This report recommends taking the following steps to keep American waters clean and protect public health from disruptions and overflows in wastewater treatment systems: Integrate climate risk into all new wastewater infrastructure; Finance resilience improvements through state infrastructure banks; Prioritize resilience in state revolving-fund investments, accounting for regional differences in climate change vulnerability; Invest in green infrastructure and the protection and restoration of wetlands and coastal ecosystems to protect and supplement wastewater treatment systems.