Increasingly, climate change and environmental hazards threaten the health of people in the United States and around the world. HHS and the entire Biden-Harris Administration have mobilized to address these challenges in the most vulnerable communities, to build resilience in healthcare systems and to accelerate decarbonization of the healthcare sector.

In addition to other new announcements made today, HHS has taken action on several fronts over the last year to increase health sector resilience and sustainability. Notable products and activities include:

• The HHS Climate Change and Health Equity Strategy Supplement, which summarizes HHS-wide efforts on resilience and decarbonization.  
• The intensive “Catalytic Program” from the Office of Climate Change and Health Equity (OCCHE) that initially ran between January and Earth Day to help organizations take advantage of the Inflation Reduction Act’s (IRA) historic tax credits, grants and other supports. (OCCHE has announced a second phase of the catalytic program today, as described in the linked press release.)
• The OCCHE Health Sector Resource Hub, including the “Quickfinder” on the IRA, which is a distillation of IRA-funded programs relevant to the health sector. 
• The OCCHE Referral Guide for Health Professionals to support clinicians in identifying federal resources that can help individuals, patients and communities manage climate-related stressors. 
• The OCCHE Climate and Health Outlook Portal, providing interactive maps with monthly regional forecasts of climate hazards. 
• An HHS/EPA Energy Star Portfolio Manager Guide intended to help health sector organizations use the EPA portfolio manager tool to track their emissions. 
• An OCCHE guidance document on Developing Climate Resilience Plans for Healthcare Organizations.
• A collaboration of federal health systems (including the Indian Health Service, Veteran’s Administration and Defense Health Agency and coordinated by OCCHE) to tackle clinical decarbonization, starting with an effort to reduce use of anesthetic gases with high global warming potential. 
• A CDC collaboration with the CDC Foundation and NORC at the University of Chicago entitled “Climate Health: A Training for Health Department Staff,” which focuses on ways climate change impacts health and how to integrate climate change considerations into existing public health work.
• Reducing Healthcare Carbon Emissions: A Primer on Measures and Actions for Healthcare Organizations to Mitigate Climate Change (Agency for Healthcare Research and Quality) to support healthcare organizations in advancing toward decarbonization commitments by offering guidance on high-priority measures and strategies for healthcare organizations to reduce their carbon footprint.
• The Centers for Medicare and Medicaid Services (CMS) Innovation Center voluntary Decarbonization and Resilience Initiative, which would seek to address threats posed by climate change to the nation's health and healthcare system. (This is a proposed initiative that would support participating organizations in monitoring, assessing, and addressing hospital carbon emissions and their effects on health outcomes, costs, and quality as part of the proposed Transforming Episode Accountability Model (TEAM). This information was released as part of the CMS Inpatient Prospective Payment System notice of proposed rulemaking on April 10th and is open for comment for 60 days.)

In addition, the White House-HHS Health Sector Climate Pledge has continued to expand. This initiative, which was originally launched on Earth Day 2022, invites private sector health organizations to align with the Biden Administration’s goals for resilience and decarbonization, including achieving Net Zero emissions by 2050. So far 139 organizations have signed on, including health systems representing 943 hospitals as well as leading health centers, suppliers, insurance companies, group purchasing organizations, pharmaceutical companies and more. New signers include Lawrence General Hospital, St. Luke’s Health System, University of Pennsylvania Health System, CannonDesign, Phase2 Technology and SION60, Inc. (The HHS/EPA Energy Star Portfolio Manager Guide, noted above, is available to help pledge signers track their emissions using the EPA Portfolio Manager platform.)

HHS has specifically introduced the following products over the last year to care for communities in the face of extreme heat and wildfire smoke:

• An EMS HeatTracker (OCCHE and the National Highway Traffic Safety Administration), which tracks Emergency Medical Services responses to heat-related emergencies. (Version 2.0 was released today after incorporating stakeholder feedback.) 
• A Cooling Season Toolkit that will be updated on Earth Day that provides more information about cooling assistance from the Administration for Children and Families (ACF) on the Low Income Home Energy Assistance Program (LIHEAP), which is a program under the Justice40 Initiative, a whole of whole-of-government initiative that aims to deliver 40 percent of the overall benefits from Federal investments in climate change, clean energy, clean transportation, affordable housing, water infrastructure, workforce development, and pollution remediation to disadvantaged communities.
• An updated version of the ACF LIHEAP Heat Stress Dashboard, which is a resource and tool to help Office of Community Services (OCS)-funded grant recipients mitigate the impact of heat stress on vulnerable populations. The Dashboard provides an overview of extreme heat, describes how extreme heat impacts health and wellbeing, and provides information on how LIHEAP funding can be used to address extreme heat.
• A Request for Information on Outdoor Workers Exposed to Wildland Fire Smoke from the Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH). NIOSH is seeking this information to support development of a hazard review document, which will provide an overview of the relevant health effects literature and develop evidence-based recommendations to protect outdoor workers, including farm workers, from the adverse health effects of occupational exposure to wildland fire smoke. Responses to the request for information are due on May 13, 2024. 
• A new SAMHSA Disaster Technical Assistance Center Supplemental Research Bulletin on Climate Change and expansion in access to the Disaster Distress Helpline for extreme heat emergencies from SAMHSA and partner federal agencies with relevant language being added to Heat.gov. (SAMHSA’s Disaster Distress Helpline (DDH) - call or text 1-800-985-5990; press “2” for Spanish - provides 24/7 crisis counseling and emotional support for anyone in the U.S./territories experiencing distress or other mental health concerns related to disaster, including extreme heat events.)

These resources are supplemented by several new CDC tools addressing extreme heat that were released today.

HHS has also taken the following steps over the last year to advance environmental justice:

• Launched a nation-wide HHS Environmental Justice Community Innovator Challenge to support disadvantaged communities and Tribes facing the brunt of environmental injustices, including health harms due to climate change. This Challenge aims to uplift community-level solutions to address health inequities with prizes totaling $1,000,000. The Challenge is co-led by the HHS Office of Environmental Justice and the Office of Minority Health. Submissions are being accepted for Phase 2.
• HHS Office for Civil Rights and the Department of Justice reached an interim resolution agreement in their environmental justice investigation into the Alabama Department of Public Health and the Lowndes County Health Department (collectively ADPH) in Lowndes County, Alabama. ADPH cooperated throughout the investigation and agreed to the interim resolution agreement that puts ADPH on a path forward towards ensuring the development of equitable and safe wastewater disposal and management systems in Lowndes County.
• ACF’s Office of Community Services released its annual Earth Day Landing page, which highlights the compounding effects of climate change and energy burden on low-income households, recognizing that vulnerable populations are disproportionately affected by climate-related emergencies and disasters, as well as environmental injustices. Through a variety of data, toolkits, animated videos, and spotlight videos, the landing page showcases how the four programs in OCS that fall under President Biden’s Justice40 Initiative are supporting vulnerable individuals, families, and children across the country.   
• ACF updated the Disaster Flexibilities Hub, which visually tracks and displays key data, guidance, and resources on declared disasters, disaster preparedness efforts, and the disaster flexibilities built into the OCS block grant programs, such as the LIHEAP and the Community Services Block Grant (CSBG). The Hub includes a live weather activity dashboard, searchable program locator to identify the nationwide network of over 3,000 OCS-funded grant recipients and subrecipients that are ready to assist during a disaster, an inventory of OCS’ disaster flexibilities guidance for all applicable OCS programs, as well as other tools and resources.  
• In March 2024, HHS released a water utility affordability survey report as part of the first-ever federal water assistance program, known as the Low Income Household Water Assistance Program (LIHWAP). The report entitled Understanding Water Affordability Across Contexts, LIHWAP Water Utility Affordability Survey Report provides an analysis of the largest survey documenting U.S. water and wastewater rates, arrears, disconnections and fees in one dataset. The survey report includes information from over 1,800 water and wastewater providers, representing the 49 states and the District of Columbia. Among other things, the report highlights the differences in water affordability across the country, including differences between urban, rural, and tribal utilities. The findings show, on average, 20% of households are in debt to their water utility -- and for tribal communities that increases to 32% of households. 
• ACF created the Rural Community Development (RCD) Information and Data Dashboard, which is a new, interactive dashboard that underscores the water and wastewater infrastructure needs of rural and tribal communities.  The Dashboard highlights national estimates of water and wastewater infrastructure needs with a focus on the experiences of rural and tribal communities; provides data on water access, quality, and environmental burdens in rural communities; and demonstrates how the RCD program improves rural water infrastructure and delivers safe and affordable water and wastewater services to communities across the country. 
• ACF’s Community Economic Development (CED) program is supporting efforts to empower workers by creating and expanding businesses and job opportunities for individuals with low incomes in energy communities. These are communities that have experienced employment loss and/or economic dislocation events because of declines in the fossil fuel industry. There are currently 19 active CED projects in energy communities, which have resulted in 629 new jobs so far. 
• ACF has released a series of videos on how OCS programs address the many facets of environmental justice, from expanding clean energy to providing disaster relief in historically underserved communities. Some of these spotlights include highlighting Washington state’s LIHEAP cooling program that brought relief to households during historic heat waves, the support RCD funds gave to communities in Kentucky following extreme flooding, new employment opportunities through Community Economic Development-funded small business growth in areas once dependent on coal mining in West Virginia, and successful efforts to install rooftop solar panels for households with low income in Wisconsin through the CSBG program. 
• The NIEHS Environmental Career Worker Training Program (ECWTP) continues to provide opportunities for eligible individuals to obtain careers in environmental cleanup, construction, hazardous waste removal, and emergency response. This program was selected as a participant in the Justice40 Initiative.
• The Indian Health Service (IHS) began an Environmental Justice/Equity Initiative in January 2024, with the Whiteriver Indian Hospital Staff and will continue the initiative with the Whiteriver, AZ community. The Initiative plans to conduct a Gathering of Native Americans (GONA) to provide a safe and culturally sensitive space to engage with the community to determine their issues of concern which could include, for example, food insecurity, climate anxiety, transportation insecurity and housing insecurity.
• The Office of the Assistant Secretary for Planning and Evaluation, in partnership with the ACF Office of Head Start, released the interactive Head Start Environmental Exposure Mapping Tool, which uses Head Start administrative data—matched with publicly available environmental data—to show the relative exposure of Head Start service locations and children to environmental and climate hazards across the country. A companion Resource Dashboard includes information, resources, and tools for Head Start providers and other early childhood stakeholders to address environmental and climate change-related challenges and support evidence-based action to advance environmental justice. 
• SAMHSA developed language related to the effects of climate and environmental risks in mental health and substance use prevention, treatment and recovery through the Mental Health and Substance Abuse Block Grants provided to states https://www.samhsa.gov/grants/block-grants. See Page 14 of the currently published 2024-2025 SAMHSA Block Grant Application and Plan for related guidance: https://www.samhsa.gov/grants/block-grants/block-grant-application.
• ACF’s Administration for Native Americans program led by the Lower Elwha Klallam Tribe, in collaboration with six Olympic Peninsula tribes, will increase tribal youth engagement in the outdoors by providing educational opportunities in natural resource sciences. Very few tribal youth are engaged in outdoor sciences, and even fewer pursue educational pathways or careers in natural resources.  At the end of the 36-month program, at least 50 of 60 tribal youth between the ages of 15-25 will be able to demonstrate knowledge gained in outdoor navigation, survival, animal tracking, plant identification, wildlife research, and the importance of pursuing education and careers in the natural resources. The project will benefit the next seven generations, subsistence harvest purposes, and the greater ecological health of their shared regional landscape: ANA Environmental Regulatory Enhancement Grants. 
• With CDC funding, the National Indian Health Board (NIHB) funded six tribes for a short-term project. The NIHB subawards are being used to support projects focusing on tribal emergency mitigation plans related to extreme weather, coastal erosion, or other impacts of climate change. The funded tribes are: Ho-Chunk (Wisconsin), Lummi (Washington State), Navajo Nation (Arizona), Wichita & Affiliated Tribes (Oklahoma), Winnebago (Nebraska), and Swinomish (Washington).
• The National Institutes of Health (NIH) Climate Change and Health Initiative is an important new cross-cutting NIH effort to reduce health threats from climate change and build health resilience in individuals, communities, and nations around the world, especially among those at highest risk. Since the initiative has launched, the NIH has had a large increase in research applications focused on climate change and has increased the number of awards made on this topic. A public webinar series also helps increase awareness about the role climate plays in health. 

HHS also announced new tools and resources today in support of Earth Day. Read the Earth Day press release here: https://www.hhs.gov/about/news/2024/04/22/hhs-marks-earth-day-with-programming-to-reduce-sector-wide-emissions-and-tools-to-address-extreme-heat.html.