[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2657 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
1st Session
S. 2657
To provide for green and resilient health care infrastructure, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 27, 2023
Mr. Markey introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for green and resilient health care infrastructure, 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 ``Granting Resources for Eliminating
Emissions Now in Hospitals Act'' or the ``GREEN Hospitals Act''.
SEC. 2. GREEN HILL-BURTON FUNDS FOR CLIMATE-READY MEDICAL FACILITIES.
(a) Grants for Construction or Modernization Projects.--
(1) In general.--Section 1610(a) of the Public Health
Service Act (42 U.S.C. 300r(a)) is amended--
(A) in paragraph (1)(A)--
(i) in clause (i), by striking ``, or'' and
inserting a semicolon;
(ii) in clause (ii), by striking the period
at the end and inserting ``; or''; and
(iii) by adding at the end the following:
``(iii) increase capacity to provide
essential health care and update medical
facilities to become more resilient to climate
disasters and public health crises to ensure
access and availability of quality health care
for communities in need.''; and
(B) by striking paragraph (3) and inserting the
following:
``(3) Priority.--In awarding grants under this subsection,
the Secretary shall give priority to applicants whose projects
will include, by design, resilience against natural disasters,
climate change mitigation, or other necessary predisaster
adaptations to ensure continuous health care access and combat
health risks due to climate change, such as--
``(A) installation of onsite distributed generation
that combines energy-efficient devices, energy storage,
and renewable energy in accordance with modern
electrical safety standards for medical facilities to
allow the medical facility to access essential energy
during power outages and optimize use of onsite and
offsite energy sources for emissions reductions;
``(B) improving air conditioning, monitoring, and
purifying through installation of high-efficiency heat
pumps that provide both cooling and heating, air
purifiers, air filtration systems, and air quality
monitoring systems integrated with energy systems and
energy efficiency considerations in preparation for
future natural hazards and public health crises, such
as wildfire, smog, extreme heat events, and pandemics;
``(C) installation and maintenance of wetlands,
drainage ponds, stormwater drainage, and any other
green infrastructure to protect the medical facility
from projected severe effects with respect to extreme
weather, natural disasters, or climate change-related
events, including sea-level rise, flooding, and
increased risk of wildfire;
``(D) green rooftops, walls, and indoor plantings,
particularly those that can provide publicly accessible
temperature management and air quality improvements;
``(E) tree planting and other green infrastructure
to create publicly accessible cool space to address
urban heat islands;
``(F) infrastructure upgrades that protect access
routes to the medical facility, such as long-term
flood, wildfire, and other disaster mitigation for the
roads, sidewalks, and public transit infrastructure
that service the medical facility;
``(G) the long-term maintenance of decarbonization
and zero-emissions infrastructure (regardless of the
source of original funding for such infrastructure);
and
``(H) any other type of plan or project the
Secretary determines will increase the sustainability
and resiliency of a medical facility, protect patient
health and community access during extreme weather, and
advance environmental justice.
``(4) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection
$100,000,000,000 for fiscal year 2024, to remain available
until expended.''.
(2) Technical amendment.--Section 1610(b) of the Public
Health Service Act (42 U.S.C. 300r(b)) is amended by striking
paragraph (3).
(b) Medical Facility Project Applications.--
(1) In general.--Section 1621(b)(1) of the Public Health
Service Act (42 U.S.C. 300s-1(b)(1)) is amended--
(A) in subparagraph (J), by striking ``and'' at the
end;
(B) in subparagraph (K), by striking the period at
the end and inserting a semicolon; and
(C) by adding at the end the following:
``(L) reasonable assurance that the facility will
have adequate staffing to fulfill the community service
obligation; and
``(M) reasonable assurance that the facility--
``(i) has a collective bargaining agreement
with 1 or more labor organizations representing
employees at the facility; or
``(ii) has an explicit policy not to
interfere with the rights of employees of the
facility under section 7 of the National Labor
Relations Act.''.
(2) Application for planning grants.--Section 1621 of the
Public Health Service Act (42 U.S.C. 300s-1) is amended by
adding at the end the following:
``(c) Application for Planning Grants.--An application for a
project submitted under part A or B shall be deemed to be complete for
purposes of section 3(d)(2) of the Granting Resources for Eliminating
Emissions Now in Hospitals Act, and the application shall be deemed to
have been submitted for purposes of consideration for a planning grant
under that section.''.
SEC. 3. PLANNING AND EVALUATION GRANT PROGRAM.
(a) Definitions.--In this section:
(1) Medical facility.--The term ``medical facility'' means
a hospital, public health center, outpatient medical facility,
rehabilitation facility, facility for long-term care, or other
facility (as may be designated by the Secretary) for the
provision of health care to ambulatory patients.
(2) Proposed project.--The term ``proposed project'' means
a construction or modernization project proposed by an eligible
entity in a sustainability and resiliency plan.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(4) Sustainability and resiliency plan.--The term
``sustainability and resiliency plan'' means a plan, including
comprehensive preproject evaluation, for a construction or
modernization project that would, in order to protect patient
health and community access, enhance--
(A) the sustainability of a medical facility and
infrastructure surrounding the medical facility; and
(B) the resiliency of that medical facility and
infrastructure surrounding the medical facility to
climate change and public health crises.
(b) Establishment.--The Secretary shall establish a grant program,
to be known as the ``Planning and Evaluation Grant Program'', under
which the Secretary shall make planning grants to eligible entities to
develop sustainability and resiliency plans for medical facilities
owned or operated by the eligible entity and infrastructure surrounding
the medical facilities.
(c) Eligible Entities.--To be eligible to receive a planning grant
under subsection (b), an applicant shall be--
(1) a State, Tribal government, or political subdivision of
a State or Tribal government, including any city, town, county,
borough, hospital district authority, or public or quasi-public
corporation; or
(2) a nonprofit private entity.
(d) Applications.--
(1) In general.--Except as provided in paragraph (2), an
eligible entity seeking a planning grant under subsection (b)
shall submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary
may by regulation prescribe, including--
(A) a description of the proposed project;
(B) a summary and breakdown of the demographics of
the patient population served or potentially served by
the medical facility under the proposed project,
including information on--
(i) whether the medical facility is a
facility for which a majority of the revenue
the facility receives for patient care is from
reimbursements for medical care furnished to
Medicare and Medicaid beneficiaries under
titles XVIII and XIX of the Social Security Act
(42 U.S.C. 1395 et seq. and 1396 et seq.); and
(ii) other indications that individuals
vulnerable to climate change are served or
potentially served by the medical facility;
(C) a description of the ways in which the proposed
project--
(i) will carry out 1 or more activities
described in subsection (g);
(ii) meet the needs of the community the
medical facility serves, especially the needs
of vulnerable populations; and
(iii) meet the sustainability and
resiliency needs of the medical facility due to
climate risks and hazards;
(D) a description of whether the community served
by the medical facility is an environmental justice
community;
(E) a description of the ways in which the planning
grant would be used to carry out 1 or more planning and
evaluation activities described in subsection (f);
(F) reasonable assurance that all laborers and
mechanics employed by contractors or subcontractors in
the performance of work on a project will be paid wages
at rates not less than those prevailing on similar work
in the locality as determined by the Secretary of Labor
in accordance with subchapter IV of chapter 31 of part
A of subtitle II of title 40, United States Code
(commonly referred to as the ``Davis-Bacon Act'') and
the Secretary of Labor shall have with respect to such
labor standards the authority and functions set forth
in Reorganization Plan Numbered 14 of 1950 (64 Stat.
1267; 5 U.S.C. App.) and section 3145 of title 40,
United States Code; and
(G) reasonable assurance that the facility--
(i) has a collective bargaining agreement
with 1 or more labor organizations representing
employees at the facility; or
(ii) has an explicit policy not to
interfere with the rights of employees at the
facility under section 7 of the National Labor
Relations Act (29 U.S.C. 157).
(2) Additional applications.--An application submitted
under part A or B of title XVI of the Public Health Service Act
(42 U.S.C. 300q et seq. and 42 U.S.C. 300r) shall be deemed to
be a complete application submitted for purposes of
consideration for a planning grant under subsection (b).
(e) Selection.--The Secretary shall--
(1) in coordination with the Secretary of Energy and the
Administrator of the Environmental Protection Agency, if
necessary, develop metrics to evaluate applications for
planning grants under subsection (b); and
(2) give priority to applications that focus on improving a
medical facility--
(A) for which--
(i) a majority of the revenue the facility
receives for patient care is from
reimbursements for medical care furnished to
Medicare and Medicaid beneficiaries under
titles XVIII and XIX of the Social Security Act
(42 U.S.C. 1395 et seq. and 1396 et seq.); or
(ii) a high proportion of patients is
uninsured, as determined by the Secretary; and
(B) that is located in a neighborhood or serves a
patient population that--
(i) experiences low-air quality;
(ii) lacks green space;
(iii) bears higher cumulative pollution
burdens; or
(iv) is at disproportionate risk of
experiencing the adverse effects of climate
change.
(f) Planning Activities.--Planning and evaluation activities
carried out by an eligible entity using grant funds received under
subsection (b) shall include 1 or more of the following:
(1) Performing project planning, community outreach and
engagement, feasibility studies, and needs assessments of the
local community and patient populations.
(2) Performing engineering and climate-risk assessments of
the medical facility infrastructure and the access routes to
the medical facility.
(3) Providing management and operational assistance for
developing and receiving funding for the proposed project.
(4) Other planning and evaluation activities and
assessments as the Secretary determines appropriate.
(g) Proposed Projects.--Construction and modernization activities
carried out by a proposed project under a sustainability and resiliency
plan developed pursuant to a planning grant received under subsection
(b) may include--
(1) improvements to the infrastructure, buildings, and
grounds of the medical facility, including--
(A) installation of onsite distributed generation
that combines energy-efficient devices, energy storage,
and renewable energy in accordance with modern
electrical safety standards for medical facilities to
allow the medical facility to access essential energy
during power outages and optimize use of onsite and
offsite energy sources for emissions reductions; and
(B) improving air conditioning, monitoring, and
purifying through installation of high-efficiency heat
pumps that provide both cooling and heating, air
purifiers, air filtration systems, and air quality
monitoring systems integrated with energy systems and
energy efficiency considerations in preparation for
future natural hazards and public health crises such as
wildfire, smog, extreme heat events, and pandemics;
(2) green infrastructure projects, such as--
(A) installation and maintenance of wetlands,
drainage ponds, and any other green infrastructure that
would protect the medical facility from projected
severe effects with respect to extreme weather, natural
disasters, or climate change-related events, including
sea-level rise, flooding, and increased risk of
wildfire; and
(B) green rooftops, walls, and indoor plantings,
particularly those that can provide publicly accessible
temperature management and air quality improvements;
(3) resiliency projects to secure local accessibility to
the medical facility by protecting the access routes to the
medical facility, such as--
(A) infrastructure upgrades that protect access
routes to the medical facility, such as long-term
flood, wildfire, and other disaster mitigation for the
roads, sidewalks, and public transit infrastructure
that service the medical facility; and
(B) the long-term maintenance of decarbonization
and zero-emissions infrastructure; and
(4) any other type of activity the Secretary determines
will increase the sustainability and resiliency of a medical
facility and protect patient health and community access during
extreme weather.
(h) Amount of Grant.--The total amount of a grant under subsection
(b) shall not exceed $500,000.
(i) Technical Assistance.--The Secretary, in coordination with the
Secretary of Energy, the Administrator of the Environmental Protection
Agency, and the Secretary of Transportation, if necessary, directly or
through partnerships with States, Tribal governments, and nonprofit
organizations, shall provide technical assistance to eligible entities
interested in carrying out proposed projects that--
(1) serve environmental justice communities or medically
underserved communities;
(2) demonstrate a commitment to provide job training,
apprenticeship programs, and contracting opportunities to
residents and small businesses owned by residents of the
community that the medical facility serves;
(3) identify and further community priority actions and
conduct robust community engagement; and
(4) employ nature-based solutions that focus on protection,
restoration, or management of ecological systems to safeguard
public health, provide clean air and water, increase natural
hazard resilience, and sequester carbon.
(j) Prohibition on Training Repayment.--As a condition of receiving
a grant or technical assistance under this section, an eligible entity
shall certify that the eligible entity does not use, and if the
eligible entity contracts with any staffing agency or training
provider, that such agency or provider does not use, any provision in
employment agreements, job training agreements, or apprenticeship
program agreements that would require an employee or training or
apprenticeship program participant to pay a debt if the employee or
training or apprenticeship program participant's employment or work
relationship or training period with a specified employer or business
entity is terminated.
(k) Environmental Justice Communities.--The Secretary shall ensure
that not less than 50 percent of grant funds awarded under subsection
(b) are used for sustainability and resiliency plans for proposed
projects located in environmental justice communities.
(l) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary to carry out this section $5,000,000,000
for fiscal year 2024, to remain available until expended.
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