May 9, 2017 President Donald J. Trump Executive Office of the President The White House 1600 Pennsylvania Avenue NW, Washington, DC 20500 Subject: Support for Continued U.S. Role in Paris Climate Agreement Dear President Trump: On behalf of the healthcare systems we individually represent—Catholic Health Initiatives, Dignity Health, and Trinity Health—we write to express our on-going support for U.S. leadership and engagement in the Paris Climate Agreement. As you carefully deliberate whether or not the U.S. will maintain its role, we urge you to keep America’s commitment to the Agreement. Our healthcare systems collectively serve communities across 35 states, providing care to a significant portion of the U.S. population. As the result of accelerating changes in the climate, we recognize on a daily basis the devastating current impacts and future threats to the health and well-being of those we serve. We are seeing the rising incidences of cardiac, respiratory, vector-borne, and mental health illnesses, and these rates are projected to worsen. The elderly, children and poor are hardest hit by climate impacts. We are compelled to act on climate change mitigation and adaptation strategies not simply by virtue of our responsibility as providers of health care, but by our faith-based calling and moral imperative to serve those most vulnerable and to protect the sanctity and dignity of all human life. We believe adherence to the terms of the Paris Climate Agreement is simply essential to the health of the U.S. and global populations. Our support of the Agreement reflects our organizations’ ongoing commitment to sustainability. As we steward precious healthcare resources and continue to plan for the transformation of healthcare in this country, we have been making strategic business decisions that align with the Agreement’s overall goals. We have set targets to minimize greenhouse gas emissions, increase our investments in renewable energy, further efforts to green our supply chain, operate more energy efficient facilities and advance other sustainable transitions that improve quality and cost-effectiveness of care. Doing our part to address climate change helps to meet the triple bottom line—healthy people, healthy economy, healthy planet. We know that healthcare is at a turning point in our country, and we remain committed to accelerating our ability to advance our healing missions into the future. Like other business leaders, we want to ensure that the U.S. can deliver on its promises. We are concerned about the political and economic risks of U.S. pulling out of the Paris Climate Agreement. Staying in the Agreement allows the U.S. to have a "voice at the table" and hedge against the risks to trade negotiations, international reputation, and other unforeseen consequences of doing business abroad when there is such strong international support. Leveraging U.S. resolve and strength could further energize climate and energy innovations domestically and influence other nations and sub-nationals to follow lead, encouraging others to take up their part in caring for our common home. Please keep the U.S. in the Paris Climate Agreement. It makes smart health and business sense. Thank you for your thoughtful consideration. President Donald J. Trump Subject: Paris Climate Agreement – Support Page 2 of 2 Sincerely, Kevin E. Lofton CEO Catholic Health Initiatives cc: Lloyd H. Dean President/CEO Dignity Health Richard J. Gilfillan, MD President & CEO Trinity Health Gary D. Cohn, Assistant to the President for Economic Policy & Director - gary.d.cohn@who.eop.gov Rex W. Tillerson, Secretary of State – tillersonrw@state.gov – Fax: (202) 647-2283 Dina Powell, U.S. Deputy National Security Advisor for Strategy - dina.h.powell@who.eop.gov Wilbur L. Ross, Jr., Secretary of Commerce – wlross@doc.gov – Fax: 482-2741 James Richard "Rick" Perry, Secretary of Energy – rperry72@hq.doe.gov – Fax: (202) 586-4403 Jared C. Kushner, Senior Advisor to the President – jared.c.kushner@who.epp.gov – Fax: (202) 456-0192 Ivanka M. Trump, Special Assistant to the President – ivanka.m.trump@who.eop.gov – Fax: (202) 456-0192 About Catholic Health Initiatives Catholic Health Initiatives, a nonprofit, faith-based health system formed in 1996 through the consolidation of four Catholic health systems, expresses its mission each day by creating and nurturing healthy communities in the hundreds of sites across the nation where it provides care. The nation’s third-largest nonprofit health system, Englewood, Colorado-based CHI operates in 17 states and comprises 104 hospitals, including four academic health centers and major teaching hospitals as well as 30 critical-access facilities; community health-services organizations; accredited nursing colleges; home health agencies; living communities; and other facilities and services and services that span the inpatient and outpatient continuum of care. CHI employs approximately 98,000 full- and part-time employees throughout the system. In fiscal year 2016, CHI provided more than $1.1 billion in total financial assistance and community benefit – a 13% increase from the previous year – for programs and services for the poor, free clinics, education and research. Financial assistance and community benefit totaled more than $2 billion with the inclusion of the unpaid costs of Medicare. For more information, please visit www.catholichealthinitiatives.org. About Dignity Health Dignity Health, one of the nation’s largest health care systems, is a 22-state network of more than 9,000 physicians, 62,000 employees, and 400 care centers, including hospitals, urgent and occupational care, imaging centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to those who are poor and underserved. In FY16, Dignity Health provided $2.2 billion in charitable care and services. For more information, please visit our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook. About Trinity Health Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 93 hospitals, as well as 120 continuing care locations that include PACE, senior living facilities, and home care and hospice services. Our continuing care programs provide nearly 2.5 million visits annually. Committed to those who are poor and underserved, Trinity Health returns almost $1 billion to our communities annually in the form of charity care and other community benefit programs. We have 35 teaching hospitals with Graduate Medical Education (GME) programs providing training for 2,080 residents and fellows in 184 specialty and subspecialty programs. We employ approximately 97,000 full-time employees, including more than 5,300 employed physicians, and have more than 15,000 physicians and advanced practice professionals committed to 22 Clinically Integrated Networks that are accountable for 1.3 million lives across the country.