Hill Heat

Subcommittee hearing on the FY2025 Department of Health and Human Services budget request.

Witness:

• Xavier Becerra Secretary, Department of Health and Human Services

The HHS budget includes the The Low Income Home Energy Assistance Program (LIHEAP), which helps low-income households access home energy and weatherization assistance, vital tools for protecting vulnerable families’ health in response to extreme weather and climate change. States administer the Low Income Home Energy Assistance Program, typically making payments to utility companies and other home energy vendors on behalf of eligible households. Preliminary FY 2022 data shows an estimated 5.7 million households received heating assistance and nearly 60,000 households received weatherization assistance funded by federal Low Income Home Energy Assistance Program dollars. Common weatherization measures include sealing air leaks, adding insulation to walls and attics, and repairing heating and cooling systems. Since the Low Income Household Water Assistance Program expired at the end of FY 2023, the budget proposes to expand the Low Income Home Energy Assistance Program to advance the goals of both programs. Specifically, the budget proposes giving states the option of using a portion of their Low Income Home Energy Assistance Program funds to help low-income households pay their water bills. The budget includes $4.1 billion, an increase of $111 million over FY 2023. This is in addition to $100 million available for the Low Income Home Energy Assistance Program from the Bipartisan Infrastructure Law. As part of the Justice40 initiative, ACF plans to continue its efforts to prevent energy shutoffs and increase support for households with young children and older people or high energy burdens.

Centers for Disease Control

CDC addresses emerging environmental health risks and responds to environmental health emergencies by developing tools, guidance, and trainings; disseminating best practices; and providing expertise and requested technical assistance on environmental health concerns. CDC provides expertise and guidance relied upon by other federal, state, tribal, local, and territorial partners, including extreme heat, wildfires and hurricanes; cancer cluster investigations; chemical exposures related to the train derailment in East Palestine, Ohio; potential chemical, radiological, nuclear or explosive mass casualty events; and ensuring drinking and recreation water are free from contaminants that can cause waterborne illness. The FY 2025 Budget includes an increase of $10 million for Climate and Health to pilot the provision of portable High Efficiency Particulate Air (HEPA) filtration systems in homes and communities most affected by wildfire smoke.

Childhood Lead Poisoning Prevention (+$10.000 million)

Lead exposure can cause adverse effects in nearly every system in the body and seriously harm a child’s health. Even at low levels, lead exposure has the potential to affect growth and development, hearing and speech, IQ, academic achievement, and behavior. Public health approaches to reducing lead exposure have protected millions of Americans since the 1970s. However, nearly 29 million U.S. homes contain at least one lead hazard, and over 10 million U.S. homes rely on lead-containing service lines to carry water from municipal sources into family dwellings, putting large numbers of children at risk for lead exposure. CDC’s Childhood Lead Poisoning Prevention Program (CLPPP) reduces the number of children exposed to lead and eliminates blood lead level disparities. CDC funds 62 states and localities to conduct blood lead testing and reporting, use data to track trends and identify risks, lead-exposed children to services, and implement tailored, community-based interventions. CDC also conducts lead poisoning prevention research to continuously improve programs and services. CDC operates the Blood Lead Surveillance System and the Flint Lead Exposure Registry, a model for the nation’s first lead-free city and support for the Flint community.

As the only federal program that directly funds health departments to address the health impacts of climate-related extreme events, CDC’s Climate and Health program is building capacity throughout the nation to prepare for and respond to weather-related health risks. In FY 2023, CDC funded 11 health departments and three tribes to prepare for and respond to extreme weather health impacts by following CDC’s Building Resilience Against Climate Effects (BRACE) Framework. The BRACE framework helps communities anticipate weather impacts, assess vulnerabilities, project disease burden, assess public health interventions, develop adaptation plans, and evaluate the impact and quality of health interventions.

CDC also develops tools that jurisdictions can use to inform decisions about how to protect people from weather-related health impacts, such as CDC’s Heat & Health Tracker. Through a collaboration with CDC’s National Environmental Public Health Tracking Program, the tracker provides real-time local-level heat and health data that can be used to inform decisions and public health actions related to heat.

CDC maintains expertise to help communities prepare for, respond to, and recover from wildfires and wildfire smoke events. As the wildfire crisis continues to increase in size, duration, and intensity, millions of people are at increasing risk from wildfire and wildfire smoke. Smoke inhalation following a wildfire is linked to increases in respiratory conditions like asthma, heart disease, and cancer. Additionally, higher levels of dissolved organic matter, volatile organic compounds, and heavy metals in community water systems following wildfires can overwhelm traditional water treatment capabilities and reduce access to safe drinking water. CDC experts develop guidance and communication materials for public health departments and others and conduct research about the public health impacts of wildfire smoke exposure that are used to develop evidence-based strategies to reduce wildfire smoke exposures. CDC activated an emergency response unit to assist the Hawaii Department of Health following the August wildfires on the island of Maui and provided technical assistance on a range of environmental health issues related to the wildfires.

National Institutes of Health

As climate change continues to be an ongoing crisis, the risks to human health will grow, exacerbating existing health threats and creating new public health challenges. Global climate change is already directly and indirectly affecting human health in the United States and around the world. Impacts occur through changes to climate systems such as temperature, air and water quality, and extreme weather events, as well as through changes to the geography and timing of exposures. Climate change contributes to or exacerbates a wide range of health impacts, including non-communicable diseases, injury and trauma, and infectious diseases. Although climate change affects everyone, certain populations are especially vulnerable to various impacts due to social determinants of health, including life stage, sex, underlying health status, access to health care, education, and economic, racial, and ethnically driven disparities. In this way, the climate change and health agenda are inextricably linked to health equity. Climate change impacts are the concern of NIH as a whole and are often at the intersection of multiple NIH ICOs. For this reason, NIH has developed an “all of NIH” approach to building a solutionsdriven climate change and health strategic framework that will build on past research investments. The NIH strategic framework will seek to understand the health impacts and factors that contribute to individual and community susceptibility, strengthen capacity for needed research and the development of a transdisciplinary workforce, and promote community-engaged research, translation, and dissemination to maximize efforts and outcomes among the United States and global communities most urgently affected. The FY 2025 budget request of $40.0 million sustains the FY 2023 Final increase to boost research on the human health impacts of climate change.

Administration for Strategic Preparedness and Response

The FY 2025 President’s Budget Request directly supports ASPR’s mission to help the country prepare for, respond to, and recover from public health emergencies and disasters. We are living in an increasingly interconnected world where diseases and other threats can travel quickly, unnoticed for days. In addition, infectious disease outbreaks are becoming more frequent and natural disasters more deadly as a result of the increasing changes to our climate. ASPR Policy and Planning manages a variety of White House policy engagements to ensure appropriate representation and coordination of ASPR’s equities in preparedness and response policy actions, and tracks ASPR-wide implementation of Executive Orders. Additionally, Policy and Planning established and uses a hub to coordinate climate change and health equity policy and activities across ASPR.