnerable
individuals.
(5) Relevant services and support for vulnerable
individuals relating to risks associated with climate change
and strategies for ensuring vulnerable individuals have access
to such services and support.
(6) Implicit and explicit bias, racism, and discrimination.
(7) Related topics identified by such health profession
school based on the engagement of such health profession school
with vulnerable individuals and stakeholder organizations
representing such individuals.
(e) Partnerships.--In carrying out activities with grant funds, a
health profession school awarded a grant under the Program may partner
with 1 or more of the following:
(1) A State or local public health department.
(2) A health care professional membership organization.
(3) A stakeholder organization.
(4) A health profession school.
(5) An institution of higher education.
(f) Reports to Secretary.--
(1) Annual report.--For each fiscal year during which a
health profession school is disbursed grant funds under the
Program, such health profession school shall submit to the
Secretary a report that describes the activities carried out
with such grant funds during such fiscal year.
(2) Final report.--Not later than the date that is 1 year
after the end of the last fiscal year during which a health
profession school is disbursed grant funds under the Program,
the health profession school shall submit to the Secretary a
final report that summarizes the activities carried out with
such grant funds.
(g) Report to Congress.--Not later than the date that is 6 years
after the date on which the Program is established, the Secretary shall
submit to Congress and publish on a public website of the Department of
Health and Human Services a report that includes the following:
(1) A summary of the reports submitted under subsection
(f).
(2) Recommendations to improve education and training
programs at health profession schools with respect to
identifying and addressing risks associated with climate change
for vulnerable individuals.
(h) Definitions.--In this section:
(1) The term ``health profession school'' means an
accredited--
(A) medical school;
(B) school of nursing;
(C) midwifery program;
(D) physician assistant education program;
(E) teaching hospital;
(F) residency or fellowship program; or
(G) other school or program determined appropriate
by the Secretary.
(2) The term ``Program'' means the grant program under this
section.
(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for the period of
fiscal years 2024 through 2027.
SEC. 5. NIH CONSORTIUM ON BIRTH AND CLIMATE CHANGE RESEARCH.
(a) Establishment.--Not later than 1 year after the date of
enactment of this Act, the Director of the National Institutes of
Health shall establish the Consortium on Birth and Climate Change
Research (in this section referred to as the ``Consortium'').
(b) Duties.--
(1) In general.--The Consortium shall coordinate, across
the institutes, centers, and offices of the National Institutes
of Health, research on the risks associated with climate change
for vulnerable individuals.
(2) Required activities.--In carrying out paragraph (1),
the Consortium shall--
(A) establish research priorities, including by
prioritizing research that--
(i) identifies the risks associated with
climate change for vulnerable individuals with
a particular focus on disparities in such risks
among racial and ethnic minority groups and
other underserved populations; and
(ii) identifies strategies to reduce levels
of, and exposure to, such risks, with a
particular focus on risks among racial and
ethnic minority groups and other underserved
populations;
(B) identify gaps in available data related to such
risks;
(C) identify gaps in, and opportunities for,
research collaborations;
(D) identify funding opportunities for community-
based organizations and researchers from racially,
ethnically, and geographically diverse backgrounds;
(E) identify opportunities to increase public
awareness related to risks associated with climate
change for vulnerable individuals; and
(F) publish annual reports on the work and findings
of the Consortium on a public website of the National
Institutes of Health.
(c) Membership.--The Director shall appoint to the Consortium
representatives of such institutes, centers, and offices of the
National Institutes of Health as the Director considers appropriate,
including, at a minimum, representatives of--
(1) the National Institute of Environmental Health
Sciences;
(2) the National Institute on Minority Health and Health
Disparities;
(3) the Eunice Kennedy Shriver National Institute of Child
Health and Human Development;
(4) the National Institute of Mental Health;
(5) the National Institute of Nursing Research; and
(6) the Office of Research on Women's Health.
(d) Chairperson.--The Chairperson of the Consortium shall be
designated by the Director and selected from among the representatives
appointed under subsection (c).
(e) Consultation.--In carrying out the duties described in
subsection (b), the Consortium shall consult with--
(1) the heads of relevant Federal agencies, including--
(A) the Environmental Protection Agency;
(B) the National Oceanic and Atmospheric
Administration;
(C) the Occupational Safety and Health
Administration; and
(D) from the Department of Health and Human
Services--
(i) the Office of Minority Health in the
Office of the Secretary;
(ii) the Centers for Medicare & Medicaid
Services;
(iii) the Health Resources and Services
Administration;
(iv) the Centers for Disease Control and
Prevention;
(v) the Indian Health Service; and
(vi) the Administration for Children and
Families; and
(2) representatives of--
(A) stakeholder organizations;
(B) health care providers and professional
membership organizations with expertise in maternal
health or environmental justice;
(C) State and local public health departments;
(D) licensed and accredited hospitals, birth
centers, midwifery practices, or other health care
practices that provide prenatal or labor and delivery
services to vulnerable individuals; and
(E) institutions of higher education, including
such institutions that are minority-serving
institutions or have expertise in maternal health or
environmental justice.
SEC. 6. STRATEGY FOR IDENTIFYING CLIMATE CHANGE RISK ZONES FOR
VULNERABLE MOTHERS AND BABIES.
(a) In General.--The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall develop a strategy
(in this section referred to as the ``Strategy'') for designating areas
that the Secretary determines to have a high risk of adverse maternal
and infant health outcomes among vulnerable individuals as a result of
risks associated with climate change.
(b) Strategy Requirements.--
(1) In general.--In developing the Strategy, the Secretary
shall establish a process to identify areas where vulnerable
individuals are exposed to a high risk of adverse maternal and
infant health outcomes as a result of risks associated with
climate change in conjunction with other factors that can
impact such health outcomes, including--
(A) the incidence of diseases associated with air
pollution, extreme heat, and other environmental
factors;
(B) the availability and accessibility of maternal
and infant health care providers;
(C) English-language proficiency among women of
reproductive age;
(D) the health insurance status of women of
reproductive age;
(E) the number of women of reproductive age who are
members of racial or ethnic groups with
disproportionately high rates of adverse maternal and
infant health outcomes;
(F) the socioeconomic status of women of
reproductive age, including with respect to--
(i) poverty;
(ii) unemployment;
(iii) household income; and
(iv) educational attainment; and
(G) access to quality housing, transportation, and
nutrition.
(2) Resources.--In developing the Strategy, the Secretary
shall identify, and incorporate a description of, the
following:
(A) Existing mapping tools or Federal programs that
identify--
(i) risks associated with climate change
for vulnerable individuals; and
(ii) other factors that can influence
maternal and infant health outcomes, including
the factors described in paragraph (1).
(B) Environmental, health, socioeconomic, and
demographic data relevant to identifying risks
associated with climate change for vulnerable
individuals.
(C) Existing monitoring networks that collect data
described in subparagraph (B), and any gaps in such
networks.
(D) Federal, State, and local stakeholders involved
in maintaining monitoring networks identified under
subparagraph (C), and how such stakeholders are
coordinating their monitoring efforts.
(E) Additional monitoring networks, and
enhancements to existing monitoring networks, that
would be required to address gaps identified under
subparagraph (C), including at the subcounty and census
tract level.
(F) Funding amounts required to establish the
monitoring networks identified under subparagraph (E)
and recommendations for Federal, State, and local
coordination with respect to such networks.
(G) Potential uses for data collected and generated
as a result of the Strategy, including how such data
may be used in determining recipients of grants under
the program established by section 3 or other similar
programs.
(H) Other information the Secretary considers
relevant for the development of the Strategy.
(c) Coordination and Consultation.--In developing the Strategy, the
Secretary shall--
(1) coordinate with the Administrator of the Environmental
Protection Agency and the Administrator of the National Oceanic
and Atmospheric Administration; and
(2) consult with--
(A) stakeholder organizations;
(B) health care providers and professional
membership organizations with expertise in maternal
health or environmental justice;
(C) State and local public health departments;
(D) licensed and accredited hospitals, birth
centers, midwifery practices, or other health care
providers that provide prenatal or labor and delivery
services to vulnerable individuals; and
(E) institutions of higher education, including
such institutions that are minority-serving
institutions or have expertise in maternal health or
environmental justice.
(d) Notice and Comment.--At least 240 days before the date on which
the Strategy is published in accordance with subsection (e), the
Secretary shall provide--
(1) notice of the Strategy on a public website of the
Department of Health and Human Services; and
(2) an opportunity for public comment of at least 90 days.
(e) Publication.--Not later than 18 months after the date of
enactment of this Act, the Secretary shall publish on a public website
of the Department of Health and Human Services--
(1) the Strategy;
(2) the public comments received under subsection (d); and
(3) the responses of the Secretary to such public comments.
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