Sec. 1005. Grant program to conduct environmental health improvement activities and to improve social determinants of health
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In this section: The term Director means the Director of the Centers for Disease Control and Prevention, acting in collaboration with the Administrator of the Environmental Protection Agency and the Director of the National Institute of Environmental Health Sciences. The term eligible entity means a State or local community that— bears a disproportionate burden of exposure to environmental health hazards; bears a disproportionate burden of exposure to unhealthy living conditions, low standard housing conditions, low socioeconomic status, poor nutrition, less opportunity for educational attainment, disproportionately high unemployment rates, or lower literacy levels and access to information; has established a coalition— with not less than 1 community-based organization or demonstration program; and with not less than 1— public health entity; health care provider organization; academic institution, including any minority-serving institution (including a Hispanic-serving institution, a historically Black college or university, or a Tribal College or University); child-serving institution; or landlord or housing provider working on lead remediation; ensures planned activities and funding streams are coordinated to improve community health; and submits an application in accordance with subsection (c).
The Director shall establish a grant program under which eligible entities shall receive grants to conduct environmental health improvement activities and to improve social determinants of health. To receive a grant under this section, an eligible entity shall submit an application to the Director at such time, in such manner, and accompanied by such information as the Director may require. An eligible entity may use a grant under this section— to promote environmental health; to address environmental health disparities among all populations, including children; and to address racial and ethnic disparities in social determinants of health.
The Director shall award grants to eligible entities at the following 3 funding levels: An eligible entity awarded a grant under this paragraph shall use the funds to identify environmental health problems and solutions by— establishing a planning and prioritizing council in accordance with subparagraph (B); and conducting an environmental health assessment in accordance with subparagraph (C). A prioritizing and planning council established under subparagraph (A)(i) (referred to in this paragraph as a PPC ) shall assist the environmental health assessment process and environmental health promotion activities of the eligible entity.
Membership of a PPC shall consist of representatives from various organizations within public health, planning, development, and environmental services and shall include stakeholders from vulnerable groups such as children, the elderly, disabled, and minority ethnic groups that are often not actively involved in democratic or decision-making processes. A PPC shall— identify key stakeholders and engage and coordinate potential partners in the planning process; establish a formal advisory group to plan for the establishment of services; conduct an in-depth review of the nature and extent of the need for an environmental health assessment, including a local epidemiological profile, an evaluation of the service provider capacity of the community, and a profile of any target populations; and define the components of care and form essential programmatic linkages with related providers in the community.
A PPC shall carry out an environmental health assessment to identify environmental health concerns. The PPC shall— define the goals of the assessment; generate the environmental health issue list; analyze issues with a systems framework; develop appropriate community environmental health indicators; rank the environmental health issues; set priorities for action; develop an action plan; implement the plan; and evaluate progress and planning for the future. Each eligible entity that receives a grant under this paragraph shall evaluate, report, and disseminate program findings and outcomes.
The Director may provide such technical and other non-financial assistance to eligible entities as the Director determines to be necessary. The Director shall award grants under this paragraph to eligible entities that have already— established broad-based collaborative partnerships; and completed environmental assessments. To be eligible to receive a grant under this paragraph, an eligible entity is not required to have successfully completed a Level 1 Cooperative Agreement (as described in paragraph (1)).
An eligible entity awarded a grant under this paragraph shall use the funds to further activities to carry out environmental health improvement activities, including— addressing community environmental health priorities in accordance with paragraph (1)(C)(ii), including— geography; the built environment; air quality; water quality; land use; solid waste; housing; violence; socioeconomic status; ethnicity, social construct and language preference; educational attainment; employment; food safety, accessibility, and affordability; nutrition; health care services; and injuries; building partnerships between planning, public health, and other sectors, including child-serving institutions, to address how the built environment impacts food availability and access and physical activity to promote healthy behaviors and lifestyles and reduce overweight and obesity, musculoskeletal diseases, respiratory conditions, dental, oral and mental health conditions, poverty, and related co-morbidities; establishing programs to address— how environmental and social conditions of work and living choices influence physical activity and dietary intake; or how the conditions described in subclause
(I)influence the concerns and needs of people who have impaired mobility and use assistance devices, including wheelchairs, lower limb prostheses, and hip, knee, and other joint replacements; and convening intervention and demonstration programs that examine the role of the social environment in connection with the physical and chemical environment in— determining access to nutritional food; improving physical activity to reduce overweight, obesity, and co-morbidities and increase quality of life; and location and access to medical facilities. An eligible entity awarded a grant under this paragraph shall use the funds to identify and address racial and ethnic disparities in social determinants of health by creating demonstration programs that assess the feasibility of establishing a federally funded comprehensive program and describe key outcomes that address racial and ethnic disparities in social determinants of health. No later than 1 year after enactment of this Act, the Director shall evaluate the best practices of existing programs from the private, public, community-based, and academically supported initiatives focused on reducing disparities in the social determinants of health for racial and ethnic populations. Not later than two years after the date of enactment of this Act, the Director shall implement at least ten demonstration projects including at least one project for each major racial and ethnic minority group, each of which is unique to the cultural and linguistic needs of each of the following groups: Native Americans and Alaska Natives. Asian Americans. African Americans/Blacks. Hispanic/Latino Americans. Native Hawaiians and Pacific Islanders. No later than 2 years after the implementation of the initial demonstration projects, the Director shall submit to Congress a report which includes— a description of each demonstration project and design; an evaluation of the cost-effectiveness of each project’s prevention and treatment efforts; an evaluation of the cultural and linguistic appropriateness of each project by racial and ethnic group; and an evaluation of the beneficiary’s health status improvement under the demonstration project. The Director shall require eligible entities awarded a grant under this paragraph to report any other information the Director determines appropriate to be shared by or developed by such entity, including the following: Developing models and evaluating methods that improve the cultural and linguistically appropriate services provided through the Centers for Disease Control and Prevention to target individuals impacted by health disparities based on their race, ethnicity, and gender. Promoting the collaboration between primary and specialty care health care providers and patients, to ensure patients impacted by health disparities based on race, ethnicity, and gender are receiving comprehensive and organized treatment and care. Educating health care professionals on the causes and effects of disparities in the social determinants of health as it relates to minority and racial and ethnic communities and the need for culturally and linguistically appropriate care in the prevention and treatment of high-impact diseases. Encouraging collaboration among community and patient-based organizations which work to address disparities in the social determinants of health as it relates to high-impact diseases in minority and racial and ethnic populations. There are authorized to be appropriated to carry out this section— $25,000,000 for fiscal year 2021; and such sums as may be necessary for fiscal years 2022 through 2024.