A Pledge for Tomorrow: What Signing the Health Sector Climate Pledge Means for Your Hospital

By: Diana Husmann, David Lamberson, Cami Lambert 

Climate change is no longer tomorrow’s threat. From record heat waves and flooding to life-threatening tornadoes and hurricanes, it is on our doorstep, creating devastation that takes a real toll on our communities.

Hospitals are not immune to these challenges. Relying on complex, interconnected infrastructure that’s often spread over dozens of acres, campus-based hospitals are uniquely vulnerable to high winds, flooding and power grid failures that are a hallmark of dangerous weather. Nevertheless, healthcare facilities must remain operational no matter what comes, both to protect current patients and help communities recover in the aftermath of extreme events.

Recognizing this, the White House and the U.S. Department of Health and Human Services (HHS) launched the Health Sector Climate Pledge on Earth Day 2022. Built around a three-step pledge that can help healthcare facilities reduce greenhouse gas (GHG) emissions and protect vital infrastructure from extreme weather, this voluntary commitment is an important step towards a more sustainable, less vulnerable future for healthcare in the United States.

Is your organization interested in signing the Health Sector Climate Pledge, but doesn’t know where to start on requirements like data collection, planning, monitoring and compliance? With a decades-long track record of helping hospitals reduce GHG emissions and harden their infrastructure against devastating weather events, Bernhard is uniquely positioned to help hospitals meet the goals of this important pledge.

Here’s how your organization can prepare to take the pledge.


Introduced by the White House and HHS in April 2022, the Health Sector Climate Pledge is a voluntary commitment to infrastructure resilience and emissions reduction by healthcare organizations in the U.S. There are three main commitments in the pledge:

  • Signees commit to reduce overall greenhouse gas emissions by 50% by 2030 (as compared to a baseline taken no earlier than 2008) and achieve net-zero emissions by 2050. Signees should also make public announcements of their progress toward these goals every year.
  • Signees commit to conduct an inventory of overall Scope 3 emissions by the end of 2024 and designate an employee at the executive level to spearhead progress on reducing emissions by the end of 2023.
  • By the end of 2023, signees commit to create and publicly release a Climate Resilience Plan for ensuring uninterrupted operation of critical services during extreme weather events. The plan should make an effort to anticipate the needs of groups in the local community that are particularly at risk of climate-related harm.

As of April 2023, 116 organizations representing 872 U.S. hospitals had signed the Health Sector Climate Pledge, including medical centers, insurance companies, pharmaceutical companies, health insurance companies and more.

Demand to sign beyond the October 2022 deadline was so great that on March 9, HHS announced they would accept new signatories to the pledge indefinitely. Under the revised rules, organizations can sign the pledge at any time, and will be recognized in official announcements by HHS issued twice each year. Organizations that submit their pledge form by November 1, 2023, will be included in an announcement during the 2023 United Nations Climate Change Conference.

Between public healthcare organizations and Federal health systems that have taken similar pledges, more than 1,100 private sector and government hospitals have joined the effort, representing more than 15% of hospitals in the United States.


While the three-step framework of the Health Sector Climate Pledge seems simple, anyone who has spent time in administration, maintenance or energy systems on a large campus understands what a lift it will be for many hospitals. Compliance requires complex monitoring, planning, resource allocation and reporting within a tight timeframe. It’s a big ask even for the most well-oiled organizations. There are, however, a few resources available that can help.

For example, if you’re interested in meeting the resilience planning requirements of the Health Sector Climate Pledge, the U.S. Climate Resilience Toolkit is particularly helpful.

Developed in cooperation with the National Oceanic and Atmospheric Administration (NOAA), the toolkit includes materials and resources to help hospitals evaluate their systems and prepare for climate-related disasters.

For hospitals, one of the most important tools in the toolkit is the Steps to Resilience process.


The Steps to Resilience process is designed to help organizations recognize, identify and make plans to address climate change-related vulnerabilities and risks to critical operations. Once issues have been identified, the process helps stakeholders prioritize issues, evaluate solutions and identify opportunities for improvement.

Before beginning the Steps to Resilience process, you should assemble a planning team. It  can be helpful to appoint a specific team leader for each step of the process.


Look closely at your organization’s most critical assets: the people, infrastructure and services that are crucial to your hospital’s ability to continue caring for patients and saving lives.

Consider how those assets might be disrupted by weather-related events like tornadoes, hurricanes and flooding, but also attacks on the power grid, chemical spills on nearby highways or railways, earthquakes, etc.

Ideally, you’ll want to document potential impacts with an exposure matrix, and inventory spatial, quantitative and qualitative data for later review with your organization’s planning team.


Collect information on how frequently various disasters have occurred in your region in the past, then determine whether climate change is likely to increase the likelihood or severity of those events over time. Consider these risks carefully.

Once you’ve identified and categorized the risks, use assessment rules to create impact statements and synthesize your findings for the planning team.


This step is the opportunity to review and consider your team’s findings from steps 1 and 2, then use the insights you’ve gained to explore strategies to protect critical assets in a disaster.

Be sure to research products or outside solutions that might improve various vulnerabilities and reallocate existing resources or low-cost workarounds. Work to identify which options would be most acceptable to your community.


In this step, it’s up to your team to design and write an implementation plan for the strategies you’ve identified. Prioritize risks and potential solutions by their impact on the overall resilience of your facility and mission-critical services.

Evaluate both resource allocation and budgetary cost of implementing the strategies you’ve identified. Avoid groupthink by giving your team room to address any doubts or uncertainties they might have without judgment. Finally, write an implementation plan that includes short, medium and long-term goals and priorities.


Planning is one thing. Execution is another. Now that you have an implementation plan, it’s time to take action. Identify and seek opportunities for funding or financing your identified strategies, including private and federal decarbonization grants. Create a plan to monitor your organization’s progress and share what you’ve learned, constantly adapting your strategies to the challenges and successes you see.


Greenhouse gas reduction is a complicated, incremental puzzle, and nobody has a crystal ball that can see the next catastrophic weather event.

With headquarters on the Gulf Coast and decades in the Energy-as-a-Service industry, Bernhard has helped hospitals all over the United States inventory and reduce Scope 1 and 2 GHG emissions and develop Climate Action Plans while strengthening critical infrastructure against the worst climate change can throw their way.

Reducing GHG emissions and protecting critical systems is what we do every day for dozens of clients. From Category 5 hurricanes to power blackouts, Bernhard knows how to help hospitals plan for and survive catastrophic events. We also understand how important setting and meeting actionable decarbonization goals can be to a large campus organization.

Our specialized decarbonization and infrastructure teams evaluate and find vulnerabilities others have missed, and turn infrastructure into resilient, closely monitored systems hospitals can trust when everything is on the line for their community.

It’s what we do. Bernhard is ready to help your large-campus hospital understand the Health Sector Climate Pledge, meet its requirements, and abide by its stipulations for years to come.