The Federation of American Scientists (FAS) Applauds the Newly Announced Board Selected to Lead the Foundation for Energy Security and Innovation (FESI)

FAS eager to see the Board set an ambitious agenda that aligns with the potential scale of FESI’s impact

Washington, D.C. – May 9, 2024 – Earlier today Secretary of Energy Granholm took the first official step to stand up the Department of Energy-affiliated non-profit Foundation for Energy Security and Innovation (FESI) by appointing its inaugural board. Today the “Friends of FESI” Initiative of the nonpartisan, non-profit Federation of American Scientists (FAS) steps forward to applaud the Secretary, congratulate the new board members, and wish FESI well as it officially begins its first year. The Inaugural FESI Board consists of 13 accomplished members whose backgrounds span the nation’s regions and communities and who have deep experience in innovation, national security, philanthropy, business, science, and other sectors. It includes:

Since the CHIPS and Science Act authorized FESI in 2022, FAS, along with many allies and supporters who collectively comprise the “Friends of FESI,” have been working to enable FESI to achieve its full potential as a major contributor to the achievement of DOE’s vital goals. “Friends of FESI” has been seeking projects and activities that the foundation could take on that would advance the DOE mission through collaboration with private sector and philanthropic partners.

“FAS enthusiastically celebrates this FESI milestone because, as one of the country’s oldest science and technology-focused public interest organizations, we recognize the scale of the energy transition challenge and the urgency to broker new collaborations and models to move new energy technology from lab to market,” says Dan Correa, CEO of FAS. “As a ‘Friend of FESI’ FAS continues our outreach amongst our diverse network of experts to surface the best ideas for FESI to consider implementing.” The federation is soliciting ideas at fas.org/fesi, underway since FESI’s authorization.

FESI has great potential to foster the public-private partnerships necessary to accelerate the innovation and commercialization of technologies that will power the transition to clean energy. Gathering this diverse group of accomplished board members is the first step. The next is for the FESI Board to pursue projects set to make real impact. Given FESI’s bipartisan support in the CHIPS & Science Act, FAS hopes the board is joined by Congress, industry leaders and others to continue to support FESI in its initial years. 

“FESI’s establishment is a vital initial step, but its value will depend on what happens next,” says David M. Hart, a professor at George Mason University’s Schar School of Policy and Government and leader of the “Friends of FESI” initiative at FAS. “FESI’s new Board of Directors should take immediate actions that have immediate impact, but more importantly, put the foundation on a path to expand that impact exponentially in the coming years. That means thinking big from the start, identifying unique high-leverage opportunities, and systematically building the capacity to realize them.”


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ABOUT FAS

The Federation of American Scientists (FAS) works to advance progress on a broad suite of contemporary issues where science, technology, and innovation policy can deliver dramatic progress, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945 by scientists in response to the atomic bomb, FAS continues to work on behalf of a safer, more equitable, and more peaceful world. More information at fas.org.


Resources

Building a Firm Foundation for the DOE Foundation: It All Starts with a Solid Board
https://fas.org/publication/fesi-board-launch/

FAS use case criteria:
https://fas.org/publication/fesi-priority-use-cases/

FAS open call for FESI ideas:
https://fas.org/publication/share-an-idea-for-what-fesi-can-do-to-advance-does-mission/

DOE announcing FESI board:
https://www.energy.gov/articles/doe-appoints-inaugural-board-directors-groundbreaking-new-foundation

DOE release announcing FESI:
https://www.energy.gov/articles/doe-launches-foundation-energy-security-and-innovation



Climate Change Challenges and Solutions in Forestry & Agriculture

Climate change is already impacting agriculture and forestry production in the U.S. However, these sectors also hold the key to adaptation and mitigation. The United States Department of Agriculture (USDA) is at the forefront of addressing these challenges and developing solutions. Understanding the implications of climate change in agriculture and forestry is crucial for our nation to forge ahead with effective strategies and outcomes, ensuring our food and shelter resources remain secure.

Currently, the atmosphere contains more key greenhouse gasses (nitrous oxides, carbon dioxide, methane) than ever in history thanks to human activities. Industrial, agricultural, and deforestation practices add to the abundance of these critical gasses that are warming our planet. This has become more noticeable through more frequent severe weather and natural disasters with record heat waves, droughts, tornadoes, and rainfall. In 2023, global climate records of temperatures were broken and hit the highest in the last 174 years. Ocean temperatures are reaching record levels, along with major melts in ice sheets. All these changes will affect forestry and agriculture in profound ways. Crop damaging insects and diseases, along with other stresses caused by extreme changes, will also have cascading effects.

Adjustments or adaptations in response to climate change have progressed globally, with planning and implementation across multiple sectors and regions. While much attention is being paid to reforestation and reducing deforestation, gaps still exist and will need continued attention and financial input to address current and future challenges. Agriculture and forestry are two sectors worth exploring as they can open up climate adaptation and mitigation solutions that have positive cascading benefits across regions.

Challenges in the Agriculture and Forestry Sector

Agriculture contributes to greenhouse gas emissions through several activities, such as burning crop residues, soil management and fertilization, animal manure management, and rice cultivation. In addition, agriculture requires significant amounts of energy for vehicles, tractors, harvest, and irrigation equipment. Agriculture involves complex systems that include inputs of fertilizers and chemicals, management decisions, social factors, and interactions between climate and soil.

Most agriculture operations need fertilizers to produce goods, but the management and specific use of fertilizers need further focus. According to the Inventory of Greenhouse Gas Emissions and Sinks, agriculture contributes 9.4% of total greenhouse gas emissions in the United States.

Agriculture is particularly vulnerable to climate change because many operations are exposed to climatic changes in the natural landscape. There has been widespread economic damage in agriculture due to climate change. Individuals and farms have been affected by flooding, tornadoes, extreme wildfires, droughts, and excessive rains. Loss of property and income, human health, and food security is real for agriculture producers. Adverse impacts will continue to be felt in agricultural systems, particularly in crop production, water availability, animal health, and pests and diseases.

Forestry is a major industry in the U.S. and plays a key role in regulating the climate by transferring carbon within ecosystems and the atmosphere.. Forests remove carbon dioxide (CO2) from the atmosphere and store it in trees and soils. Forestry has seen a decline in the last few decades due to development and cropland expansion. The decline in forestry acres affects essential services such as air purification, regulating water quantity and quality, wood products for shelter, outdoor recreation, medicines, and wildlife habitat. Many Indigenous people and Tribal Nations depend on forest ecosystems for food, timber, culture, and traditions. Effective forest management is crucial for human well-being and is influenced by social and economic factors.

Land cover types and distribution of the United States. Forest lands have decreased in the last two decades. (Source: Fifth National Climate Assessment)

Forests are affected by climate change on local or regional levels based on climate conditions such as rainfall and temperature. The West has been significantly affected, with higher temperatures and drought leading to more wildfires. Higher temperatures come with higher evaporation rates, leading to drier forests that are susceptible to fires. The greater amount of dry wood causes extensive fires that burn more intensely. Fire activity is projected to increase with further warming and less rain. Since 1990, these extensive fires have produced greater greenhouse gas emissions of carbon dioxide (CO2). Other regions of the country with forests that typically receive more rain, like the southeast and northeast, are challenging to predict fire hazards. Other climate change effects include insects, diseases, and invasive species, which change forest ecosystems’ growth, death, and regeneration. Various degrees of disruption can impact a forest’s dynamics.

Current Adaptation Approaches in Agriculture and Forestry

Since agriculture’s largest contribution to greenhouse gas emissions is agriculture soil management, emphasis is being placed on reducing emissions from this process. Farmers are tilling less and using cover crops to keep the ground covered, which helps soils perform the important function of carbon storage. These techniques can also help lower soil temperatures and conserve moisture. In addition, those working in the agriculture sector are taking measures to adapt to the changing climate by developing crops that can withstand higher temperatures and water stress. Ecosystem-based solutions such as wetland restoration to reduce flooding have also been effective. Another potential solution is agroforestry, in which trees are planted, and other agricultural products are grown between the trees or livestock is grazed within a forestry system. This system provides shade to the animals and enhances biodiversity. It protects water bodies by keeping the soil covered with vegetation throughout the year. The perennial vegetation also stores carbon in above-ground vegetation and below-ground roots.

In the forestry space, land managers and owners are developing plans to adapt to climate challenges by building adaptations in key areas such as relationships and connections of land stewardship, research teamwork, and education curriculum. Several guides, assessments, and frameworks have been designed to help private forest owners, Tribal lands, and federally managed forests. Tribal adaptation plans also include Tribal values and cultural considerations for forests. The coasts will be adapting to more frequent flooding, and relocation of recreation areas in vulnerable areas is being planned. In major forestry production areas in the West, forestry agencies are developing plans for prescribed burning to keep dead wood lower, eliminate invasive species, and enable fire-adapted ecosystems to thrive, all while reducing severe wildfires. Thinning forests and fuel removal also help with reducing wildfire risk.      

While both sectors have made progress in quickly adjusting their practices, much more needs to be done to ensure that land managers and affected communities are better prepared for both the short-term and long-term effects of climate change. The federal government, through USDA, can drive adaptation efforts to help these communities.

Current Policy

The USDA created the Climate Adaptation and Resilience Plan in response to Executive Order 14008, Tackling the Climate Crisis at Home and Abroad, which requires all federal agencies to develop climate adaptation plans in all public service aspects, including management, operations, missions, and programs. 

The adaptation plan focuses on key threats to agriculture and forestry, such as:

Many USDA agencies have developed actions to address the impacts of climate change in different mission areas of USDA. These adaptation plans provide information for farmers, ranchers, forest owners, rural communities, trade and foreign affairs on ways to address the impact of climate change that affects them the most. For example, farm and ranch managers can use COMET Farm, a user-friendly online tool co-developed by Colorado State University and USDA that helps compare land management practices and account for carbon and greenhouse gas emissions.

USDA has invested $3.1 billion in Partnerships for Climate-Smart Commodities, encompassing 141 projects that involve small and underserved producers. The diverse projects are matched financially with non-federal funds and include over 20 tribal projects, 100 universities, including 30 minority-serving institutions, and others. The goals of the federal and private sector funding include:

The USDA Forest Service has also developed its own Climate Adaptation Plan that comprehensively incorporates climate adaptation into its mission and operations. The Forest Service has cultivated partnerships with the Northwest Climate Hub, National Park Service, Bureau of Land Management, University of Washington, and the Climate Impacts Group to develop tools and data to help with decision-making, evaluations, and developing plans for implementation. One notable example is the Sustainability and Climate website, which provides information on adaptation, vulnerability assessments, carbon, and other aspects of land management. 

Conclusion

While sustained government incentives can help drive adaptation efforts, it is important for everyone to play a role in adapting to climate change, especially in the agriculture and forestry sectors. Purchasing products that are grown sustainably and in climate-smart ways will help protect natural resources and support these communities. Understanding the significance of resilience against climate changes and disruptions is crucial, both in the short and long term. These challenges require collaborators to work together to creatively solve problems in addressing greenhouse gas contributions. Climate models can help solve complex problems and test different scenarios and solutions. As the Fifth National Climate Assessment of the United States notes, greenhouse gas concentrations are increasing, global warming is on the rise, and climate change is currently happening. The choices we make now can have a significant impact on our future.

The Federation of American Scientists values diversity of thought and believes that a range of perspectives — informed by evidence — is essential for discourse on scientific and societal issues. Contributors allow us to foster a broader and more inclusive conversation. We encourage constructive discussion around the topics we care about.

Enhancing Public Health Preparedness for Climate Change-Related Health Impacts

The escalating frequency and intensity of extreme heat events, exacerbated by climate change, pose a significant and growing threat to public health. This problem is further compounded by the lack of standardized education and preparedness measures within the healthcare system, creating a critical gap in addressing the health impacts of extreme heat. The Department of Health and Human Services (HHS), especially the Centers for Medicare & Medicaid Services (CMS), the Health Resources and Services Administration (HRSA), and the Office of Climate Change and Health Equity (OCCHE) can enhance public health preparedness for the health impacts of climate change. By leveraging funding mechanisms, incentives, and requirements, HHS can strengthen health system preparedness, improve health provider knowledge, and optimize emergency response capabilities. 

By focusing on interagency collaboration and medical education enhancement, strategic measures within HHS, the healthcare system can strengthen its resilience against the health impacts of extreme heat events. This will not only improve coding accuracy, but also enhance healthcare provider knowledge, streamline emergency response efforts, and ultimately mitigate the health disparities arising from climate change-induced extreme heat events. Key recommendations include: establishing dedicated grant programs and incentivizing climate-competent healthcare providers; integrating climate-resilience metrics into quality measurement programs; leveraging the Health Information Technology for Economic and Clinical Health (HITECH) Act to enhance ICD-10 coding education; and collaborating with other federal agencies such as the Department of Veterans Affairs (VA), the Federal Emergency Management Agency (FEMA), and the Department of Defense (DoD) to ensure a coordinated response. The implementation of these recommendations will not only address the evolving health impacts of climate change but also promote a more resilient and prepared healthcare system for the future.

Challenge

The escalating frequency and intensity of extreme heat events, exacerbated by climate change, pose a significant and growing threat to public health. The scientific consensus, as documented by reports from the Intergovernmental Panel on Climate Change (IPCC) and the National Climate Assessment, reveals that vulnerable populations, such as children, pregnant people, the elderly, and marginalized communities including people of color and Indigenous populations, experience disproportionately higher rates of heat-related illnesses and mortality. The Lancet Countdown’s 2023 U.S. Brief underscores the escalating threat of fossil fuel pollution and climate change to health, highlighting an 88% increase in heat-related mortality among older adults and calling for urgent, equitable climate action to mitigate this public health crisis.

Inadequacies in Current Healthcare System Response

Reports from healthcare institutions and public health agencies highlight how current coding practices contribute to the under-recognition of heat-related health impacts in vulnerable populations, exacerbating existing health disparities. The current inadequacies in ICD-10 coding for extreme heat-related health cases hinder effective healthcare delivery, compromise data accuracy, and impede the development of targeted response strategies. Challenges in coding accuracy are evident in existing studies and reports, emphasizing the difficulties healthcare providers face in accurately documenting extreme heat-related health cases. An analysis of emergency room visits during heat waves further indicates a gap in recognition and coding, pointing to the need for improved medical education and coding practices. Audits of healthcare coding practices reveal inconsistencies and inaccuracies that stem from a lack of standardized medical education and preparedness measures, ultimately leading to underreporting and misclassification of extreme heat cases. Comparative analyses of health data from regions with robust coding practices and those without highlight the disparities in data accuracy, emphasizing the urgent need for standardized coding protocols.

There is a crucial opportunity to enhance public health preparedness by addressing the challenges associated with accurate ICD-10 coding in extreme heat-related health cases. Reports from government agencies and economic research institutions underscore the economic toll of extreme heat events on healthcare systems, including increased healthcare costs, emergency room visits, and lost productivity due to heat-related illnesses. Data from social vulnerability indices and community-level assessments emphasize the disproportionate impact of extreme heat on socially vulnerable populations, highlighting the urgent need for targeted policies to address health disparities.

Opportunity

As Medicare is the largest federal source of Graduate Medical Education (GME) funding (Figure 1), the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) play a critical role in developing coding guidelines. Thus, it is essential for HHS, CMS, and other pertinent coordinating agencies to be involved in the process for developing climate change-informed graduate medical curricula.

By focusing on medical education enhancement, strategic measures within HHS, and fostering interagency collaboration, the healthcare system can strengthen its resilience against the health impacts of extreme heat events. Improving coding accuracy, enhancing healthcare provider knowledge, streamlining emergency response efforts, and mitigating health disparities related to extreme heat events will ultimately strengthen the healthcare system and foster more effective, inclusive, and equitable climate and health policies. Improving the knowledge and training of healthcare providers empowers them to respond more effectively to extreme heat-related health cases. This immediate response capability contributes to the overarching goal of reducing morbidity and mortality rates associated with extreme heat events and creates a public health system that is more resilient and prepared for emerging challenges. 

The inclusion of ICD-10 coding education into graduate medical education funded by CMS aligns with the precedent set by the Pandemic and All Hazards Preparedness Act (PAHPA), emphasizing the importance of preparedness and response to public health emergencies. Similarly, drawing inspiration from the Health Information Technology for Economic and Clinical Health Act (HITECH Act), which promotes the adoption of electronic health records (EHR) systems, presents an opportunity to modernize medical education and ensure the seamless integration of climate-related health considerations. This collaborative and forward-thinking approach recognizes the interconnectedness of health and climate, offering a model that can be applied to various health challenges. Integrating mandates from PAHPA and the HITECH Act serves as a policy precedent, guiding the healthcare system toward a more adaptive and proactive stance in addressing climate change impacts on health.

Conversely, the consequences of inaction on the health impacts of extreme heat extend beyond immediate health concerns. They permeate through the fabric of society, widening health disparities, compromising the accuracy of health data, and undermining emergency response preparedness. Addressing these challenges requires a proactive and comprehensive approach to ensure the well-being of communities, especially those most vulnerable to the effects of extreme heat.

Plan of Action

The following recommendations aim to facilitate public health preparedness for extreme heat events through enhancements in medical education, strategic measures within the Department of Health and Human Services (HHS), and fostering interagency collaboration.

Recommendation 1a. Integrate extreme heat training into the GME curriculum. 

Integrating modules on extreme heat-related health impacts and accurate ICD-10 coding into medical education curricula is essential for preparing future healthcare professionals to address the challenges posed by climate change. This initiative will ensure that medical students receive comprehensive training on identifying, treating, and documenting extreme heat-related health cases. Sec. 304. Core Education and Training of the PAHPA provides policy precedent to develop foundational health and medical response curricula and training materials by modifying relevant existing programs to enhance responses to public health emergencies. Given the prominence of Medicare in funding medical residency training, policies that alter Medicare GME can affect the future physician supply and can be used to address identified healthcare workforce priorities related to extreme heat (Figure 2).

Figure 2: A model for comprehensive climate and medical education (adapted from Jowell et al. 2023)

Recommendation 1b. Collaborate with Veterans Health Administration Training Programs. 

Partnering with the Department of Veterans Affairs (VA) to extend climate-related health coding education to Veterans Health Administration (VHA) training programs will enhance the preparedness of healthcare professionals within the VHA system to manage and document extreme heat-related health cases among veteran populations.

Implementation plan
Agency/Department InvolvementAction StepsEvaluation
HHS; CMS, NCHS, Health Resources and Services Administration (HRSA), Office of Climate Change and Health Equity (OCCHE): Coordinates efforts to integrate extreme heat training into medical education.Needs Assessment: OCCHE within HHS collaborates with VA to assess climate-related health coding education needs within VHA and GME training programs.Curriculum Integration: Assess the extent to which modules on extreme heat-related health impacts and ICD-10 coding are integrated into medical school curricula.
VA: Implements climate-related health coding education initiatives within VHA.Curriculum Development: OCCHE, CMS, NCHS, HRSA collaborate with medical accrediting bodies and subject matter experts to develop modules on extreme heat health impacts and ICD-10 coding for inclusion in medical education curricula.Student Performance: Evaluate medical students’ performance on assessments related to extreme heat-related health impacts and coding practices.
VHA: Participates in training programs and integrates education into its curriculum.Accreditation Standards Integration: Accrediting bodies revise accreditation standards to include requirements for teaching extreme heat-related health topics and coding practices. Work with CMS to update Conditions of Participation to include climate mitigation and resilience. Training Participation: Monitor the number of healthcare professionals, including those in the VHA, participating in climate-related health coding education and assess their level of engagement.
The Joint Commission (TJC); Healthcare Facilities Accreditation Program (HFAP): Accrediting bodies responsible for setting standards for climate competent healthcare facility accreditation.Faculty Training: HHS supports faculty training programs to ensure educators have the necessary knowledge and skills to teach extreme heat topics effectively. VHA incorporates climate-related health coding education into existing training programs for healthcare professionals, including physicians, nurses, and other staff.Faculty Feedback:
Solicit feedback on the effectiveness of training and support provided for delivering the new curriculum.
Environmental Protection Agency (EPA), National Oceanic and Atmospheric Administration (NOAA), Department of Homeland Security (FEMA), Assistant Secretary for Preparedness and Response (ASPR): Provide subject matter expertise on extreme heat and support curriculum development.Funding: Titles VII and VIII of the Public Health Service Act (PHSA) provide funding for programs to improve the healthcare workforce and support public health initiatives.Impact on Patient Care: Assess the impact of enhanced climate-related health coding education on patient care outcomes within participating hospitals and within the VHA system.
Title VII: Health Professions Education Programs can be used to support medical education programs focused on climate-related health impacts, including curriculum development, faculty training, and student scholarships or stipends.
Title VIII: Nursing Workforce Development Programs can support the integration of climate-related health content into nursing education programs, including undergraduate, graduate, and continuing education initiatives.
Evaluation and Feedback: Continuous evaluation of curriculum integration and feedback mechanisms are established to assess the effectiveness of training and make improvements as needed. Research funding provided through PHSA Titles VII and VIII can support studies evaluating the effectiveness of educational interventions on climate-related health knowledge and practice behaviors among healthcare providers.

Recommendation 2. Collaborate with the Agency for Healthcare Research and Quality (AHRQ) 

Establishing a collaborative research initiative with the Agency for Healthcare Research and Quality (AHRQ) will facilitate the in-depth exploration of accurate ICD-10 coding for extreme heat-related health cases. This should be accomplished through the following measures:

Establish joint task forces. CMS, NCHS, and AHRQ should establish joint research initiatives focused on improving ICD-10 coding accuracy for extreme heat-related health cases. This collaboration will involve identifying key research areas, allocating resources, and coordinating research activities. Personnel from each agency, including subject matter experts and researchers from the EPA, NOAA, and FEMA, will work together to conduct studies, analyze data, and publish findings. By conducting systematic reviews, developing standardized coding algorithms, and disseminating findings through AHRQ’s established communication channels, this initiative will improve coding practices and enhance healthcare system preparedness for extreme heat events.

Develop standardized coding algorithms. AHRQ, in collaboration with CMS and NCHS, will lead efforts to develop standardized coding algorithms for extreme heat-related health outcomes. This involves reviewing existing coding practices, identifying gaps and inconsistencies, and developing standardized algorithms to ensure consistent and accurate coding across healthcare settings. AHRQ researchers and coding experts will work closely with personnel from CMS and NCHS to draft, validate, and disseminate these algorithms.

Integrate into Continuous Quality Improvement (CQI) programs. Establish collaborative partnerships between the VA and other federal healthcare agencies, including CMS, HRSA, and DoD, to integrate education on ICD-10 coding for extreme heat-related health outcomes into CQI programs. Regularly assess the effectiveness of training initiatives and adjust based on feedback from healthcare providers. For example, CMS currently requires physicians to screen for the social determinants of health and could include level of climate and/or heat risk within that screening assessment.

Allocate resources. Each agency will allocate financial resources, staff time, and technical expertise to support collaborative activities. Budget allocations will be based on the scope and scale of specific initiatives, with funds earmarked for research, training, data sharing, and evaluation efforts. Additionally, research funding provided through PHSA Titles VII and VIII can support studies evaluating the effectiveness of educational interventions on climate-related health knowledge and practice behaviors among healthcare providers.

Recommendation 3. Leverage the HITECH Act and EHR.

Agency/Department InvolvementAction StepsEvaluation
HHS: Coordinates efforts to integrate climate-related health coding education into HITECH Act programs.Integrate ICD-10 Coding Training in EHR Adoption Programs: HHS, NCHS and CMS coordinate with ONC to include specific modules or training components related to ICD-10 coding for extreme heat-related health outcomes within the educational programs facilitated under HITECH Act incentives. This ensures that healthcare professionals adopting EHR systems receive comprehensive training on coding practices relevant to climate-related health challenges.Integration Success: HHS regularly evaluates the extent to which ICD-10 coding education and climate-related health data collection are integrated into CMS-funded GME programs and EHR systems.
CMS: Implements incentives and requirements for EHR integration and coding education.Customize EHR Templates: ONC provides guidance to EHR vendors and developers to create customized templates or modules within EHR systems that facilitate accurate documentation of extreme heat-related health cases.Coding Accuracy: Assess the accuracy of ICD-10 coding for extreme heat-related health outcomes in electronic health records and reporting systems.
Office of the National Coordinator for Health Information Technology (ONC): Provides technical assistance and guidance on EHR integration.Incorporation into Meaningful Use Criteria: CMS and ONS to oversee the integration of the accurate coding of climate-related health outcomes into the Meaningful Use/Promoting Interoperability Programs criteria outlined by the HITECH Act.Provider Feedback: Solicit feedback from healthcare providers on the effectiveness of training modules and EHR integration efforts.
Establish Reporting Requirements: Use the HITECH Act to establish reporting requirements for climate-related health data, encouraging the inclusion of ICD-10 codes for extreme heat-related health outcomes in electronic reporting systems supported by EHRs.
Incentives for Climate-Ready EHR Implementation:
Expanding incentives within the HITECH Act to healthcare providers integrating climate-related health coding into HER systems could enhance healthcare management. The 2009 program allocated $27 billion to promote EHR adoption. Aligning incentives with climate-related coding fosters a more comprehensive approach. This incentivizes EHR and climate-related ICD-10 coding practices, advancing the capacity to address climate-related health challenges.

Recommendation 4. Establish climate-resilient health system grants to incentivize state-level climate preparedness initiatives

HHS and OCCHE should create competitive grants for states that demonstrate proactive climate change adaptation efforts in healthcare. These agencies can encourage states to integrate climate considerations into their health plans by providing additional funding to states that prioritize climate resilience.

Within CMS, the Center for Medicare and Medicaid Innovation (CMMI) could help create and administer these grants related to climate preparedness initiatives. Given its focus on innovation and testing new approaches, CMMI could design grant programs aimed at incentivizing state-level climate resilience efforts in healthcare. Given its focus on addressing health disparities and promoting preventive care, the Bureau of Primary Health Care (BPHC) within HRSA could oversee grants aimed at integrating climate considerations into primary care settings and enhancing resilience among vulnerable populations.

Conclusion

These recommendations provide a comprehensive framework for HHS — particularly CMS, HRSA, and OCCHE— to bolster public health preparedness for the health impacts of extreme heat events. By leveraging funding mechanisms, incentives, and requirements, HHS can enhance health system preparedness, improve health provider knowledge, and optimize emergency response capabilities. These strategic measures encompass a range of actions, including establishing dedicated grant programs, incentivizing climate-competent healthcare providers, integrating climate-resilience metrics into quality measurement programs, and leveraging the HITECH Act to enhance ICD-10 coding education. Collaboration with other federal agencies further strengthens the coordinated response to the growing challenges posed by climate change-induced extreme heat events. By implementing these policy recommendations, HHS can effectively address the evolving landscape of climate change impacts on health and promote a more resilient and prepared healthcare system for the future.

This idea of merit originated from our Extreme Heat Ideas Challenge. Scientific and technical experts across disciplines worked with FAS to develop potential solutions in various realms: infrastructure and the built environment, workforce safety and development, public health, food security and resilience, emergency planning and response, and data indices. Review ideas to combat extreme heat here.

Frequently Asked Questions
What are the expected outcomes of these recommended policy actions?

  1. Improved Accuracy in ICD-10 Coding: Healthcare providers consistently apply accurate ICD-10 coding for extreme heat-related health cases.

  2. Enhanced Healthcare Provider Knowledge: Healthcare professionals possess comprehensive knowledge on extreme heat-related health impacts, improving patient care and response strategies.

  3. Strengthened Public Health Response: A coordinated effort results in a more effective and equitable public health response to extreme heat events, reducing health disparities.

  4. Improved Public Health Resilience:

    1. Short-Term Outcome: Healthcare providers, armed with enhanced knowledge and training, respond more effectively to extreme heat-related health cases.

    2. Long-Term Outcome: Reduced morbidity and mortality rates associated with extreme heat events lead to a more resilient and prepared public health system.



  5. Enhanced Data Accuracy and Surveillance:

    1. Short-Term Outcome: Improved accuracy in ICD-10 coding facilitates more precise tracking and surveillance of extreme heat-related health outcomes.

    2. Long-Term Outcome: Comprehensive and accurate data contribute to better-informed public health policies, targeted interventions, and long-term trend analysis.



  6. Reduced Health Disparities:

    1. Short-Term Outcome: Incentives and education programs ensure that healthcare providers prioritize accurate coding, reducing disparities in the diagnosis and treatment of extreme heat-related illnesses.

    2. Long-Term Outcome: Health outcomes become more equitable across diverse populations, mitigating the disproportionate impact of extreme heat on vulnerable communities.



  7. Increased Public Awareness and Education:

    1. Short-Term Outcome: Public health campaigns and educational initiatives raise awareness about the health risks associated with extreme heat events.

    2. Long-Term Outcome: Informed communities adopt preventive measures, reducing the overall burden on healthcare systems and fostering a culture of proactive health management.



  8. Streamlined Emergency Response and Preparedness:

    1. Short-Term Outcome: Integrating extreme heat preparedness into emergency response plans results in more efficient and coordinated efforts during heatwaves.

    2. Long-Term Outcome: Improved community resilience, reduced strain on emergency services, and better protection for vulnerable populations during extreme heat events.



  9. Increased Collaboration Across Agencies:

    1. Short-Term Outcome: Collaborative efforts between OCCHE, CMS, HRSA, AHRQ, FEMA, DoD, and the Department of the Interior result in streamlined information sharing and joint initiatives.

    2. Long-Term Outcome: Enhanced cross-agency collaboration establishes a model for addressing complex public health challenges, fostering a more integrated and responsive government approach.



  10. Empowered Healthcare Workforce:

    1. Short-Term Outcome: Incentives for accurate coding and targeted education empower healthcare professionals to address the unique challenges posed by extreme heat.

    2. Long-Term Outcome: A more resilient and adaptive healthcare workforce is equipped to handle emerging health threats, contributing to overall workforce well-being and satisfaction.



  11. Informed Policy Decision-Making:

    1. Short-Term Outcome: Policymakers utilize accurate data and insights to make informed decisions related to extreme heat adaptation and mitigation strategies.

    2. Long-Term Outcome: The integration of health data into broader climate and policy discussions leads to more effective, evidence-based policies at local, regional, and national levels.



Combating Extreme Heat with a National Moonshot

Extreme heat is the leading cause of weather-related deaths in the United States and has been for the past 30 years. Low-income communities and many other vulnerable populations are disproportionately affected by heat risk. As the climate continues to warm, the threat to public health will correspondingly increase. Through a presidential directive, the White House Climate Policy Office (WHCPO) should establish the National Moonshot to Combat Extreme Heat, an all-of-government program to harmonize and accelerate federal efforts to reduce heat risk and heat illness, save lives, and improve the cost-effectiveness of federal expenditures. 

The goals of the Moonshot are to:

  1. Reduce heat deaths by 20% by 2030, 40% by 2035, and 60% by 2050. 
  2. Build 150 heat-resilient communities by 2030 by facilitating access to funding and uplifting social infrastructure actions prioritizing at-risk, vulnerable populations.
  3. Increase visibility and awareness of federal efforts to protect residents from extreme heat. 

The Moonshot will be overseen by a new, high-level appointee at WHCPO to serve as the Executive Officer of the White House Interagency Work Group on Extreme Heat (WHIWG). 

Challenge and Opportunity

The threat to public health and safety from extreme heat is serious, expansive, and increasing as the planet continues to warm. According to Heat.gov, “Extreme heat has been the greatest weather-related cause of death in the U.S. for the past 30 years — more than hurricanes, tornadoes, flooding or extreme cold.” The number of deaths from extreme heat is difficult to accurately determine and is frequently undercounted. More recently, during the Heat Dome of 2021, the state of Washington reported 1,231 heat deaths in just one month. Further, heat-related illness includes a broad spectrum of diseases, from mild heat cramps to life-threatening heat stroke. Heat exposures have been linked to mental health illnesses and adverse birth outcomes, such as preterm births and low birth weights. Extreme heat disproportionately impacts marginalized people, including those that are low-income, BIPOC, seniors, veterans, children, the unhoused, and those with compromised health status, among others. All heat illnesses and deaths are considered preventable.

Extreme heat is an all-of-society problem that requires an all-of-government response. As the frequency, intensity, duration, and breadth of heat waves have increased dramatically over the past four years, officials and leaders at all levels have begun taking action. 

The federal government has launched new programs for addressing extreme heat over the last few years as heat waves have become a front-page issue. Recent programs initiated by the Biden Administration are providing a variety of resources and increasing awareness of this threat. Key examples are:

Actions are needed to remedy the deficit in attention to extreme heat by uplifting the role of extreme heat in the federal response to climate impacts and give greater emphasis to social infrastructure actions. 

Several bills to address extreme heat through federal legislation have been introduced in Congress, though none have advanced. Most notable are:

  1. S. 2645: Senator Edward Markey’s Preventing HEAT Illness and Deaths Act of 2023 would authorize NIHHIS to prescribe actions and provide funding. 
  2. HR 3965: Representative Ruben Gallego’s “Extreme Heat Emergency Act of 2023” would amend the Stafford Act by adding “extreme heat” as a natural disaster for which response aid is authorized.
  3. H.R. 2945: Representative Ruben Gallego’s Excess Urban Heat Mitigation Act of 2023” would require the Department of Housing and Urban Development (HUD) to establish a grant program to fund activities to mitigate or manage heat in urban areas. The Senate version of this bill, S. 1379, is led by Senator Sherrod Brown.

Even with this momentum, actions are dispersed across many departments and agencies. Plus, many local and state governments tend to apply for federal funding on a program-by-program, agency-by-agency basis and must navigate a complicated landscape with limited funding explicitly earmarked for heat resilience. Further, most “infrastructure” and capacity-building funding is based on mitigating or restoring economic loss of property, leading to financial relief that has gone primarily to built infrastructure and natural infrastructure projects. Communities need social infrastructure: social cohesion, policy and governance, public health, communications and alerts, planning, etc., to respond to extreme heat. This requires a pathway for communities to access funds to combat extreme heat in a comprehensive and coordinated way and bring social infrastructure actions up to a level equal to built and natural infrastructure interventions. 

There is a need to improve the coordination of heat actions across the federal government, align heat resilience activities with Justice40 mandates, and promote community-based interventions to reduce heat deaths. A National Moonshot to Combat Extreme Heat can do this by leveraging several new community-focused programs to accelerate the protection of at-risk populations from heat-related death and illness. The challenge, and therefore the opportunity, for the Moonshot is to identify, integrate, and accelerate existing resources in a human-centric framework to reduce preventable deaths, promote cool and healthy communities, and deliver value nationwide. 

Plan of Action 

The WHCPO should appoint a new Deputy Director for Heat to serve as the Executive Officer of the WHIWG and coordinate the National Moonshot to Combat Extreme Heat – an all-of-government program to accelerate federal actions to address extreme heat. The goals of the Moonshot are to:

  1. Reduce heat deaths by 20% by 2030, 40% by 2035, and 60% by 2050; 
  2. Build 150 heat-resilient communities by 2030 by facilitating access to funding and uplifting social infrastructure actions prioritizing at-risk, vulnerable populations. Social infrastructure encompasses a variety of actions in four categories: social cohesion, policy, communications, and planning.  Social infrastructure centers the needs of people in resilience.  This target aligns with the U.S. goal to reduce greenhouse gas emissions by 50% by 2030. 
  3. Improve visibility and awareness of federal efforts to protect residents from extreme heat.

The Moonshot will capitalize on existing policies, programs, and funding and establish a human-centric approach to climate resilience by uplifting extreme heat. The Moonshot will identify and evaluate existing federal activities and available funding, including funds from the Inflation Reduction Act (IRA) and the Bipartisan Infrastructure Law (BIL), as well as agency budgets, including Federal Emergency Management Agency’s funding for the Building Resilient Infrastructure and Communities (BRIC) and the Hazard Mitigation Grant Program (HMGP). The Moonshot will integrate actions among the many existing programs dispersed across the government into a well-coordinated, integrated inter-agency initiative that maximizes results and will support cool, safe, and healthy communities

Recommendation 1. Enhance the visibility, responsibility, and capacity of the WHIWG. 

Signaling high-level support through a presidential directive, the WHCPO should appoint a Deputy Director for Heat as the Executive Officer of the WHIWG to lead the Moonshot. Two additional staff positions will be established to support the assessment, stakeholder engagement, and planning processes. The WHIWG and the Deputy Director will design and implement the Moonshot working with the Department of Health and Human Services Office of Climate Change and Health Equity. A lead contact will be designated in each agency and department participating in the NIHHIS program. 

Recommendation 2. Assess and report current status. 

The Moonshot should identify, evaluate, and report on existing programs addressing heat across the federal government, including those recently launched by the White House, to establish a current baseline, identify gaps, and catalog opportunities for integration within the federal government. The Moonshot will generate a database of existing programs and a budget cross-cut analysis to identify current funding levels. The report will incorporate the NIHHIS Extreme Heat Strategy and identify existing funding opportunities, including those in the IRA, Bipartisan Infrastructure Law, and agency programs. The Moonshot will also work with CDC and NIHHIS to develop a method to identify heat deaths to establish a baseline for tracking progress on the goals. 

Recommendation 3. Build broad community support.

The Moonshot should convene conversations and conduct regional extreme heat workshops with state, local, and tribal government personnel; external experts and stakeholders; Justice40 community leaders; professional associations; private sector representatives; and philanthropies. Topics should span the spectrum of social infrastructure, including social cohesion, public health, insurance, infrastructure, communications, and more. Based on input, the Moonshot will establish an advisory committee of non-government participants and develop pathways to connect stakeholders with federal community-focused climate resilience programs, including the White House’s Justice 40 program, EPA’s Environmental Justice Thriving Communities Technical Assistance Centers Program, and the Department of Transportation’s Thriving Communities Network, and other relevant federal programs identified in Recommendation 2. The Moonshot would add extreme heat as a covered issue area in these programs.

Recommendation 4. Make a plan.

The Moonshot should expand upon the NIHHIS Extreme Heat Strategy and make a heat action plan uplifting human health and community access to harness the potential of federal heat programs. The plan would assign roles, responsibilities, and deadlines and establish a process to track and report progress annually. In addition, the Moonshot would expand the NCR Framework to include an implementation plan and establish a human-centric approach. The Moonshot will evaluate co-benefits from heat reduction strategies, including the role cool surfaces play in protecting public health while also decreasing smog, reducing energy use, and solar radiation management. And, consistent with the Biden Administration’s 2025 priorities, the Moonshot will support research and development on emerging technologies such as microfiber fabrics that keep people cool during heat waves, temperature-sensitive coatings, and high-albedo reflective materials that can reduce the need for mechanical air-conditioning. Innovation is especially needed related to resurfacing the nation’s aging roadways.

The Moonshot will also include a communications plan to increase awareness of federal programs and funding opportunities to combat extreme heat. This should all be in place in nine months to prepare for the FY 2026 budget. The NIHHIS and CDC will develop an enhanced method for improving the accuracy of tracking heat deaths. 

Recommendation 5. Connect with people and communities.

The Moonshot should emphasize social infrastructure projects and facilitate access to funding by establishing a centralized portal for comprehensive local heat action planning and programs. The Moonshot will help build cool, safe, healthy communities by integrating heat into federal climate equity programs and supporting local heat plans and projects that reflect community input and priorities. Local heat plans should be comprehensive and integrate a suite of actions that emphasize social infrastructure and include built infrastructure and natural infrastructure. 

Recommendation 6. Initiate all-of-government action.

The Moonshot will catalyze the implementation of the plan across the government, including all the agencies and departments identified in Recommendation 1. It will establish the grant portal to enhance access to federal resources for heat-related projects for state, local, tribal, and territorial governments, and community groups. It will launch a communications plan targeting press, social media, public employees at all levels of government, stakeholders, and more. 

Recommendation 7. Support legislation to secure long-term success 

In coordination with the White House Office of Legislative Affairs and Office of Management and Budget (OMB), the Moonshot should work with Congress to draft and support federal legislation and appropriations addressing extreme heat. Congressional authority is needed to firmly establish this human-centric approach to extreme heat. The Moonshot may recommend Congressional hearings on legislation or a Congressional commission to review the Administration’s work on heat. For example, the passage of S. 2645 would enshrine the position of NIHHIS in law. The Moonshot will help Congress fulfill its role in the all-of-government response and help empower local action. 

Costs

Using information gathered in Recommendation 2, the Moonshot will focus on capturing and directing existing federal funding, including from the IRA, BIL, agency budgets, and grant programs to uplift actions addressing extreme heat and implementing the Moonshot action plan. Initial costs should be minimal: $1 million to hire the Executive Director and two staff and to report on existing programs, funding, and agency budgets. The Moonshot will produce a budget cross-cut initially and annually thereafter and assemble a budget proposal for the WHIWG on Extreme Heat for the FY 2025 and FY 2026 budget.

The Moonshot recommendation is aligned with the OMB Budget Memo of August 17, 2023, which transmits Guidance for Research and Development Priorities for the FY 2025 Budget. The OMB priorities call for addressing climate change by protecting communities’ health and mitigating its health effects, especially for communities that experience these burdens disproportionately.

Conclusion

Extreme heat is a serious public health problem disproportionately impacting many vulnerable populations, and the threat is increasing tremendously. So far in winter 2023, more than 130 monthly high-temperature records were set across the U.S. 

The federal government has several programs addressing the threat of extreme heat in the U.S., and the WHIWG reflects the all-of-government approach needed to meet the threat. The next step is to capture the full potential of existing programs and funding by launching a focused and intensive National Moonshot to Combat Extreme Heat with quantitative goals to track and reduce heat deaths and build healthy communities. This  effort will enable state and local governments and communities, especially those disproportionately impacted by extreme heat, to more readily access federal funding to develop and implement comprehensive heat action plans. The Moonshot will reduce heat deaths, improve the quality of life in cities, and reduce economic productivity loss while increasing the visibility of federal leadership on this issue. 

With heat season 2024 beginning on April 29th, it’s essential to establish an all-of-government response to address extreme heat at all levels.

This idea of merit originated from our Extreme Heat Ideas Challenge. Scientific and technical experts across disciplines worked with FAS to develop potential solutions in various realms: infrastructure and the built environment, workforce safety and development, public health, food security and resilience, emergency planning and response, and data indices. Review ideas to combat extreme heat here.

Frequently Asked Questions
What entities are partners in NIHHIS?

Federal agencies involved in NIHHIS include: National Oceanic and Atmospheric Administration, Centers for Disease Control and Prevention, Administration for Community Living, Administration for Children and Families, Administration for Strategic Preparedness and Response, Environmental Protection Agency, Department of Housing and Urban Development, Federal Emergency Management Agency, Department of Defense, Department of Energy, Department of Transportation, National Institute for Occupational Safety and Health, Department of Veterans Affairs, US Census Bureau, Forest Service, National Park Service, Department of Health and Human Services, National Institute of Environmental Health Sciences, Occupational Safety and Health Administration, Substance Abuse and Mental Health Services Administration, and United States Agency for International Development.

Non-federal partners include, but are not limited to: CAPA Strategies, ESRI, Global Cool Cities Alliance, National League of Cities, and Global Heat Health Information Network.

For America to Become Climate Resilient, We Need Innovative Policy Solutions to Address The Extreme Heat Crisis

As 2023 was the hottest year on record, America must start to prepare for even hotter years in the future. To meet this moment, the Federation of American Scientists (FAS) has launched the Extreme Heat Policy Sprint, an initiative to accelerate experts’ high-impact policy recommendations to comprehensively address the extreme heat crisis.

The urgency of this initiative is underscored by global average temperatures soaring to a record 2.63°F (1.46°C) increase from pre-industrial levels and heat-related mortalities forecasted to surge 370% within the next three decades. In Maricopa County, Arizona alone, at least 579 people lost their lives to heat last year, with senior citizens accounting for one in three deaths. This staggering number is widely considered an undercount, as heat-related mortalities are difficult to document.

With heat being the top weather-related killer of Americans and the nation having faced the hottest summer on record, the federal government made the largest resourcing of extreme heat mitigation in history last year. The United States Department of Agriculture (USDA) distributed $1 billion in grants to projects expanding urban tree canopies to reduce average temperatures during extreme heat events, amongst other co-benefits like flood reduction and improved public health outcomes. In addition, the National Oceanic and Atmospheric Administration (NOAA) provided $5 million in funding for two centers of excellence to deliver actionable, place-based climate information for community heat resilience. These efforts were complemented by the Federal Emergency Management Agency’s (FEMA) distribution of $1.8 billion through two grant programs designed to help communities increase their resilience to the impacts of climate change, including extreme heat. 

Despite these federal programs, the resourcing needs for future extreme heat conditions are growing exponentially, with anticipated exposure to dangerous heat (>125 °F) expected to impact 107.6 million Americans by 2053. Several key U.S. cities are expected to experience risky wet bulb temperatures of +87°F, which would trigger deadly heat stress and stroke in vulnerable populations within just a few years. These conditions would completely suspend safe outdoor operations of the city during the summer months. Further, the exponential growth of cooling technology adoption across the country catalyzes increased demand for energy, thereby increasing fossil fuel emissions and straining electric grids to the point of risky blackouts. 

With such immense risks coming alarmingly soon, there is a need for transformative strategies to protect Americans from the heat where they live, where they work, and in their communities. Resilience to heat must be included in nationwide planning and management. The built environment must be adapted to chronic, sustained heat. Novel resilient cooling technologies need to be brought rapidly to market. Communities need climate services that include heat risk and offer regionally-specific solutions. The full health and economic costs of heat must be accounted for and responded to. All of this requires integrating heat resilience into every part of the federal government and developing new governance models for climate and health, focusing on adaptation-forward, people-centered disaster response approaches.  

Introducing the Participants of the Extreme Heat Policy Sprint

This critical situation sets the stage for the pivotal contributions of the experts in the Extreme Heat Policy Sprint. Each of these professionals offer innovative and impactful policy recommendations, drawing from diverse areas of expertise, including but not limited to climate resilience, health care, public policy, law, and urban planning. This collaboration is essential in shaping effective federal strategies to mitigate the far-reaching impacts of extreme heat on communities nationwide.

Infrastructure and the Built Environment

Workforce Safety and Development

Public Health and Preparedness

Food Security

Planning and Response

Data and Indices

Leveraging Positive Tipping Points to Accelerate Decarbonization

Summary

The Biden Administration has committed the United States to net-zero emissions by 2050. Meeting this commitment requires drastic decarbonization transitions across all sectors of society at a pace never seen before. This can be made possible by positive tipping points, which demarcate thresholds in decarbonization transitions that, once crossed, ensure rapid progress towards completion. A new generation of economic models enables the analysis of these tipping points and the evaluation of effective policy interventions. 

The Biden Administration should undertake a three-pronged strategy for leveraging the power of positive tipping points to create a larger-than-anticipated return on investment in the transition to a clean energy future. First, the President’s Council of Advisors on Science and Technology (PCAST) and the Council of Economic Advisors (CEA) should evaluate new economic models and make recommendations for how agencies can incorporate such models into their decision-making process. Second, federal agencies should integrate positive tipping points into the research agendas of existing research centers and programs to uncover additional decarbonization opportunities. Finally, federal agencies should develop decarbonization strategies and policies based on insights from this research.

Challenge and Opportunity

Climate change brings us closer each year to triggering negative tipping points, such as the collapse of the West Antarctic ice sheet or the Atlantic Meridional Overturning Circulation. These negative tipping points, driven by self-reinforcing environmental feedback loops, significantly accelerate the pace of climate change. 

Meeting the Biden Administration’s commitment to net-zero emissions by 2050 will reduce the risk of these negative tipping points but requires the United States to significantly accelerate the current pace of decarbonization. Traditional economic models used by the federal government and organizations such as the International Energy Agency consistently underestimate the progress of zero-emission technologies and the return on investment of policies that enable a faster transition, resulting in the agency’s “largest ever upwards revision” last year. A new school of thought presents “evidence-based hope” for rapidly accelerating the pace of decarbonization transitions. Researchers point out that our society consists of complex and interconnected social, economic, and technological systems that do not change linearly under a transition, as traditional models assume; rather, when a positive tipping point is crossed, changes made to the system can lead to disproportionately large effects. A new generation of economic models has emerged to support policymakers in understanding these complex systems in transition and identifying the best policies for driving cost-effective decarbonization.

At COP26 in 2021, leaders of countries responsible for 73% of world emissions, including the United States, committed to work together to reach positive tipping points under the Breakthrough Agenda. The United Kingdom and other European countries have led the movement thus far, but there is an opportunity for the United States to join as a leader in implementing policies that intentionally leverage positive tipping points and benefit from the shared learnings of other nations. 

Domestically, the Inflation Reduction Act (IRA) and the Infrastructure Investment and Jobs Act (IIJA) include some of the strongest climate policies that the country has ever seen. The implementation of these policies presents a natural experiment for studying the impact of different policy interventions on progress towards positive tipping points.

How do positive tipping points work?

Figure 1. Diagram of a system and its positive tipping point. The levers for change on the left push the system away from the current high-emission state and towards a new net-zero state. As the system moves away from the current state, the self-reinforcing feedback loops in the system become stronger and accelerate the transition. At the positive tipping point, the feedback loops become strong enough to drive the system towards the new state without further support from the levers for change. Thus, policy interventions for decarbonization transitions are most crucial in the lead up to a positive tipping point. (Adapted from the Green Futures Network.)

Just as negative tipping points in the environment accelerate the pace of climate change, positive tipping points in our social, economic, and technological systems hold the potential to rapidly accelerate the pace of decarbonization (Figure 1). These positive tipping points are driven by feedback loops that generate increasing returns to adoption and make new consumers more likely to adopt (Figure 2):

The right set of policies can harness this phenomenon to realize significantly greater returns on investment and trigger positive tipping points that give zero-emission technologies a serious boost over incumbent fossil-based technologies.

Figure 2. Examples of positive feedback loops: (a) learning by doing, (b) social contagion, and (c) complementary technology reinforcement.

One way of visualizing progress towards a positive tipping point is the S-curve, where the adoption of a new zero-emission technology grows exponentially and then saturates at full adoption. This S-curve behavior is characteristic of many historic energy and infrastructure technologies (Figure 3). From these historic examples, researchers have identified that the positive tipping point occurs between 10% and 40% adoption. Crossing this adoption threshold is difficult to reverse and typically guarantees that a technology will complete the S-curve.

Figure 3. The historic adoption of a sample of infrastructure and energy systems (top) and manufactured goods (bottom). Note that the sharpness of the S-curve can vary significantly. (Source: Systemiq)

For example, over the past two decades, the Norwegian government helped build electric vehicle (EV) charging infrastructure (complementary technology) and used taxes and subsidies to lower the price of EVs below that of gas vehicles. As a result, consumers began purchasing the cheaper EVs, and over time manufacturers introduced new models of EVs that were cheaper and more appealing than previous models (learning by doing and economies of scale). This led to EVs skyrocketing to 88% of new car sales in 2022. Norway has since announced that it would start easing its subsidies for EVs by introducing two new EV taxes for 2023, yet EV sales have continued to grow, taking up 90% of total sales so far in 2023, demonstrating the difficult-to-reverse nature of positive tipping points. Norway is now on track to reach a second tipping point that will occur when EVs reach price parity with gas vehicles without assistance from taxes or subsidies.

Due to the interconnected nature of social and technological systems, triggering one positive tipping point can potentially increase the odds of another tipping point at a greater scale, resulting in “upward-scaling tipping cascades.” Upward-scaling tipping cascades can occur in two ways: (1) from a smaller system to a larger system (e.g., as more states reach their tipping point for EV adoption, the nation as a whole gets closer to its tipping point) and (2) from one sector to another. For the latter, researchers have identified three super-leverage points that policymakers can use to trigger tipping cascades across multiple sectors:

  1. Light-duty EVs → heavy-duty EVs and renewable energy storage: The development of cheaper batteries for light-duty EVs will enable cheaper heavy-duty EVs and renewable energy storage thanks to shared underlying battery technology. The build-out of charging infrastructure for light-duty EVs will also facilitate the deployment of heavy-duty EVs.
  2. Green ammonia → heavy industries, shipping, and aviation: The production of green ammonia requires green hydrogen as an input, so the growth of the former will spur the growth of the latter. Greater production of green hydrogen and green ammonia will catalyze the decarbonization of the heavy industries, shipping, and aviation sectors, which use these chemicals as fuel inputs.
  3. Traditional and alternative plant proteins → land use: Widespread consumption of traditional and alternative plant proteins over animal protein will reduce pressure on land-use change for agriculture and potentially restore significant amounts of land for conservation and carbon sequestration.

The potential for this multiplier effect makes positive tipping points all the more promising and critical to understand.

Further research to identify positive tipping points and tipping cascades and to improve models for evaluating policy impacts holds great potential for uncovering additional decarbonization opportunities. Policymakers should take full advantage of this growing field of research by integrating its models and insights into the climate policy decision-making process and translating insights from researchers into evidence-based policies. 

Plan of Action

In order for the government to leverage positive tipping points, policymakers must be able to (1) identify positive tipping points and tipping cascades before they occur, (2) understand which policies or sequences of policies may be most cost-effective and impactful in enabling positive tipping points, and (3) integrate that insight into policy decision-making. The following recommendations would create the foundations of this process.

Recommendation 1. Evaluate and adopt new economic models

The President’s Council of Advisors on Science and Technology (PCAST) and the Council of Economic Advisors (CEA) should conduct a joint evaluation of new economic models and case studies to identify where new models have been proven to be more accurate for modeling decarbonization transitions and where there are remaining gaps. They should then issue a report with recommendations on opportunities for funding further research on positive tipping points and new economic models and advise sub agenciessubagencies responsible for modeling and projections, such as the Energy Information Administration within the Department of Energy (DOE), on how to adopt these new economic models.

Recommendation 2. Integrate positive tipping points into the research agenda of federally funded research centers and programs.

There is a growing body of research coming primarily from Europe, led by the Global Systems Institute and the Economics of Energy Innovation and Systems Transition at the University of Exeter and Systemiq, that is investigating global progress towards positive tipping points and different potential policy interventions. The federal government should foster the growth of this research area within the United States in order to study positive tipping points and develop models and forecasts for the U.S. context.

There are several existing government-funded research programs and centers that align well with positive tipping points and would benefit synergistically from adding this to their research agenda:

Recommendation 3. Use insights from positive tipping points research to develop and implement policies to accelerate progress towards positive tipping points

Researchers have already identified three super-leverage points around which the federal government should consider developing and implementing policies. As future research is published, the PCAST should make further recommendations on actions that the federal government can take in leveraging positive tipping points.

Super-Leverage Point #1: Mandating Zero-Emission Vehicles (ZEVs) 

ZEV mandates require car manufacturers to sell a rising proportion of ZEVs within their light duty vehicles sales. Ensuring a growing supply of ZEVs results in falling costs and rising demand. Evidence of the effect of such policies in U.S. states, Canadian provinces, and China and future projections suggest that ZEV mandates are a crucial policy lever for ensuring a full EV transition. Such policies rely on the reallocation of private capital rather than government spending, making it particularly cost-effective. Combined with the investments in EV manufacturing and public charging infrastructure in the IRA and IIJA, a national ZEV mandate could radically boost the EV transition. 

A national ZEV mandate is unlikely to pass Congress anytime soon. However, the recently proposed Environmental Protection Agency (EPA) greenhouse gas emissions standards for passenger cars and trucks would effectively require 67% of car sales to be ZEVs by 2032 in order for car manufacturers to comply with the regulations. The proposed standards would provide regulatory strength behind the Biden Administration’s goal of 50% of new cars sold by 2030 to be ZEVs. The EPA should finalize these standards as soon as possible at or above the currently proposed stringency. 

The proposed EPA standards are projected to result in a 50% reduction in the price of EV batteries by 2035. This will have knock-on effects on the cost of batteries for renewable energy storage and battery electric trucks and other heavy-duty vehicles, which would likely bring forward the cost parity tipping point for these technologies by a number of years.

Super-Leverage Point #2: Mandating Green Ammonia Use in Fertilizer Production 

Ammonia is the primary ingredient for producing nitrogen-based fertilizer and requires hydrogen as an input. Traditionally, this hydrogen is produced from natural gas, and the production of hydrogen for ammonia accounts for 1% of global CO2 emissions. Green hydrogen produced from water and powered by renewable energy would enable the production of green ammonia for nitrogen-based fertilizers.

Based on a DOE tipping point analysis, green ammonia production is one of the most promising areas for initial large-scale deployment of green hydrogen, thanks to its ability to use established ammonia supply chains and economies of scale. Green ammonia production also has one of the lowest green premia in the hydrogen economy. Green ammonia production will enable infrastructure development and cost reductions for green hydrogen to decarbonize other sectors, including shipping, aviation, and heavy industries like steel. 

The Biden Administration should set a target for green ammonia production for domestic fertilizer in the Federal Sustainability Plan similar to India’s draft hydrogen strategy requiring 20% green ammonia production by 2027–2028. The EPA should then propose Clean Air Act carbon emission limits and guidelines for nitrogen-based fertilizer production plants, similar to the recently proposed standards for coal and natural gas power plants, to provide regulatory strength behind that target. These limits would effectively require fertilizer plants to blend a growing percentage of green ammonia into their production line in order to meet emission limits. According to the DOE, the clean hydrogen production tax credit in the IRA has enabled cost parity between green ammonia and fossil-based ammonia, so the EPA should be able to set such limits without increasing food production costs.

Super-Leverage Point #3: Public Procurement to Promote Plant and Alternative Proteins

Shifting protein consumption from meat to plant and alternative proteins can reduce emissions from livestock farming and reduce land use change for meat production. Plant proteins refer to protein-rich plants, such as nuts and legumes, and traditional products made from those plants, such as tofu and tempeh. Alternative proteins currently on the market include plant- and fermentation-based protein products intended to mimic the taste and texture of meat. Studies show that if plant and alternative proteins are able to reach a tipping point of 20% market share, this would ease up 7–15% of land currently used for agriculture to conservation and the restoration of its ability to serve as a carbon sink. 

Public procurement of alternative proteins for federal food programs leverages government spending power to support this nascent market and introduce new consumers to alternative proteins, thus increasing its accessibility and social traction. Last year, the National Defense Authorization Act established a three-year pilot program for the U.S. Navy to offer alternative protein options. The California state legislature also invested $700 million to support schools in procuring more plant-based foods and training staff on how to prepare plant-based meals.

The United States Department of Agriculture (USDA) is a major procurer of food through collaboration between the Agricultural Marketing Service (AMS) and the Food and Nutrition Service (FNS) and distributes the majority of procured food through the Child Nutrition Programs (CNPs), especially the National School Lunch Program (NSLP). Currently, AMS does not procure any traditional or alternative protein products made from plant protein, but USDA guidelines do allow traditional and alternative protein products to fulfill meat/meat alternate requirements for CNPs. The AMS should develop product specifications and requirements for procuring these types of products and assist traditional and alternative protein companies to become USDA food vendors. The FNS should then launch a pilot program spending, for example, 1% of their procurement budget on traditional and alternative protein products. This should be supported by education and training of food service workers at schools that participate in the NSLP on how to prepare meals using traditional and alternative proteins.

Conclusion

The sooner that positive tipping points that accelerate desired transitions are triggered, the sooner that decarbonization transitions will be realized and net-zero goals will be met. Early intervention is crucial for supporting the growth and adoption of new zero-emission technologies. The recommendations above present the foundations of a strategy for leveraging positive tipping points and accelerating climate action.

Acknowledgements

I’d like to acknowledge Erica Goldman for her generous feedback and advice on this piece and for her thought leadership on this topic at FAS.

FAQs about Leveraging Positive Tipping Points to Accelerate Decarbonization
What are the necessary conditions for a positive tipping point?

The key conditions for triggering a positive tipping point are affordability, attractiveness, and accessibility of new zero-emission technologies compared to incumbents. Affordability is often the most crucial condition: achieving price parity with incumbent technologies (with and then without the support of taxes and subsidies) can unlock rapid growth and adoption. Attractiveness refers to consumer preferences about a new technology’s performance, complementary features, or ability to signal social values. Accessibility refers to whether supporting infrastructure or knowledge, such as charging stations for EVs or recipes for cooking alternative proteins, is commonly available to support adoption. Due to the relative nature of these conditions, policymakers can influence them either by making the new technology more affordable, attractive, and accessible or by making the incumbent technology less affordable, attractive, and accessible. Often, a combination of both approaches is required to achieve the optimal effect.

Are federal policymakers the only actors that can trigger positive tipping points? What about state policymakers?

States can cooperate to identify and coordinate policies that activate upward-scaling tipping cascades into other states and eventually the federal government. A promising example of this is the growing adoption of California’s Advanced Clean Cars II EV sales mandate by Vermont, New York, Washington, Oregon, Rhode Island, New Jersey, Maryland, and soon Colorado, Massachusetts, and Delaware.

What about individuals and social movements?

Social contagion, mentioned above, is a powerful type of feedback loop that can drive the spread of not just technology adoption but also new behaviors, opinions, knowledge, and social norms. Through social contagion, social movement can be formed, capable of wielding greater influence than the sum of individuals. That influence can then translate into demands for government and industry action to decarbonize. A prime example is Greta Thunberg and the Fridays for Future student movement. Another example is the Social Tipping Point Coalition that in 2021 rallied a coalition of over 100 scientists, universities, nongovernmental and grassroots organizations, and other individuals to petition the new Dutch parliament to implement new climate policies.

What about industry stakeholders?

Industry has a direct hand in creating the conditions for a positive tipping point through their business models, technological development, and production. Industries are more likely to invest in adopting and improving low- and zero-carbon technologies and practices if the government clearly signals that it will back the transition, resulting in positive, reinforcing “ambition loops” between government climate policy and industry climate action. Industry coordination is also key to ensuring that new technologies are complementary and that infrastructure supporting a technology is developed alongside the technology itself. For example, coordination between EV companies is necessary to develop compatible charging mechanisms across manufacturers. Coordination between charging companies and EV companies can help charging companies identify which geographies have greatest demand for chargers.

What about international coordination?

International coordination strengthens positive feedback loops and accelerates cost reductions for green technologies. For example, a recent study suggests that if the three largest car markets—the United States, Europe, and China—implement zero-emission vehicle (ZEV) sales mandates (i.e., requirements that an increasing percentage of each car manufacturer’s sales must be EVs), EVs will be able to reach cost parity with gas vehicles five years sooner than in the scenario without those ZEV mandates.

What has the federal government done to identify or accelerate positive tipping points so far?

The U.S. Global Change Research Program’s 2022–2031 Strategic Plan includes tipping points and nonlinear changes in complex systems as two of its research priorities. Specifically, the Strategic Plan highlights the need to investigate “the potential for beneficial tipping points” and incorporate research on nonlinearity in economics-based models to evaluate societal decisions in future National Climate Assessments. However, it will take another four to five years to produce the next National Climate Assessment under this strategic plan. (The fifth National Climate Assessment, which is expected to be published this fall, was drafted before the new strategic plan was published.) Thus, additional executive and agency action is necessary to operationalize positive tipping points in the federal government before the next National Climate Assessment is released.

How can we track progress towards positive tipping points?

The federal government currently collects some data on the sales and adoption rates of the relatively more mature clean energy technologies, such as electric vehicles. A 2022 Bloomberg report attempted to identify “early-stage tipping points” at around 5% adoption for 10 clean energy technologies that reflect when their adoption becomes measurably exponential and compare their adoption curves across countries globally. Beyond adoption rates, a number of additional factors indicate progress towards positive tipping points, such as the number of companies investing in a zero-emission technology or the number of states adopting regulations or incentives that support zero-emission technologies in a sector. Tracking these indicators can help policymakers sense when a system is approaching a positive tipping point. The nonprofit Systems Change Lab currently tracks the adoption of decarbonization technologies and factors that affect decarbonization transitions on a global scale. Philanthropic funding or a public-private partnership with the Systems Change Lab could leverage their existing infrastructure to track tipping point indicators on a national scale for the United States.

What are the risks or potential unintended consequences to consider when crossing a positive tipping point?

Approaching a positive tipping point first requires a system to become destabilized in order to make change possible. Once a positive tipping point is crossed, the system then accelerates towards a new state and begins to restabilize. However, the destabilization during the transition can have unintended consequences due to the rapid shift in how social, economic, and technological systems are organized and how resources are distributed within those systems. Potential risks include economic precarity for people employed in rapidly declining industries and resulting social instability and backlash. This can potentially exacerbate inequality and undesirable social division. As such, policies ensuring a just transition must be implemented alongside policies to accelerate positive tipping points. Research on the interaction between these policies is currently ongoing. It is essential that decisions to develop policies that accelerate movement towards positive tipping points always consider and evaluate the potential for unintended consequences.

Six hot opportunity areas to beat the heat through federal policy

Extreme heat is the number one weather-related killer of Americans, yet receives minimal targeted federal support and dedicated funding for planning, mitigation, and recovery.

This summer, 130 million Americans were placed under some type of heat alert. National records for heat continue to be shattered each month, with July estimated to be the hottest month recorded on Earth. This relentless heat will continue to affect millions of Americans in August and for every summer to come. 

Extreme heat is the number one weather-related killer of Americans, yet receives minimal targeted federal support and dedicated funding for planning, mitigation, and recovery. Unlike other weather-related disasters, the consequences of extreme heat are hard to respond to and challenging to account for under current federal law. For starters, the Stafford Act does not consider extreme heat to be a Major Disaster (Sec. 102), barring sufficient coordinated federal action. Further, extreme heat is not only risky to infrastructure, like our power grids, roads, and homes, but also has devastating direct impacts on public health.

Prolonged exposure to extreme heat increases the risk of developing potentially fatal heat-related illnesses, such as heat stroke where the human body reaches dangerously high internal temperatures. If a person cannot cool down, especially when the nights bring no relief from the heat, this high core temperature can result in organ failure, cognitive damage, and death. These human health impacts are harder to account for in benefit-cost analyses that drive disaster preparedness funding allocations. Extreme heat is a crisis that impacts everyone. However, certain populations are more vulnerable to the increased health risks from heat, including older adults, outdoor workers, those with preexisting health conditions, low income communities, and people experiencing homelessness. 

Extreme heat also creates conditions that increase the likelihood and severity of other natural hazards, such as droughts and wildfires, further threatening public health. These compounding disasters put a major strain on national and global agricultural systems and threaten food security. This is particularly true for low-income communities as “heatflation” makes staple foods more unaffordable. 

We can better prevent, manage, and recover from extreme heat. With increased federal attention towards the effects of extreme heat and climate adaptation and resilience, there is an opportunity to take action. Federal policy can be a powerful lever of systems change, ensuring better coordination across federal agencies, state and local governments, and public and private sectors to beat the heat.

Starting now, the Federation of American Scientists is launching an Open Call for Extreme Heat Policy Ideas to source policy solutions to improve how the federal government coordinates a comprehensive response to heat. FAS is collecting ideas throughout Fall 2023 to prepare effectively for the next heat season. More information can be found by following this link.

FAS has completed a preliminary diagnosis of six opportunity areas for innovative extreme heat policy ideas that can make the most substantial impact on American heat resiliency: Infrastructure, Workforce, Public Health, Food Security, Planning and Management, and Data and Indices.

Infrastructure

Many Americans offset heat through increasing their use of air conditioning. Yet, this creates many issues, including the risk of overloading our electrical grids, equity concerns surrounding who has continuous access to air conditioning, and variance in the effectiveness of different air conditioning units. 1 in 4 Americans experience energy insecurity which puts them at risk of energy shut-offs, and Americans at large hold $19.3 billion in energy debt as of March 2023.

Further, AC units fail to address fundamental issues in infrastructure, such as the poor design of buildings or lack of building codes that specify maximum temperature inside buildings. A study done by CAPA Strategies and the Portland Bureau of Emergency Management on heat in public housing found that even units with AC saw observed temperatures consistently greater than 80℉, putting the health of residents at risk. Even more alarming, research has projected that in the event of a multi-day blackout during a heatwave, the heat-related mortality rate in Phoenix, Atlanta, and Detroit would increase dramatically. In Phoenix, more than 50% of the urban population would require medical attention. This calls into question an AC-only heat mitigation strategy. Rather, how we design and build our infrastructure can make our communities more heat resilient. 

Extreme heat presents multiple challenges to our current infrastructure, including concerns over grid and transportation resilience, lack of building codes for heat, lack of well-researched passive cooling technologies (i.e. non-air conditioning) to combat heat, and urban planning and design to beat the heat. Infrastructure investments, such as increasing grid resilience and creating more urban green space and nature-based solutions, can serve as preventive measures to keep communities cool as temperatures continue to rise. 

With the Bipartisan Infrastructure Law and the Inflation Reduction Act, several federal agencies have created programs that could address infrastructure concerns surrounding extreme heat. 

While these programs provide necessary support and funding to address infrastructure concerns, multiple gaps still persist. First, federal agencies may have capital but are not coordinated in their approach to addressing extreme heat and proactively building community resilience to heat. The Equitable Long-Term Recovery and Resilience Interagency Working Group has found difficulties in interagency coordination of notices of funding opportunities, place-based engagement for deployment of funds, direct technical assistance to communities, and maintenance of continuous sources of funding along a project’s timeline (i.e. ensure once infrastructure is built that there are people to upkeep passive infrastructure such as green spaces or people to staff active infrastructure like cooling centers). Without strategy and clarity for how communities should proceed and what they should invest in, there will be no sustainable change in infrastructure across the nation. 

Second, nuances in specific programs and the way grants are chosen through benefit-cost analysis (i.e. greater value to property damage over harder to quantify measures like impacts on human lives) may limit funding that goes to projects specifically focused on extreme heat. For example, while communities have been told that FEMA’s BRIC can fund extreme heat resilience, BRIC grant applications have been repeatedly rejected for extreme heat-related projects, a consequence of the “cost-effective” statute for BRIC. Even if a cooling center is approved, BRIC money cannot staff the center in the event of a disaster. 

Third, many jurisdictions around the country lack building codes that specify a maximum indoor temperature inside buildings as well as required strategies to mitigate extreme heat – contributing to heightened risk for individuals developing heat-related illnesses.  

Workforce

Rising temperatures place many members of the workforce, such as farmworkers and construction workers, at increased risk for heat-related illnesses. Extreme heat also leads to immense losses in workplace productivity, with research estimating a total annual loss of $100 billion to the U.S. economy. Without any measures to address the impacts of extreme heat in the future, this figure could double to $200 billion by 2030 and $500 billion by 2050. The Occupational Safety and Health Administration (OSHA) within the Department of Labor recently released a heat hazard alert which provides information to employers about how they should be protecting employees in extreme heat conditions as well as information on employees’ rights. With recent direction from the White House, OSHA will also increase its inspections and enforcement of violations in industries at higher risk for extreme heat, such as agriculture. Yet, OSHA is historically under-resourced in its ability to effectively carry out inspections and enforcement, with each inspector now responsible for securing the rights of 200,000 workers. 

This under-resourcing extends to OSHA’s ability to create a national standard for protection against extreme heat which is still years off from implementation. This leaves employee protection to state-level standards. Some states, including California and Oregon, have issued heat standards to protect workers. Yet, other states, such as Texas, have eliminated the requirement for employers to provide basic safety measures like water breaks. In this current system, employees are being put at significant risk. Providing employees consistent breaks for water and shade while working in extreme heat conditions is a simple way to mitigate these risks while lowering costs of workers’ compensation for employers in the event of a work-exposure related heat illness. 

Public Health

Each summer, extreme heat can cost the healthcare industry upwards of $1 billion dollars. Exposure to extreme heat, and often accompanying high humidity, can cause multiple heat-related illnesses, including heat cramps, heat exhaustion and heat stroke. The risks of developing severe symptoms are heightened by social and environmental factors, such as lack of access to air conditioning, shade, or transportation to medical centers. Individual factors, including types of medication being taken, can also increase sensitivity towards heat. Further, rising temperatures exacerbate negative mental health outcomes, such as fatigue and aggression

When patients with a heat-illness are admitted to the hospital, there are numerous limitations with coordination and response. Diagnostic codes, used for insurance claims, exist for heat-related illness. However, physicians may not recognize the symptoms of heat-related illnesses and instead diagnose and assign other related codes, such as dehydration. Therefore, patients may not be properly diagnosed and treated. This also leads to significant underreporting of the effects of extreme heat on health. 

Quick coordination and response by health care professionals is critical in preventing long-term damage. A nationwide survey by Americares found that less than 20% of staff in clinics feel that their clinics are “very resilient” to extreme weather. During the Northwest Heat Dome in 2021, a lack of coordinated public health preparation led to 229 deaths, more than any other disaster that year. In order to increase preparedness and timely response, it is essential for the public health workforce to be educated on best practices in responding to heat-illnesses. For example, after the Northwest Heat Dome, Seattle has begun to implement new plans for hospitals to meet to review best practices if extreme heat is forecasted, including checking whether centers have ice and body bags available. 

Extreme heat can also have unexpected consequences on public health. For instance, extreme heat creates favorable conditions for infectious disease carriers, such as ticks and fungal spores, to exist in areas of the country where they were historically unable to survive. Transmission of disease is also more likely as people congregate in community hubs, such as cooling centers or beaches. 

As heat waves become more frequent and intense across the nation, it’s critical to create standardized coordination efforts. The Office of Climate Change and Health Equity serves as a resource hub, producing a seasonal Climate and Health Outlook and the new Heat-Related Emergency Medical Services Activation Surveillance Dashboard. Yet, they are not federally funded and are therefore limited in their capacity to coordinate heat and health resilience. In terms of public health preparedness resources, the Center for Disease Control’s (CDC) Climate Ready States and Cities Initiative can only support nine states, one city, and one county, despite 40 jurisdictions having applied. The Trust for America’s Health (TFAH) found increasing funding from $10 million to $110 million is required to support all states, and improve climate surveillance. 

The threat of extreme heat speaks to a critical need for a funded agency or office to take a leadership role in the following three efforts: 1) strengthening holistic natural disaster resiliency and response efforts within the healthcare and public health sectors through interagency collaboration 2) orchestrating and supporting efforts to close information gaps, synthesize data, and identify practical applications of information on natural disasters and climate threats and 3) coordinate efforts to develop communication and education on climate-related health threats. 

Food Security

Extreme heat and its exacerbation of other natural hazards, including droughts, can have a significant impact on our agricultural productivity and food security. The COVID-19 pandemic has illustrated the impact of large-scale emergencies on our national and global food supply chains and distribution systems. 

Increases in temperature may directly cause a reduction in crop growth and agricultural yields by affecting plants’ growth cycle. Rising temperatures affect livestock, potentially leading to increased mortality and reduced production of certain products, such as milk and eggs. It also impacts the way food can be stored and transported. Changes in food supply can ultimately increase the costs of certain foods and thus may not be affordable for everyone, particularly low-income populations. 

Extreme heat also contributes to the creation of favorable conditions for droughts, increasing the risk for crop failure. For instance, in Texas and the Midwest, extended droughts are causing farmers to be concerned about their agricultural yields and placing too heavy of a reliance on irrigation systems. Over a thousand communities are currently under disaster designation by the USDA this summer because of extended drought exacerbated by extreme heat.

It is critical for resources to be devoted to the research and development of strategies to improve the heat resilience of crops and livestock given the economic unsustainability of evergreen emergency disaster assistance. A report by the Perry World House Center recommended specific strategies including restorative agriculture practices, diversifying crop production, and learning from indigenous agricultural practices. The US Department of Agriculture’s Climate Hubs provide information on climate resilience to inform decision-making by natural resource and agricultural managers – and would benefit from additional appropriations. Additionally, the USDA’s Partnerships for Climate Smart Commodities is investing $1 billion into financing pilot projects that use climate-smart practices, yet no projects focus explicitly on extreme heat resiliency. 

Planning and Management

Despite its immense impacts, extreme heat is not considered a hazard that can trigger a federal emergency declaration under the Stafford Act. Many agencies, such as the Department of Interior and Housing and Urban Development, are not able to unlock funds without an emergency declaration and supplemental appropriations from Congress, illustrating the need to create more active resilience measures for these agencies to strategically act on extreme heat. 

The lack of specific staff within agencies and overarching federal leadership for heat resilience, response, and recovery limits an effective and coordinated response. Communities need agencies to have the tools, guidance, and technical assistance needed for implementation of extreme heat resilience. Lastly, having no federal office with national responsibility for extreme heat presents a major risk as certain parts of the country reach the upper limits of human habitability despite all resilience efforts triggering potentially destabilizing internal climate migrations.

Within local and state governments, there is often no specific agency or officer responsible for heat. Currently, only a handful of local jurisdictions are beginning to experiment with different organizational structures to address heat, such as the appointment of a designated Chief Heat Officer in Miami-Dade, Florida. On the state and local level, there is a lack of research into which organizational structure is most effective and efficient at extreme heat mitigation and response. In addition, there’s no incentive from the federal government for local jurisdictions to create effective heat response personnel. 

Finally, many states and local jurisdictions fail to plan for heat as a part of their Hazard Mitigation Plans, often required by FEMA to unlock disaster preparedness and recovery investments. Yet, there are currently no best practices on how to plan and respond, beyond high-level, non-specific guidance documents from the CDC and Environmental Protection Agency, leaving each city to create their own plans of action.

Data and Indices

While heat blankets entire regions, its impacts are not felt equitably across the population. Urban heat island effects can make parts of cities far hotter – thus worsening the disaster for people residing in these zones. Further, there is a lack of consensus over how to name, categorize, and communicate the severity of extreme heat events. Heat is very context dependent. Temperature is not the only consideration in determining the severity of heat. Levels of humidity are an integral factor in determining the extent to which the human body can control internal temperature. 

Inadequate data collection can result in underestimating the severity of heat, particularly in urban neighborhoods. Localized factors, including neighborhood design and the infrastructure of individual buildings can exacerbate the severity and consequences of heat. Within one city or local jurisdiction, data for heat can vary by multiple degrees. When these temperatures are not accurately accounted for, it can contribute to lack of efficient planning and emergency management. The National Oceanic and Atmospheric Administration and the Center for Disease Control created the National Integrated Heat Health Information System (NIHHIS) to provide tools and information on extreme heat. While NIHHIS produces useful information, such as the vulnerability mapping tool and urban heat island mapping campaign with the EPA, there is still a gap in applying this information and connecting localities with useful data and information on which strategies are most effective at combating extreme heat. Since this issue is dependent on context and locality, it’s crucial to have a system that collects nuanced data that tracks all of the impacts of extreme heat. 

Issues in communicating extreme heat’s severity arise because different heat indices use different standards and ultimately communicate output at varying levels of severity. This contributes to confusion surrounding what temperatures should constitute extreme heat. For instance, heat index calculations are a common measurement that take humidity into account. However, the formula assumes that people are resting in the shade. On the other hand, Wet Bulb Globe temperature calculations use direct sunshine measurements and assume people are active. Both of these measurements assume people are healthy. Not only does this create confusion about which index to rely on, it also excludes and may underestimate the severity of heat in certain populations. Naming heat waves is one solution that’s been explored in Spain to make it easier to explain the severity of extreme heat to the public.

Extreme heat presents multiple challenges to our planning, response, and management systems. While the consequences of extreme heat can be deadly, they can be avoided with a coordinated and comprehensive federal response. If you’re feeling inspired to act, submit an idea to our Open Call for Extreme Heat Policy Ideas here.

Eliminate Billion-Dollar Disasters: Equitable Science-Based Disaster Policy for a Resilient Future

Summary

Every year, Americans lose billions of dollars to natural hazards. Hurricanes, wildfires, floods, heat waves, and droughts affect millions of Americans and are particularly devastating for low-income communities and communities of color. The number of ‘billion-dollar disasters’—those that cause over a billion dollars in damage—is rising as a result of climate change, urbanization, high risk developments, communities in vulnerable areas, aging infrastructure, and federal policy that rewards risk-prone behavior rather than incentivizing risk reduction. An overhaul of U.S. federal disaster policy will reverse the trend and eliminate billion-dollar disasters. This goal requires action at all levels of government, coordination across agencies, and leadership from the highest levels.

The Biden-Harris Administration should implement a multi-phase plan beginning with an executive order instructing federal agencies to define federal roles in disaster response, coordinate agency efforts, and integrate social justice and climate change into decision-making. Agency-level mandates will develop and implement best practices, incentivize state and local measures, and create an evidentiary basis for funding allocations. Finally, legislative reform of disaster laws will enable flexible responses to the continuing effects of climate change. A coordinated overhaul of federal laws and policies will inspire change at state and local levels, leading to a U.S. disaster policy that is climate-ready, addresses social inequities, reduces taxpayer liability and disaster damage, and saves lives.

Challenge and Opportunity

Disaster effects continue to worsen. Climate change is exacerbating hurricanes, floods, heat waves, and wildfires. Development and population growth in at-risk areas have placed more people, infrastructure, and economic activity in harm’s way. Serious disasters are more frequent and more costly (Figure 1). In 2019 alone, the U.S. experienced fourteen different billion-dollar disasters. In a five-month period that year, flooding affected eleven states: Oklahoma, Nebraska, Missouri, Illinois, Kansas, Arkansas, Kentucky, Tennessee, Texas, Mississippi, and Louisiana.

Federal aid is designed to be a last resort in disasters: the backstop when local and state resources have been overwhelmed. Current disaster policy and practice, however, results in disincentives for local governments to engage in proactive risk reduction. The more damage a county experiences, for example, the more money the county receives from the Federal Government, providing little incentive to adopt better building codes or limit development in risk-prone areas. The National Institute of Building Sciences estimates that updating and refining building codes alone could save $4 for every $1 spent—as well as save 600 lives, avoid 4,000 cases of post-traumatic stress disorder (PTSD), and create 87,000 new jobs (NIBS 2019). Despite this alternative approach, U.S. disaster policy emphasizes recovery rather than prevention. Only a fraction of disaster funding—just 15%—is spent on reducing future losses.

Figure 1.

Relief decisions use wealth and assets as measures of need, rather than people. The result is that disaster funding increases wealth inequality. There is also little evidence that the billions in disaster recovery paid by U.S. taxpayers each year has increased community resilience. According to the Government Accountability Office, nearly 45,000 new homes experienced repeat flood losses over the last decade, while less than half that number had their flood risk reduced through elevation, acquisition, or floodproofing.

The Federal Emergency Management Agency (FEMA) is a key organizer for federal response in the immediate aftermath of a disaster. In the long tail of recovery, though, other agencies— including the Department of Housing and Urban Development (HUD), Federal Transit Authority (FTA), U.S. Army Corps of Engineers (USACE), and Small Business Administration (SBA)— become involved. These agencies have significant and increasing spending authority and autonomy, but the risk reduction projects they prioritize and the reasons for their selection are often unclear or unavailable to researchers or the public. Projects are also not required to complement or support one another; each agency has its own mission, and there is little overarching coordination. At times, their actions may even work at cross-purposes.

Overhauling U.S. disaster policy will require a major effort across multiple levels and branches of government. This effort will not only limit but also potentially reverse the trend of increasing disaster costs. Disaster policy can create incentives for risk-smart development, promote climateproof investments in infrastructure, and protect society’s most vulnerable populations.

Plan of Action

A complete overhaul of U.S. disaster policy will require many actions across government branches. The following roadmap is a starting point: an initial set of steps to establish leadership, coordination, and a structure within which numerous actors can engage in a collaborative effort to build a disaster-resilient nation.

The plan is guided by the following principles:

Executive Branch

An executive order from the President or memorandum from the Office of Science and Technology Policy should direct agencies to address climate change and social equity in all federal actions. The order should provide a new mandate for inter-agency task forces such as the Mitigation Framework Leadership Group (MitFLG) to take, at minimum, the following actions:

Legislative Branch

Following the executive action, Congress should legislate reform both the National Flood Insurance Act of 1968 (NFIP) and the Stafford Act of 1988. Congress should adopt the guidelines made by inter-agency task forces and recommendations made by the hazard science community. Congress must deliberate on:

University and Government Research

New science is needed to create a more robust foundation of evidentiary knowledge. Through National Science Foundation calls and inter-agency task force member agencies commissioning National Academies Studies, funding should be allocated toward:

Frequently Asked Questions
How does this proposal fit into existing disaster resilience efforts?

Existing efforts at achieving disaster resilience need coordination and high-level direction to become priorities. Existing task forces (such as MitFLG) should be leveraged and given expanded membership and mandates to promote a more widely coordinated approach to disaster reduction and response. Executive Order 13653, “Preparing the United States for the Impacts of Climate Change” should be reinstated and additional guidance should be provided to state agencies on how to assess climate risk, how to promote incentives for resilience, and how to include equity in decision-making processes.

If hazards are expected to intensify and become more frequent due to climate change, do we have ways to reduce losses from disasters?
Yes! As Gilbert White said, “floods are ‘acts of god,’ but flood losses are largely acts of man.” The same logic can be applied to nearly all hazards. Decades of scientific research and empirical data have identified simple principles that are known to reduce disaster losses. These principles are: (1) avoid building in areas known to be hazardous, (2) protect and/or insure infrastructure in hazardous areas, (3) reduce carbon emissions, (4) protect the most vulnerable. The National Institute of Building Sciences estimates that updated building codes alone could save $4 for every $1 spent—as well as save 600 lives, avoid 4,000 cases of post-traumatic stress disorder (PTSD), and create 87,000 new jobs.
Why are agencies other than FEMA included? Does the problem not primarily lie with FEMA?
FEMA’s role is to coordinate emergency management following disasters that are beyond the ability of states to respond. FEMA also provides grants that support disaster mitigation, mitigation, preparedness, response, and recovery. Furthermore, the majority of the rules laid out by the Stafford Act apply to FEMA activities. However, in recent decades, numerous agencies have been allocated money by Congress in disaster relief authorizations. The Department of Housing and Urban Development (HUD) is now a primary disaster response funder, through the Community Development Block Grant Disaster Recovery (CDBG-DR) program. The US Army Corps of Engineers (USACE) takes primary responsibility for levees, dredging, and beach nourishment, and their decisions have important implications for disaster risk reduction policy. A wide range of other agencies—i.e., the Small Business Administration (SBA), the Department of Agriculture (USDA), etc.—disperse disaster funds. The Department of Education, for example, disperses funds for school recovery. While FEMA plays a central role in disaster management, the coordination between all of these agencies is a major area where improvement is needed.
Why should Congress reconsider elements of the Stafford Act?

The Stafford Act is supposed to position the Federal Government as the intervener of last resort. It allows the President to declare disaster, and then it generally reimburses state and local governments—and other public organizations—a minimum of 75% of the cost of damage to public infrastructure. FEMA makes disaster recommendations to the President based upon a uniformly-applied and highly-prescribed loss threshold. The process is known to be wrought with politicization and assumes that every location experiences disasters in the same way. We know that each community has unique resources and advantages and disadvantages; a political decision about disbursement runs contrary to the Federal Government as the intervener of last resort.


To truly establish the Federal Government as the intervener of last resort, Congress must reconsider the disaster threshold by taking into account local capacity and ability to recover. Congress must also reconsider the cost-share and whether different incentive models are better equipped to induce better local hazard-reduction decisions and improve long-term resilience. Finally, Congress must formally address the role of each agency—as opposed to FEMA alone— to ensure government efficiency and that actions are not at cross-purposes.

FEMA recommended significant changes to the Public Assistance Program in 2016 that may not require congressional approval. Are those changes sufficient?

No. FEMA recommended adopting a state-wide deductible which must be met before Public Assistance is made available. While a positive step, it only addressed one of scores of disaster relief programs, albeit the largest. Furthermore, the recommendation did not include an evaluation of whether the proposed structure would incentivize local change. It does not explicitly reward individual hazard-reducing behaviors, but rather evaluates hazard reduction at a state level.


However, this proposed rule makes a step in the right direction by stating that the deductible level should be influenced by local hazard exposure and ability to recover.

Is your position anti-growth?

No. In face of the climate crisis, the only way to ensure consistent long-term growth is to put policies and incentives in place that protect people and infrastructure. In the same way that smart growth urban planning guides development based on economic and social priorities, we encourage growth that aligns with hazard risk reduction goals.

Has a federal ‘push’ worked to change state and local approaches in other issue areas?

Seatbelts. The Federal Government passed the first seatbelt law, which required lap and shoulder belts in all vehicles beginning in 1968. Throughout the 1970s and 1980s, however, the effort to require states to implement seatbelt laws had limited success. But in 1985, Secretary Dole issued a rule requiring automakers to install driver side airbags in all vehicles, unless two-thirds of the states had passed a mandatory seatbelt law. This set off intense lobbying by automakers for bill passage in state legislatures. In 1998, an Executive Order (13043) mandated that all federal employees use seatbelts. As of 2020, only one state (New Hampshire) does not require seatbelts.


Clean Air. The 1990 Clean Air Act Amendments (CAAA) promulgated new air quality standards for acceptable levels of carbon monoxide, ground level ozone, and fine particulates. The 1991 Intermodal Surface Transportation Efficiency Act coordinated with CAAA by including directions on how cities and metropolitan areas were to demonstrate achievement of and progress toward air quality goals. These guidelines stated that transportation planning should emphasize system efficiency, and that in cities with severe air pollution, transportation projects must contribute to cleaner air. Urban areas were given flexibility to focus on local priorities and problems, with strict federal sanctions as incentives for compliance with both laws. The result has been a significant and continuing drop in criteria air pollutants.


Similarly, financial incentives for resilience (either carrots or sticks) could encourage state and local governments to use their authority to reduce risk exposure in their jurisdictions. This is the rationale behind the National Flood Insurance Program (NFIP) Community Rating System (CRS), which rewards communities who engage in resilience behaviors with lower insurance rates. The CRS could be improved by requiring local governments to take stronger actions to qualify for reduced rates and by increasing transparency about how community ratings are calculated. Additional incentives could be used to encourage state and local governments to take actions such as: adopt internationally recognized building codes, enforce building codes, zone hazardous lands for no or low-density development, charge externality fees for developers, and invest in stormwater management upgrades.


This was also the rationale behind FEMA recommendations in 2016 that would have required states to contribute a set amount towards disaster recovery (a ‘disaster deductible’) before Public Assistance would be made available. The amount of the deductible could be reduced if the state demonstrated that it had taken actions to reduce risk exposure. We recommend that this and similar programs be revisited and strengthened.

Extreme Weather Threatens Military Facilities

Extreme weather events and rising sea levels are causing damage to U.S. military facilities and could threaten U.S. military infrastructure around the world.

“Is the military ready for climate change?,” asked Rep. John Garamendi (D-CA). “It is not.”

“In the last 12 months, severe storms have devastated Marine Corps Base Camp Lejeune, Marine Corps Air Station Cherry Point, Tyndall Air Force Base, and Offutt Air Force Base,” he said during the House debate on the FY2020 defense authorization bill on July 10.

The defense bill that was passed by the House therefore included several provisions to require the Department of Defense “to plan for and respond to the threat that climate change poses to military installations and military operations.”

Similar requirements to incorporate weather projections in defense facility planning were included in the Senate version of the pending defense authorization bill.

On a political plane, there are still ideologically-driven disparities in perception of the threat of climate change. But those disparate perceptions may soon be overtaken by the reality of climate-induced damage, including damage to defense infrastructure.

“The Department of Defense (DOD) manages more than 1,700 military installations in worldwide coastal areas that may be affected by sea-level rise,” the Congressional Research Service observed in a new brief. See Military Installations and Sea-Level Rise, CRS In Focus, July 26, 2019.

“Hurricane Michael damaged every building on Florida’s Tyndall Air Force Base (repair estimate $4.7 billion),” CRS noted. “Hurricane Florence dropped 36 inches of rain, flooding three North Carolina Marine Corps installations (repair estimate $3.6 billion).”

Failure to act will incur increased costs, the Government Accountability Office warned in June.

“Not assessing risks or using climate projections in installation planning may expose DOD facilities to greater-than-anticipated damage or degradation as a result of extreme weather or climate-related effects,” GAO said. See Climate Resilience: DOD Needs to Assess Risk and Provide Guidance on Use of Climate Projections in Installation Master Plans and Facilities Designs, GAO-19-453, June 12, 2019.

“The effects of a changing climate are a national security issue with potential impacts to Department of Defense missions, operational plans, and installations,” the Pentagon acknowledged in a January 2019 report to Congress (with a March supplement).

“Damage to communication, energy, and transportation infrastructure could affect low-lying military bases, inflict economic costs, and cause human displacement and loss of life,” warned outgoing Director of National Intelligence Dan Coats in January.

“Global environmental and ecological degradation, as well as climate change, are likely to fuel competition for resources, economic distress, and social discontent through 2019 and beyond,” he told Congress.

Trump Admin Would Curtail Carbon Capture Research

The Trump Administration budget request for FY 2018 would “severely reduce” Energy Department funding for development of carbon capture and sequestration technologies intended to combat the climate change effects of burning fossil fuels.

The United States has “more than 250 years’ worth of clean, beautiful coal,” President Trump said last month, implying that remedial measures to diminish the environmental impact of coal power generation are unnecessary.

Research on the carbon capture technology that could make coal use cleaner by removing carbon dioxide from power plant exhaust would be cut by 73% if the Trump Administration has its way.

“The Trump Administration’s approach would be a reversal of Obama Administration and George W. Bush Administration DOE policies, which supported large carbon-capture demonstration projects and large injection and sequestration demonstration projects,” the Congressional Research Service said this week in a new report.

“We have finally ended the war on coal,” President Trump declared.

However, congressional approval of the Administration’s proposal to slash carbon capture and sequestration (CCS) development is not a foregone conclusion.

“The House Appropriations Committee’s FY2018 bill funding DOE disagrees with the Administration budget request and would fund CCS activities at roughly FY2017 levels,” the CRS report said.

“This report provides a summary and analysis of the current state of CCS in the United States.” It also includes a primer on how CCS could work, and a profile of previous funding in this area. See Carbon Capture and Sequestration (CCS) in the United States, July 24, 2017.

Other new and updated reports from the Congressional Research Service include the following.

Methane and Other Air Pollution Issues in Natural Gas Systems, updated July 27, 2017

The U.S. Export Control System and the Export Control Reform Initiative, updated July 24, 2017

Base Erosion and Profit Shifting (BEPS): OECD Tax Proposals, July 24, 2017

Oman: Reform, Security, and U.S. Policy, updated July 25, 2017

Lebanon, updated July 25, 2017

Aviation Bills Take Flight, but Legislative Path Remains Unclear, CRS Insight, July 25, 2017

Military Officers, CRS In Focus, July 3, 2017

Military Enlisted Personnel, CRS In Focus, July 3, 2017

Transgender Servicemembers: Policy Shifts and Considerations for Congress, CRS Insight, July 26, 2017

Systematic, authorized publication of CRS reports on a government website came a step closer to reality yesterday when the Senate Appropriations Committee voted to approve “a provision that will make non-confidential CRS reports available to the public via the Government Publishing Office’s website.”

“Climate Change” Enters the DoD Lexicon

The term “climate change” was included for the first time in the latest revision of the Department of Defense Dictionary of Military and Associated Terms (Joint Publication 1-02), published last week.

Climate change is officially defined by DoD as “Variations in average weather conditions that persist over multiple decades or longer that encompass increases and decreases in temperature, shifts in precipitation, and changing risk of certain types of severe weather events.”

The new entry in the DoD Dictionary reflects a growing awareness of the actual and potential impacts of climate change on military operations.

The definition was originally proposed in the January 2016 DoD Directive 4715.21 on Climate Change Adaptation and Resilience.

“The DoD must be able to adapt current and future operations to address the impacts of climate change in order to maintain an effective and efficient U.S. military,” the January directive stated.

Department of Defense Confronts Climate Change

The Department of Defense is organizing itself to address the effects of climate change on the U.S. military, some of which are already being felt.

“The DoD must be able to adapt current and future operations to address the impacts of climate change in order to maintain an effective and efficient U.S. military,” according to a Pentagon directive that was issued last week. See Climate Change Adaptation and Resilience, DoD Directive 4715.21, January 14, 2016.

Among other things, the new directive requires the Under Secretary of Defense for Intelligence and the Director of National Intelligence to coordinate on “risks, potential impacts, considerations, vulnerabilities, and effects [on defense intelligence programs] of altered operating environments related to climate change and environmental monitoring.”

“The Department of Defense sees climate change as a present security threat, not strictly a long-term risk,” DoD said last year in a report to Congress.

“We are already observing the impacts of climate change in shocks and stressors to vulnerable nations and communities, including in the United States, and in the Arctic, Middle East, Africa, Asia, and South America…. Although DoD and the Combatant Commands cannot prepare for every risk and situation, the Department is beginning to include the implications of a changing climate in its frameworks for managing operational and strategic risks prudently.” See National Security Implications of Climate-Related Risks and a Changing Climate, DoD report to Congress, July 2015.

“We are almost done with a baseline survey to assess the vulnerability of our military’s more than 7,000 bases, installations, and other facilities,” wrote then-Secretary of Defense Chuck Hagel in a 2014 Climate Change Adaptation Roadmap. “In places like the Hampton Roads region in Virginia, which houses the largest concentration of US military sites in the world, we see recurrent flooding today, and we are beginning work to address a projected sea-level rise of 1.5 feet over the next 20 to 50 years.”

“Politics or ideology must not get in the way of sound planning,” Secretary Hagel wrote.

“The concept of global warming was created by and for the Chinese in order to make U.S. manufacturing non-competitive,” said Republican presidential candidate Donald J. Trump in a 2012 tweet that has been retweeted more than 24,000 times. (h/t Ed Husain)