Green New Deal for Health Act

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 9962 Introduced in House (IH)]

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119th CONGRESS 2d Session H. R. 9962

To establish a Green New Deal for Health to prepare and empower the health care sector to protect the health and well-being of our workers, our communities, and our planet in the face of the climate crisis, and for other purposes.

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IN THE HOUSE OF REPRESENTATIVES

July 27, 2026

Mr. Khanna (for himself, Mr. Frost, Ms. Tlaib, Ms. Norton, Mr. Thanedar, Ms. Clarke of New York, and Ms. Omar) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Science, Space, and Technology, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

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A BILL

To establish a Green New Deal for Health to prepare and empower the health care sector to protect the health and well-being of our workers, our communities, and our planet in the face of the climate crisis, 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; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``Green New Deal for Health Act''. (b) Table of Contents.--The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents. Sec. 2. Definitions. Sec. 3. Findings and sense of Congress on health and climate change. TITLE I--WHOLE-OF-GOVERNMENT APPROACH

Sec. 101. Definitions. Sec. 102. Office of Climate Change and Health Equity; national strategic action plan. Sec. 103. Advisory board. Sec. 104. Climate change health protection and promotion reports. Sec. 105. Authorization of appropriations. TITLE II--PROTECTING ESSENTIAL HEALTH CARE ACCESS

Sec. 201. Maintenance of health care access relating to hospital discontinuation of services or closure. Sec. 202. Empowering community health in environmental justice communities. TITLE III--GREEN AND RESILIENT HEALTH CARE INFRASTRUCTURE

Sec. 301. Green Hill-Burton funds for climate-ready medical facilities. Sec. 302. Planning and Evaluation Grant Program. TITLE IV--HEALTH CARE SECTOR DECARBONIZATION

Sec. 401. Office of Sustainability and Environmental Impact. Sec. 402. Climate risk disclosure for medical supplies. Sec. 403. Green health care manufacturing. TITLE V--A HEALTH WORKFORCE TO TACKLE THE CLIMATE CRISIS

Sec. 501. Education and training relating to health risks associated with climate change. Sec. 502. Building a community health workforce for the climate crisis. Sec. 503. Safeguarding essential health care workers. TITLE VI--SAFE, STRONG, AND RESILIENT COMMUNITIES

Subtitle A--Empowering Resilient Community Mental Health

Sec. 601. Grants for resilient community mental health. Subtitle B--Understanding and Preventing Heat Risk

Sec. 611. Definitions. Sec. 612. Study on extreme heat information and response. Sec. 613. Financial assistance for research and resilience in addressing extreme heat risks. Sec. 614. Authorization of appropriations. Subtitle C--Home Resiliency for Medical Needs

Sec. 621. Medicare coverage of medically necessary home resiliency services. TITLE VII--RESEARCH AND INNOVATION FOR CLIMATE AND HEALTH

Sec. 701. Research and innovation for climate and health.

SEC. 2. DEFINITIONS.

In this Act: (1) Environmental justice community.--The term ``environmental justice community'' means a community with significant representation of communities of color, low-income communities, or Tribal and Indigenous communities that experiences, or is at risk of experiencing, higher or more adverse human health or environmental effects. (2) Individual disproportionately affected by climate change.--The term ``individual disproportionately affected by climate change'' means an individual that may face elevated mental and physical health risks due to climate change based on 2 or more of the following factors: (A) Age under 5 years old or over 65 years old. (B) Race and ethnicity, and experience of racial bias. (C) Sex, gender, and gender minority status. (D) Being of reproductive age. (E) Exposure to environmental health risks due to living conditions or location, including current or past experience of homelessness. (F) Occupation or exposure to occupational hazards. (G) Household income. (H) Disability. (I) Co-morbidities. (J) Current or past exposure to personal or systemic trauma, including natural disasters. (K) Immigration status. (L) Language isolation. (3) Medically underserved community.--The term ``medically underserved community'' has the meaning given such term in section 799B of the Public Health Service Act (42 U.S.C. 295p).

SEC. 3. FINDINGS AND SENSE OF CONGRESS ON HEALTH AND CLIMATE CHANGE.

(a) Findings.--Congress finds that, according to the assessment of the United States Global Change Research Program entitled ``The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment'' and dated 2016-- (1) the impacts of human-induced climate change are increasing nationwide; (2) rising greenhouse gas concentrations result in increases in temperature, changes in precipitation, increases in the frequency and intensity of some extreme weather events, and rising sea levels; (3) the climate change impacts described in paragraph (2) endanger our health by affecting-- (A) our access to care, food, and water sources; (B) the air we breathe; (C) the weather we experience; and (D) our interactions with the built and natural environments; and (4) as the climate continues to change, the risks to human health continue to grow. (b) Sense of Congress.--It is the sense of Congress that-- (1) climate change poses threats to the United States and globally through its impacts on society, the economy, the physical environment, and physical and mental health; (2) climate change health threats are growing in scale and severity; (3) climate change disproportionately affects individuals in the United States who are economically disadvantaged, belong to communities of color, or have other social and health vulnerabilities; (4) the health care sector accounts for 8.5 percent of United States emissions, further worsening the overall health impacts of climate change; and (5) the Federal Government, working with international, State, Tribal, and local governments, nongovernmental organizations, businesses, and individuals, should use all practicable means and measures-- (A) to deploy a whole-of-government and whole-of- health approach to protect our collective health from the impacts of climate change and to mitigate environmental health impacts from health sector operations; (B) to build a just health care ecosystem where all Americans have access to dignified, high-quality care in their communities; (C) to ensure the health care system is resilient to extreme weather and can continue to provide care before, during, and after crises; (D) to lead the health sector to decarbonize its facilities and operations in an equitable and just manner; (E) to empower a thriving health workforce with good, high-wage union jobs and to recognize the value of all of the essential workers that enable high- quality health care; and (F) to invest in, empower, and build safe, strong, and resilient communities.

TITLE I--WHOLE-OF-GOVERNMENT APPROACH

SEC. 101. DEFINITIONS.

In this title: (1) Director.--The term ``Director'' means the Director of the Office. (2) National strategic action plan.--The term ``national strategic action plan'' means the national strategic action plan published pursuant to section 102(b)(1). (3) Office.--The term ``Office'' means the Office of Climate Change and Health Equity established by section 102(a)(1). (4) Secretary.--The term ``Secretary'' means the Secretary of Health and Human Services.

SEC. 102. OFFICE OF CLIMATE CHANGE AND HEALTH EQUITY; NATIONAL STRATEGIC ACTION PLAN.

(a) Office of Climate Change and Health Equity.-- (1) Establishment.-- (A) In general.--There is established within the Department of Health and Human Services the Office of Climate Change and Health Equity. (B) Purpose.--The purpose of the Office shall be to facilitate a robust, Federal response to the impact of climate change on the health of the American people and the health care system. (C) Director.--There is established the position of Director of the Office, who-- (i) shall be the head of the Office; and (ii) may report to the Assistant Secretary for Health. (2) Activities.--The duties of the Office shall be to address priority health actions relating to the health impacts of climate change, including by doing each of the following: (A) Contribute to assessments of how climate change is affecting the health of individuals living in the United States. (B) Understand the needs of the populations most disproportionately affected by climate-related health threats. (C) Serve as a credible source of information on the physical, mental, and behavioral health consequences of climate change. (D) Align Federal efforts to deploy climate- conscious human services and direct services to support and protect populations composed of individuals disproportionately affected by climate change. (E) Create and distribute tools and resources to support climate resilience for the health sector, community-based organizations, and individuals. (F) Create and distribute tools and resources to support health sector efforts to track and decrease greenhouse gas emissions. (G) Lead efforts to reduce the carbon footprint and environmental impacts of the health sector. (H) Carry out other activities determined appropriate by the Secretary. (b) National Strategic Action Plan.-- (1) In general.--Not later than 1 year after the date of enactment of this Act, the Secretary, on the basis of the best available science, and in consultation pursuant to paragraph (2), shall publish a national strategic action plan to coordinate effective deployment of Federal efforts to ensure that public health and health care systems are prepared for and can respond to the impacts of climate change on health in the United States. (2) Consultation.--In developing or making any revision to the national strategic action plan, the Secretary shall-- (A) consult with the Director, the Administrator of the Environmental Protection Agency, the Under Secretary of Commerce for Oceans and Atmosphere, the Administrator of the National Aeronautics and Space Administration, the Director of the Indian Health Service, the Secretary of Labor, the Secretary of Defense, the Secretary of State, the Secretary of Veterans Affairs, the National Environmental Justice Advisory Council, the heads of other appropriate Federal agencies, Tribal governments, and State and local government officials; and (B) provide meaningful opportunity for engagement, comment, and consultation with relevant public stakeholders, particularly representatives of populations composed of individuals disproportionately affected by climate change, environmental justice communities, Tribal communities, health care providers, public health organizations, and scientists. (3) National strategic action plan components.--The national strategic action plan shall include an assessment of, and strategies to improve, the health sector capacity of the United States to address climate change, including-- (A) identifying, prioritizing, and engaging communities and populations who are disproportionately affected by exposures to climate hazards; (B) addressing mental and physical health disparities exacerbated by climate impacts to enhance community health resilience; (C) identifying the link between environmental injustice and vulnerability to the impacts of climate change and prioritizing those who have been harmed by environmental and climate injustice; (D) providing outreach and communication aimed at public health and health care professionals and the public to promote preparedness and response strategies; (E) tracking and assessing programs across Federal agencies to advance research related to the impacts of climate change on health; (F) identifying and assessing existing preparedness and response strategies for the health impacts of climate change; (G) prioritizing critical public health and health care infrastructure projects; (H) providing modeling and forecasting tools of climate change health impacts, including local impacts, where feasible; (I) establishing academic and regional centers of excellence; (J) recommending models for maintaining access to health care during extreme weather; (K) providing technical assistance and support for preparedness and response plans for the health threats of climate change in States, municipalities, territories, Indian Tribes, and developing countries; (L) addressing the impacts of fossil fuel pollution and greenhouse gas emissions on the health of individuals living in the United States; (M) tracking health care sector contributions to greenhouse gas emissions and identifying actions to reduce those emissions; (N) recommending new regulations or policies to address identified gaps in the health system capacity to effectively reduce emissions, reduce environmental impact, and address climate change; and (O) developing, improving, integrating, and maintaining disease surveillance systems and monitoring capacity to respond to health-related impacts of climate change, including on topics addressing-- (i) water-, food-, and vector-borne infectious diseases and climate change; (ii) pulmonary effects, including responses to aeroallergens, infectious agents, and toxic exposures; (iii) cardiovascular effects, including impacts of temperature extremes; (iv) air pollution health effects, including heightened sensitivity to air pollution such as wildfire smoke; (v) reproductive health effects, including access to reproductive health care; (vi) harmful algal blooms; (vii) mental and behavioral health impacts of climate change; (viii) the health of migrants, refugees, displaced persons, and communities composed of individuals disproportionately affected by climate change; (ix) the implications for communities and populations vulnerable to the health effects of climate change, as well as strategies for responding to climate change within such communities; (x) Tribal, local, and community-based health interventions for climate-related health impacts; (xi) extreme heat and weather events; (xii) decreased nutritional value of crops; and (xiii) disruptions in access to routine and acute medical care, public health programs, and other supportive services for maintaining health. (c) Periodic Assessment and Revision.--Not later than 1 year after the date of first publication of the national strategic action plan, and annually thereafter, the Secretary shall periodically assess, and revise as necessary, the national strategic action plan, to reflect new information collected, including information on-- (1) the status of and trends in critical environmental health indicators and related human health impacts; (2) the trends in and impacts of climate change on public health; (3) advances in the development of strategies for preparing for and responding to the impacts of climate change on public health; and (4) the effectiveness of the implementation of the national strategic action plan in protecting against climate change health threats. (d) Implementation.-- (1) Implementation through hhs.--The Secretary shall exercise the Secretary's authority under this title and other Federal statutes to achieve the goals and measures of the Office and the national strategic action plan. (2) Other public health programs and initiatives.--The Secretary and Federal officials of other relevant Federal agencies shall administer public health programs and initiatives authorized by laws other than this title, subject to the requirements of such laws, in a manner designed to achieve the goals of the Office and the national strategic action plan. (3) Health impact assessment.-- (A) In general.--Not later than 180 days after the date of enactment of this Act, the Secretary shall identify proposed and current laws, policies, and programs that are of particular interest for their impact in contributing to or alleviating health burdens and the health impacts of climate change. (B) Assessments.--Not later than 2 years after the date of enactment of this Act, the head of each relevant Federal agency shall-- (i) assess the impacts that the proposed and current laws, policies, and programs identified under subparagraph (A) under their jurisdiction have or may have on protection against the health threats of climate change; and (ii) assist State, Tribal, local, and territorial governments in conducting such assessments.

SEC. 103. ADVISORY BOARD.

(a) Establishment.--The Secretary shall, pursuant to chapter 10 of title 5, United States Code, establish a permanent science advisory board to be composed of not less than 10 and not more than 20 members. (b) Appointment of Members.-- (1) In general.--The Secretary shall appoint the members of the science advisory board from among individuals who-- (A) are recommended by the President of the National Academy of Sciences or the President of the National Academy of Medicine; and (B) have expertise in essential public health and health care services, including with respect to diverse populations, climate change, environmental and climate justice, and other relevant disciplines. (2) Requirement.--The Secretary shall ensure that the science advisory board includes members with practical or lived experience with relevant issues described in paragraph (1)(B). (c) Functions.--The science advisory board shall-- (1) provide scientific and technical advice and recommendations to the Secretary on the domestic and international impacts of climate change on public health and populations and regions disproportionately affected by climate change, and strategies and mechanisms to prepare for and respond to the impacts of climate change on public health; (2) advise the Secretary regarding the best science available for purposes of issuing the national strategic action plan and conducting the climate and health program; and (3) submit a report to Congress on its activities and recommendations not later than 1 year after the date of enactment of this Act and not later than every year thereafter. (d) Support.--The Secretary shall provide financial and administrative support to the board.

SEC. 104. CLIMATE CHANGE HEALTH PROTECTION AND PROMOTION REPORTS.

(a) In General.--The Secretary shall offer to enter into an agreement, including the provision of such funding as may be necessary, with the National Academies of Sciences, Engineering, and Medicine, under which such National Academies will prepare periodic reports to aid public health and health care professionals in preparing for and responding to the adverse health effects of climate change that-- (1) review scientific developments on health impacts and health disparities of climate change; (2) evaluate the measurable impacts of activities undertaken at the directive of the national strategic action plan; and (3) recommend changes to the national strategic action plan and climate and health program. (b) Submission.--The agreement under subsection (a) shall require a report to be submitted to Congress and the Secretary and made publicly available not later than 1 year after the first publication of the national strategic action plan, and every 4 years thereafter.

SEC. 105. AUTHORIZATION OF APPROPRIATIONS.

(a) Office of Climate Change and Health Equity.--There is authorized to be appropriated to the Secretary to carry out section 102(a) $10,000,000 for each of fiscal years 2027 through 2033. (b) National Strategic Action Plan.--There is authorized to be appropriated to the Secretary to carry out section 102(b) $2,000,000 for fiscal year 2027, to remain available until expended. (c) Advisory Board.--There is authorized to be appropriated to the Secretary to carry out section 103(c) $500,000 for fiscal year 2027, to remain available until expended.

TITLE II--PROTECTING ESSENTIAL HEALTH CARE ACCESS

SEC. 201. MAINTENANCE OF HEALTH CARE ACCESS RELATING TO HOSPITAL DISCONTINUATION OF SERVICES OR CLOSURE.

Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is amended-- (1) in subsection (a)(1)-- (A) in subparagraph (X), by striking ``and'' at the end; (B) in subparagraph (Y)(ii)(V), by striking the period and inserting ``, and''; and (C) by inserting after subparagraph (Y) the following new subparagraph: ``(Z) beginning 60 days after the date of the enactment of this subparagraph, in the case of a hospital, to comply with the requirements of subsection (l) (relating to discontinuation of services or closure).''; and (2) by adding at the end the following new subsection: ``(l) Requirements for Hospitals Relating to Discontinuation of Services or Closure.-- ``(1) Requirements.-- ``(A) In general.--For purposes of subsection (a)(1)(Z), except as provided in subparagraph (B), the requirements described in this subsection are that a hospital-- ``(i) notify the Secretary, in accordance with paragraph (2), not less than 90 days prior to the discontinuation of services or full hospital closure; ``(ii) prohibit the discontinuation of essential services (as defined in paragraph (6)) during the notification period (as defined in such paragraph) unless there is a clear harm posed to patient or employee health or safety in the hospital continuing to furnish such services; ``(iii) respond to any inquiries by the Secretary relating to the implementation of this subsection, including the determination of essential services under paragraph (6)(C); and ``(iv) if applicable-- ``(I) submit a mitigation plan and related information as described in paragraph (3); and ``(II) participate in the public comment and review process (including, if applicable, the alternative mitigation plan) described in paragraph (4). ``(B) Application in case of catastrophic events.-- In the case where a discontinuation of services or closure of a hospital is due to an unforeseen catastrophic event (as defined by the Secretary), the requirements described in subparagraph (A) shall apply, except-- ``(i) the hospital shall provide the notification under clause (i) of such subparagraph not later than 30 days after the catastrophic event or as soon as feasible as determined by the Secretary; and ``(ii) clause (ii) of such subparagraph (relating to prohibiting the discontinuation of services) shall not apply. ``(2) Notification information.--For purposes of paragraph (1)(A)(i), the notification under such paragraph shall include the following information with respect to a hospital: ``(A) Discontinuation of services.--In the case where the hospital is discontinuing services (without full hospital closure): ``(i) The services that will be discontinued and number of hospital beds impacted. ``(ii) The number of individuals furnished such services annually and a breakdown of the type of insurance used by such individuals for such services. ``(iii) The number of impacted employees and what labor organization represents them (and the contact information for such organization). ``(iv) The names and addresses of any organized health care coalitions and community groups that represent the communities impacted by the discontinuation of such services. ``(v) Alternative providers of such services, including provider type, contact information, and distance and transportation time by car and public transit from the hospital. ``(B) Full hospital closure.--In the case of full hospital closure: ``(i) Hospital ownership entities. ``(ii) The full extent of services that will no longer be furnished by the hospital. ``(iii) The number of individuals furnished services annually by the hospital, a description of the services furnished, and a breakdown of the type of insurance type used by such individuals for such services. ``(iv) The number of impacted employees and, if applicable, what labor organizations represent them (and the contact information for each such organization). ``(v) The names and addresses of any organized health care coalitions and community groups that represent the communities impacted by the closure. ``(vi) Alternative providers, including provider type, contact information, and distance and transportation time by car and public transit from the hospital. ``(vii) Steps taken prior to the decision to close in order to avoid closure. ``(viii) Distribution of liquidation proceeds (cash or assets) or any payments (cash or assets) made to employees, owners, or contractors related to the closure. ``(3) Submission of mitigation plan and related information for essential services.-- ``(A) Notification by secretary.--If the Secretary determines that the discontinuation of services or closure of an applicable hospital would negatively impact access to essential services, the Secretary shall notify the applicable hospital of such determination. ``(B) Submission of mitigation plan and related information.--If an applicable hospital receives a notification under subparagraph (A), the applicable hospital shall, not later than 15 days after receiving such notification, submit to the Secretary-- ``(i) a plan to-- ``(I) preserve access to essential services for impacted communities through partnerships, commitments from surrounding facilities, transportation plan access, and preparation for surge response; and ``(II) support employees in transitioning to new positions within health care; ``(ii) information on workforce and public engagement to ensure awareness of the discontinuation of services or closure; and ``(iii) a description of potential alternatives to the discontinuation of services or closure that the hospital considered and an explanation of why those alternatives are not a viable option. ``(C) Public availability.--The Secretary shall make a mitigation plan and related information submitted by an applicable hospital under this paragraph available to the public on the internet website of the Centers for Medicare & Medicaid Services. ``(4) Public comment and review process; alternative mitigation plan.-- ``(A) Public comment period.-- ``(i) In general.--The Secretary shall provide a public comment period of not less than 45 days with the opportunity to submit written comments regarding the impact of the potential discontinuation of services or closure of an applicable hospital. ``(ii) Notice.--Notice of the opportunity to submit comments shall be published in the Federal Register and distributed to-- ``(I) providers of services and suppliers that may be impacted by the discontinuation of services or closure of the applicable hospital; ``(II) any labor organization that represents any subdivision of employees of the applicable hospital; ``(III) organized health care coalitions and community groups that represent the communities impacted by the discontinuation of services or closure; ``(IV) the State health agency; and ``(V) the local department of public health. ``(B) Alternative mitigation plan.-- ``(i) In general.--If, after reviewing the mitigation plan submitted by an applicable hospital under paragraph (3) and the comments submitted during the public comment period under subparagraph (A) with respect to the discontinuation of services or closure of the applicable hospital, the Secretary finds that the discontinuation of services or closure of the applicable hospital would have a significant impact on access to essential services, the Secretary shall work with the applicable hospital or other providers of services and suppliers in the area, as appropriate, to develop and implement an alternative plan to the plan submitted by the applicable hospital under paragraph (3) (referred to in this subsection as the `alternative mitigation plan') in order to ensure continued access to essential services, which may include an agreement to delay the discontinuation of services or closure of the applicable hospital until the alternative mitigation plan is complete. ``(ii) Technical assistance.--An alternative mitigation plan under clause (i) may include technical assistance or information on available funding mechanisms to support the furnishing of essential services. ``(iii) Collaboration.--The Secretary should, to the extent practicable, collaborate with State and municipal government officials in the development of an alternative mitigation plan under clause (i). ``(iv) Public availability.--The Secretary shall make any information submitted and the alternative mitigation plan developed under this paragraph available to the public on the internet website of the Centers for Medicare & Medicaid Services. ``(C) Implementation.--The Secretary shall promulgate regulations to detail the required response time by an applicable hospital and the speed of the review process under this paragraph in order to ensure that such process can be completed with respect to an applicable hospital prior to the proposed service discontinuation date or closure date of the applicable hospital. ``(D) Prohibition.--In the case where the Secretary finds that a hospital has violated the requirements of this subsection, the Secretary may prohibit the hospital and any hospital under the same hospital ownership entity from being eligible to enroll or reenroll under the program under this title under section 1866(j) until the earlier of-- ``(i) the date that is 3 years after the date on which the hospital discontinues services or closes; ``(ii) the date on which the Secretary determines essential health services that were negatively impacted by the discontinuation or closure have been restored; or ``(iii) such time as the Secretary is satisfied with the mitigation plan submitted by the hospital under paragraph (3) or the alternative mitigation plan under this paragraph. ``(5) Annual reports.--The Secretary shall submit an annual report to Congress on the discontinuation of services and full closure of hospitals. Each report submitted under the preceding sentence shall include-- ``(A) a description of trends in the discontinuation of services and closures of hospitals, including hospital ownership type, geographic location, types of services furnished, demographic served, and insurance type; ``(B) an analysis of the impact of the discontinuation of services and closures on health care access and ability to meet surge demand due to emergency (such as a pandemic or climate disaster); ``(C) recommendations for such administrative or legislative changes as the Secretary determines appropriate to preserve access to essential services nationwide. ``(6) Definitions.--In this subsection: ``(A) Applicable hospital.--The term `applicable hospital' means a hospital that submits a notification under paragraph (1)(A)(i) of a discontinuation of services or full hospital closure. ``(B) Discontinuation.--The term `discontinuation' may include any reduction or discontinuation of services furnished by an applicable hospital, including those that occur as part of a merger or acquisition agreement. ``(C) Essential services.--The term `essential services' means, with respect to an applicable hospital, services that are necessary for preserving health care access (as determined by the Secretary), including services for which the Secretary determines-- ``(i) there are no equivalent services available within the same travel time; ``(ii) that loss of the services would result in meaningful reductions in surge capacity that will negatively impact access to services; ``(iii) that loss of the services would limit health care access for specific demographics of individuals based on sex, sexuality, race, nationality, age, or disability status; ``(iv) that loss of the services would have a meaningful impact on the ability of health systems to respond to impacts of climate change; or ``(v) there is a health or health care- related emergency declaration status applicable to the surrounding geographical area of the hospital on the date on which the hospital submits notification under paragraph (1)(A)(i) of a discontinuation of services or full hospital closure. ``(D) Notification period.--The term `notification period' means, with respect to an applicable hospital, the period beginning on the date on which the hospital submits notification under paragraph (1)(A)(i) of a discontinuation of services or full hospital closure and ending on the date of such discontinuation of services or closure. ``(7) No preemption of state law.--Nothing in subsection (a)(1)(Z) or this subsection shall be construed to limit any rights or remedies under State or local law relating to protecting access to essential services or reviewing proposed hospital closures or reduction of services.''.

SEC. 202. EMPOWERING COMMUNITY HEALTH IN ENVIRONMENTAL JUSTICE COMMUNITIES.

Section 10503 of the Patient Protection and Affordable Care Act (42 U.S.C. 254b-2) is amended-- (1) in subsection (b)-- (A) in paragraph (1)-- (i) in subparagraph (J), by striking ``and'' at the end; and (ii) by adding at the end the following: ``(L) $130,000,000,000 for the period of fiscal years 2027 through 2031; and''; and (B) in paragraph (2)-- (i) in subparagraph (K), by striking ``and'' at the end; (ii) in subparagraph (L), by striking the period and inserting ``; and''; and (iii) by adding at the end the following: ``(M) $2,000,000,000 for each of fiscals years 2027 through 2031.''; and (2) by adding at the end the following: ``(f) Environmental Justice Communities.--The Secretary shall ensure that not less than 50 percent of the amounts appropriated under subsection (b) on or after 2027 are awarded to entities for use with respect to projects or sites located in or serving environmental justice communities (as defined in section 2 of the Green New Deal for Health Act). ``(g) Prohibition.--No amounts made available under this section may be used for any activity that is subject to the reporting requirements set forth in section 203(a) of the Labor-Management Reporting and Disclosure Act of 1959 (29 U.S.C. 433(a)).''.

TITLE III--GREEN AND RESILIENT HEALTH CARE INFRASTRUCTURE

SEC. 301. 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, 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; 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 2027, 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 302(d)(2) of the Green New Deal for Health Act, and the application shall be deemed to have been submitted for purposes of consideration for a planning grant under that section.''.

SEC. 302. 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 No. 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 2027, to remain available until expended.

TITLE IV--HEALTH CARE SECTOR DECARBONIZATION

SEC. 401. OFFICE OF SUSTAINABILITY AND ENVIRONMENTAL IMPACT.

(a) Establishment.--There is hereby established in the Centers for Medicare & Medicaid Services an Office of Sustainability and Environmental Impact (in this section referred to as the ``Office'') to prepare the health care system for the impacts of climate change by supporting health care decarbonization, sustainability, and environmental efforts and to ensure that the health care system minimizes and mitigates its climate harm while advancing patient health and safety. (b) Priority Goals.--The Office shall-- (1) collaborate with the Office of Climate Change and Health Equity, the Environmental Protection Agency, and other interagency committees to support a whole-of-government and whole-of-health approach to addressing the climate crisis; (2) develop and promulgate regulations that support climate-informed care, support health care decarbonization and sustainability, and mitigate the environmental impacts of the health care system upon patients, communities, and health care workers; (3) develop and promulgate regulations that support patient access to, and coverage of, climate-informed health care services to prevent and address the health impacts of climate change; (4) conduct oversight of health care systems, their climate emissions, and environmental harms and provide interagency technical assistance in remediating such emissions and environmental harms; and (5) issue ``Climate-Friendly'' health system designations and accreditations that identify health systems that demonstrate commitment to, and substantial evidence of, reducing emissions and environmental harm while advancing health care quality and patient and worker safety. (c) Director.-- (1) In general.--The Office shall be headed by a Director, to be known as the Director of Sustainability and Environmental Impact, who shall be appointed by the Secretary of Health and Human Services (in this section referred to as the ``Secretary''). (2) Functions.--The Director shall-- (A) convene stakeholders (including key health care stakeholders) for strategic planning towards the priority goals of the Office; (B) advise the Secretary and the Administrator of the Centers for Medicare & Medicaid Services in matters of sustainability and environmental impact and the role of the Centers for Medicare & Medicaid Services in sustainability and environmental impact; (C) collaborate with academic experts and community leaders to understand and establish best practices for decarbonizing health care operations; and (D) develop and evaluate the Office's strategy to tackle health care decarbonization and sustainability and mitigating environmental impacts within the Centers for Medicare & Medicaid Services. (d) Report to Congress.--Not later than 2 years after the date of the enactment of this Act, and every 2 years thereafter, the Secretary shall submit to Congress a Health Care Sustainability and Environmental Impact Report, which shall be prepared by the Director of Sustainability and Environmental Impact, with appropriate assistance from other agencies in the executive branch of the Federal Government. Each such report shall include the following: (1) A summary of interagency collaboration. (2) A methodology to designate and accredit health systems that achieve substantial reductions in emissions and environmental harm as ``Climate-Friendly'' health systems. (3) An inventory of ``Climate-Friendly'' designated health systems, their strategies, challenges, and best practices for sustainability and mitigating environmental impact, and any significant effects of these efforts on-- (A) quality of care; (B) patient safety; (C) safety of health care workers and health care facility workers; (D) health care costs; and (E) environmental health and overall health of the community served. (4) An analysis of the demographics and climate vulnerability of patients and types of communities served by ``Climate-Friendly'' health systems. (5) Recommendations for actions by health systems and for Federal technical assistance and supportive resources for the health system to achieve substantial reductions in emissions and environmental harm in order to attain ``Climate-Friendly'' designation. (6) A summary of oversight efforts of the Centers for Medicare & Medicaid Services regarding emissions and environmental impacts and payment and coverage impacts on climate change preparedness, mitigation, and response. (7) Recommendations for such legislation and administration action as the Secretary determines appropriate to regulate and promote health care sustainability, decarbonization, and mitigate environmental impact within the health care system. (e) Authorization of Appropriations.--There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2027 through 2036.

SEC. 402. CLIMATE RISK DISCLOSURE FOR MEDICAL SUPPLIES.

Subchapter A of chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 351 et seq.) is amended by adding at the end the following:

``SEC. 524C. CLIMATE RISK DISCLOSURE FOR MEDICAL SUPPLIES.

``(a) Task Force.-- ``(1) In general.--The Secretary, in coordination with the Commissioner and the Administrator of the Environmental Protection Agency, shall establish a task force for purposes of developing a strategy to establish climate risk disclosure policies for manufacturers of drugs (including biological products) and devices. ``(2) Duties.--The task force established under paragraph (1) shall-- ``(A) recommend a methodology for drug and device manufacturers to calculate the emissions and climate risk due to clinical use of the drug or device, factoring in emissions from the manufacture, transport, use, processing, reprocessing, and waste relating to the drug or device; ``(B) recommend a policy and process for mandatory public disclosure of emissions and climate risk relating to drugs and devices; ``(C) recommend a policy for oversight of disclosures to ensure accuracy and transparency of emissions reporting as described in subparagraph (B), and to ensure that patient safety and necessary access is maintained; ``(D) develop methods to disseminate information to clinicians for low environmental impact options for clinically equivalent treatment options; ``(E) develop suggestions for the reduction of emissions by drug and device manufacturers without harming or risking patient safety; and ``(F) provide technical assistance and establish partnerships to facilitate lower emissions design and manufacture of comparable drugs and comparable devices. ``(3) Membership.--The task force established under paragraph (1) shall be composed of the following: ``(A) 3 representatives of the Food and Drug Administration, appointed by the Commissioner. ``(B) 3 representatives of the Environmental Protection Agency, appointed by the Administrator of the Environmental Protection Agency. ``(C) 3 representatives of the Office of Climate Change and Health Equity of the Department of Health and Human Services, appointed by the Secretary. ``(b) Regulations.--Not later than 1 year after the date of enactment of the Green New Deal for Health Act, the Secretary shall promulgate regulations to-- ``(1) establish mandatory climate risk disclosure and transparency policies for drugs and devices approved, licensed, or cleared under section 505, 510(k), 513(f)(2), or 515 of this Act or section 351 of the Public Health Service Act; and ``(2) incorporate climate risk into policies related to transparency, labeling, and other regulatory policies related to drugs and devices, based on the recommendations of the task force described in subsection (a). ``(c) Authorization of Appropriations.--There is authorized to be appropriated to carry out this section $4,000,000 for fiscal year 2027, to remain available until expended.''.

SEC. 403. GREEN HEALTH CARE MANUFACTURING.

(a) In General.--There is established a Federal interagency working group, to be known as the ``Council on Green Health Care Manufacturing'' (referred to in this section as the ``Council''). (b) Membership.--The membership of the Council shall consist of-- (1) the Secretary of Health and Human Services (referred to in this section as the ``Secretary''), who shall serve as the Chair; (2) the Secretary of Energy; (3) the Secretary of Transportation; (4) the Secretary of Labor; (5) the Administrator of the Environmental Protection Agency; (6) the Director of the Office of Climate Change and Health Equity; (7) the Director of Sustainability and Environmental Impact; (8) the Chair of the Council on Environmental Quality; (9) the United States Trade Representative; and (10) the heads of other Federal agencies, as determined necessary by the Chair. (c) Duties.-- (1) Assessment and report.-- (A) In general.--Not later than 1 year after the date of enactment of this Act, the Council shall conduct an assessment of global and domestic medical supply chains, including an assessment of-- (i) the environmental and climate impacts of medical supply chains, including-- (I) emissions from the production, transportation, and packaging of medical and pharmaceutical products; (II) chemical and other environmental pollution; (III) excessive energy consumption; (IV) negative externalities relating to waste; and (V) any other environmental or climate impacts the Council determines relevant; (ii) labor conditions for workers in the United States and globally who produce medical and pharmaceutical products consumed by individuals residing in the United States, including the degree to which such workers-- (I) are ensured a protected right to organize; (II) are provided adequate workplace safety protections; and (III) are adequately compensa

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