1.Short title; table of
contents
(a)This Act may be cited
as the Retooling the Health Care
Workforce for an Aging America Act of 2009
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
TITLE I—Amendments to the Public Health Service Act
Subtitle A—Health professions education related to
geriatrics
Sec. 101. Geriatric education centers.
Sec. 102. Improving geriatric training for physicians,
dentists, and behavior and mental health professionals.
Sec. 103. Geriatric academic career awards.
Sec. 104. Geriatric Career Incentive Awards.
Sec. 105. National Center for Health Workforce
Analysis.
Subtitle B—Improved nursing services
Sec. 121. Comprehensive geriatric education nursing grant
program.
TITLE II—Amendments to the Workforce Investment Act of
1998
Sec. 201. Core services.
Sec. 202. Individual training accounts.
Sec. 203. Collaboration between State boards and the veterans
agencies of the States.
Sec. 204. Collaboration between Department of Labor and
Department of Veterans Affairs.
Sec. 205. Training opportunities for direct care
workers.
TITLE III—Amendments to the Older Americans Act of
1965
Sec. 301. Family caregiver training.
Sec. 302. Redesignations in provisions for multigenerational
and civic engagement activities.
Sec. 303. National Resource Center on Volunteers, Students, and
Seniors.
TITLE IV—Amendments to the Social Security Act
Sec. 401. Demonstration program for personal or home care
aides, nurse aides, and home health aides in long-term care
settings.
Sec. 402. Medicare family caregiver information and
referral.
Sec. 403. Medicaid assessment of family caregiver support
needs.
TITLE V—Studies and reports
Sec. 501. Studies and reports.
2.Congress finds the following:
(1)The United States
will not be able to meet near-term demands for chronic, geriatric, and
long-term care without a workforce that is prepared for the job.
(2)Between 2005 and
2030, it is estimated that the number of adults aged 65 and older will almost
double from 37,000,000 to over 70,000,000, increasing from 12 percent of the
population of the United States to almost 20 percent of the population.
(3)Because the
overall size of the population of older adults in the United States will
increase rapidly, the number of older adults in the United States who are
disabled will soar in the coming decades. Between 2000 and 2040 the number of
older adults who are disabled will more than double, increasing from an
estimated 10,000,000 to an estimated 21,000,000.
(4)A
2008 report by the Institute of Medicine of the National Academies, entitled,
“Retooling for an Aging America” concludes that the health care workforce will
lack the capacity, in both size and ability, to meet the needs of older
patients in the future unless action is taken immediately.
(5)Inadequate
training in geriatrics, gerontology, chronic care management, and long-term
care is known to result in misdiagnoses, medication errors, and inadequate
coordination of services and treatments that result in poor care and is costly
for the health care system as a whole.
(6)Currently, only 1
percent of all physicians (approximately 7,000) in the United States are
certified geriatricians, even as the population of older adults is on track to
double by 2030.
(7)Inadequate amounts
of time devoted to geriatric training are reported by ¼ of graduating medical
students, and close to ½ of graduating medical students say they are unprepared
to care for residents in nursing homes.
(8)Less than 1
percent of all nurses are certified gerontological nurses. Absent any change,
by the year 2020, the total supply of nurses in the United States is projected
to fall 29 percent below requirements, resulting in a severe shortage of
nursing expertise relative to the demand for care of medically complex, frail
older adults.
(9)Estimates suggest
that there are currently only 700 practicing geropsychologists in the United
States, falling far short of the current need for 5,000 to 7,500
geropsychologists.
(10)The Bureau of
Labor Statistics of the Department of Labor predicts that personal or home care
aides and home health aides will represent the second and third fastest-growing
occupations between 2006 and 2016. Yet personal or home care aides are not
subject to any Federal requirements related to training or education, and
States have very different requirements for personal or home care aides.
(11)Research shows
that inadequate training is a major contributor to high turnover rates among
direct care workers and more training is correlated with better staff
recruitment and retention rates.
(12)An estimated
44,000,000 family caregivers are being asked to provide increasingly complex
medical services to frail and elderly loved ones wishing to live at home.
Multiple surveys have documented that basic training and access to other
targeted services are necessary for family caregivers to provide consistent
quality care on an ongoing basis.
<enum>I</enum><header>Amendments to the
Public Health Service Act</header>
<subtitle id="H054FC15F5E99487B9B951DAF2634E423"><enum>A</enum><header>Health professions
education related to geriatrics</header>
<section id="H1B66B61FCD14489DB1B7800225CD69"><enum>101.</enum><header>Geriatric
education centers</header><text display-inline="no-display-inline">Section 753
of the Public Health Service Act (42 U.S.C. 294) is amended by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H29C7501602014FAE97D361F57EFCED" style="OLC">
<subsection id="HBC34D31F0162458181424BE9F9D95E37"><enum>(d)</enum><header>Grants To expand
and improve geriatric education centers</header>
<paragraph id="H9053D40DC7FE414995E5C27B053700D4"><enum>(1)</enum><header>In
general</header><text>The Secretary shall award grants or contracts under this
subsection to entities that operate a geriatric education center pursuant to
subsection (a)(1).</text>
</paragraph><paragraph id="HFC8B5F0EE6A4457A93DB55D1F4E2DE7F"><enum>(2)</enum><header>Application</header><text>To
be eligible for an award under paragraph (1), an entity described in such
paragraph shall submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may require.</text>
</paragraph><paragraph id="H4E08726CB7664FB5BCBC76A769AE64B7"><enum>(3)</enum><header>Use of
funds</header><text>Amounts awarded under a grant or contract under paragraph
(1) shall be used to—</text>
<subparagraph id="H8D9382031E6B4925865C8674B8CA2C95"><enum>(A)</enum><text>carry out the
fellowship program described in paragraph (4); and</text>
</subparagraph><subparagraph id="H53463014A20A40A7A6EF00EFBED9A560"><enum>(B)</enum><text>carry out 2 of the
3 activities described in paragraph (5).</text>
</subparagraph></paragraph><paragraph id="H6B30E099BABA4AE9B60309209C6CF205"><enum>(4)</enum><header>Fellowship
program</header>
<subparagraph id="H488C07AB9B5F493F916DD24EEA3B90A8"><enum>(A)</enum><header>In
general</header><text>Pursuant to paragraph (3), a geriatric education center
that receives an award under this subsection shall use such funds to offer
short-term intensive courses (referred to in this subsection as a
<quote>fellowship</quote>) that focus on geriatrics, chronic care management,
and long-term care that provide supplemental training for faculty members in
medical schools and other health professions schools with programs in
psychology, pharmacy, nursing, social work, dentistry, public health, or other
health disciplines, as approved by the Secretary. Such a fellowship shall be
open to current faculty, and appropriately credentialed volunteer faculty and
practitioners, who do not have formal training in geriatrics, to upgrade their
knowledge and clinical skills for the care of older adults and adults with
functional limitations and to enhance their interdisciplinary teaching
skills.</text>
</subparagraph><subparagraph id="H003CE24EC7CE4A9FBFED3CB88700E5BD"><enum>(B)</enum><header>Location</header><text>A
fellowship shall be offered either at the geriatric education center that is
sponsoring the course, in collaboration with other geriatric education centers,
or at medical schools, schools of nursing, schools of pharmacy, schools of
social work, graduate programs in psychology, or other health professions
schools approved by the Secretary with which the geriatric education centers
are affiliated.</text>
</subparagraph><subparagraph id="H3FE473C346694A5798EB07F46EC4D5B0"><enum>(C)</enum><header>CME
credit</header><text>Participation in a fellowship under this paragraph shall
be accepted with respect to complying with continuing medical education
requirements. As a condition of such acceptance, the recipient shall agree to
subsequently provide a minimum of 18 hours of voluntary instructional support
through a geriatric education center that is providing clinical training to
students or trainees in long-term care settings.</text>
</subparagraph></paragraph><paragraph id="H4B1F85448D774A549568E18219FDB1FD"><enum>(5)</enum><header>Additional
required activities described</header><text>Pursuant to paragraph (3), a
geriatric education center that receives an award under this subsection shall
use such funds to carry out 2 of the 3 activities:</text>
<subparagraph id="H9674A66223D04F4D8094AB315B16778B"><enum>(A)</enum><header>Family caregiver
training</header><text>A geriatric education center that receives an award
under this subsection shall offer at least 2 courses each year, at no charge or
nominal cost, to family caregivers that are designed to provide practical
training for supporting frail elders and individuals with disabilities. The
Secretary shall require such Centers to work with appropriate community
partners, including family caregivers and family caregiver organizations, to
develop training program content and to publicize the availability of training
courses in their service areas. All family caregiver training programs shall
include instruction on the management of psychological and behavioral aspects
of dementia, communication techniques for working with individuals who have
dementia, and the appropriate, safe, and effective use of medications for older
adults.</text>
</subparagraph><subparagraph id="H934DE0E9DA704888835C001CB5A5109E"><enum>(B)</enum><header>Direct care
working training</header><text>A geriatric education center that receives an
award under this subsection shall offer at least 2 courses each year to
certified nurse aides, home health aides, personal or home care aides and other
types of direct care workers on <quote>best practices</quote> for working with
frail elders and individuals with disabilities, including individuals with
dementia, urinary incontinence, and problems with balance or mobility, and
raising awareness of medication issues for older adults.</text>
</subparagraph><subparagraph id="HF155084AD46542A0AACE7C408FB27664"><enum>(C)</enum><header>Incorporation of
best practices</header><text>A geriatric education center that receives an
award under this subsection shall develop and include material on depression
and other mental disorders common among older adults, medication safety issues
for older adults, and management of the psychological and behavioral aspects of
dementia and communication techniques with individuals who have dementia in all
training courses, where appropriate.</text>
</subparagraph></paragraph><paragraph id="H8738A2A731DD4EE19C06318E4778A77B"><enum>(6)</enum><header>Targets</header><text>A
geriatric education center that receives an award under this subsection shall
meet targets approved by the Secretary for providing geriatric training to a
certain number of faculty or practitioners during the term of the grant, as
well as other parameters established by the Secretary, including guidelines for
the content of the fellowships.</text>
</paragraph><paragraph id="H21735944EB764DFC89135E93D84372A4"><enum>(7)</enum><header>Amount of
award</header><text>An award under this subsection shall be in an amount of
$150,000. Not more than 24 geriatric education centers may receive an award
under this subsection.</text>
</paragraph><paragraph id="H32FEE58F757D452686FE630E3FB2E9B"><enum>(8)</enum><header>Maintenance of
effort</header><text>A geriatric education center that receives an award under
this subsection shall provide assurances to the Secretary that funds provided
to the geriatric education center under this subsection will be used only to
supplement, not to supplant, the amount of Federal, State, and local funds
otherwise expended by the geriatric education center.</text>
</paragraph><paragraph id="H932F0DB08EE6470DAE84C3472F0039C6"><enum>(9)</enum><header>Authorization of
appropriations</header><text>In addition to any other funding available to
carry out this section, there is authorized to be appropriated to carry out
this subsection, $10,800,000 for the period of fiscal year 2011 through
2013.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H386C65CB631549479F5200B7AEA3ACFA"><enum>102.</enum><header>Improving
geriatric training for physicians, dentists, and behavior and mental health
professionals</header><text display-inline="no-display-inline">Section 753 of
the Public Health Service Act (42 U.S.C. 294), as amended by section 101, is
amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HADD994F701D34004AF06E2F7EF0057B7" style="OLC">
<subsection id="H05B0096609E048AFA70113A3DA09304B"><enum>(e)</enum><header>Geriatric
training for physicians, dentists, and behavior and mental health
professionals</header><text>An accredited school of medicine or osteopathic
medicine, an accredited psychology program, a teaching hospital, or a graduate
medical education program that receives an award under subsection (c) may use
the funds under such award to carry out a program to train individuals for
either 1 year, 2 years, or both, who are seeking a certificate of added
qualification or specialization in geriatrics for either 1 year, 2 years, or
both. Such a program may be located in a medical school or academic health
center that offers programs in 2 of the 3 disciplines described in subsection
(c)(5). Such program may fund the training of psychologists, psychiatric nurse
practitioners, and clinical social workers as part of the behavior and mental
health training
programs.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H457262C14AD8420D9100475C49DE26E2"><enum>103.</enum><header>Geriatric
academic career awards</header>
<subsection id="HEF75F04451C04B269DC50139335655F"><enum>(a)</enum><header>Expansion of
eligibility for geriatric academic career awards; payment to
institution</header><text>Section 753(c) of the Public Health Service Act (42
U.S.C. 294(c)) is amended—</text>
<paragraph id="HCFA973ADCF5A4CD2BFDB3377A85F94C6"><enum>(1)</enum><text>by striking
paragraph (2) through paragraph (3) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H10A8ABC3799149BF005F6129EF9D4800" style="OLC">
<paragraph id="HD007E361CF304B87955949D274457F56"><enum>(2)</enum><header>Eligible
individuals</header><text>To be eligible to receive an Award under paragraph
(1), an individual shall—</text>
<subparagraph id="HEC3B170E6EDB42F7A96006E4E59BEF9"><enum>(A)</enum><text>be board certified
or board eligible in internal medicine, family practice, or psychiatry or have
completed any required training in a discipline and employed in an accredited
health professions school that is approved by the Secretary, including
dentistry, pharmacy, nursing, social work, and psychology;</text>
</subparagraph><subparagraph id="H814580663F164EC0BDA056741DC1F6D6"><enum>(B)</enum><text>have completed an
approved fellowship program in geriatrics; and</text>
</subparagraph><subparagraph id="H6EFDA9F44B4B49709D2DCAC78C8400D9"><enum>(C)</enum><text>have a junior
(non-tenured) faculty appointment at an accredited (as determined by the
Secretary) school of medicine, osteopathic medicine, nursing, social work,
psychology, dentistry, pharmacy, or other allied health disciplines in an
accredited health professions school that is approved by the Secretary.</text>
</subparagraph></paragraph><paragraph id="H1D78ACD65AAB4885BF000156C3122EBB"><enum>(3)</enum><header>Limitations</header><text>No
Award under paragraph (1) may be made to an eligible individual unless the
individual—</text>
<subparagraph id="H68426F54426145FCBB8C22FD318C8B1C"><enum>(A)</enum><text>has submitted to
the Secretary an application, at such time, in such manner, and containing such
information as the Secretary may require, and the Secretary has approved such
application;</text>
</subparagraph><subparagraph id="H600E499830EE444EB4CA19844C31D51E"><enum>(B)</enum><text>provides, in such
form and manner as the Secretary may require, assurances that the individual
will meet the service requirement described in paragraph (5); and</text>
</subparagraph><subparagraph id="H2E6BFBF1094A4C99BF522D3400B449AE"><enum>(C)</enum><text>provides, in such
form and manner as the Secretary may require, assurances that the individual
has a full-time faculty appointment in a health professions institution and
documented commitment from such institution to spend 75 percent of the total
time of such individual on teaching and developing skills in interdisciplinary
education in geriatrics.</text>
</subparagraph></paragraph><paragraph id="HFD7CECF537ED4EE184A672D995BE059E"><enum>(4)</enum><header>Maintenance of
effort</header><text>An eligible individual that receives an Award under
paragraph (1) shall provide assurances to the Secretary that funds provided to
the eligible individual under this subsection will be used only to supplement,
not to supplant, the amount of Federal, State, and local funds otherwise
expended by the eligible individual.</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HCC0718961B51431DAB2F609CDB68F511"><enum>(2)</enum><text>in paragraph
(4)—</text>
<subparagraph id="H24755A0C3E3A4D16B145422EAD31DD94"><enum>(A)</enum><text>in subparagraph
(A)—</text>
<clause id="H4890A7E977AF4B9682B4BFB7D3DFCEE"><enum>(i)</enum><text>by
inserting <quote>for individuals who are physicians</quote> after <quote>this
section</quote>; and</text>
</clause><clause id="H2A09070B124E4C6F82001123D22C34C8"><enum>(ii)</enum><text>by
inserting after the period at the end the following: <quote>The Secretary shall
determine the amount of an Award under this section for individuals who are not
physicians.</quote>; and</text>
</clause></subparagraph><subparagraph id="HFF23CE88C8A94A45935D18A5305DF26C"><enum>(B)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H04735C89EDD74A2C008D6CB1BB2687A9" style="OLC">
<subparagraph id="HD7D52F19361745EC9ECF089ECD76BA38"><enum>(C)</enum><header>Payment to
institution</header><text>The Secretary shall transfer funds awarded to an
individual under this section to the institution where such individual will
carry out the award, in order to facilitate financial management of the reward
pursuant to guidelines of the Health Resources and Services
Administration.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="H34991AB5DB1043C7BB2F435D58989033"><enum>(b)</enum><header>Authorization of
appropriations</header><text>There are authorized to be appropriated to carry
out the amendments made by this section $6,000,000 for each of fiscal years
2011, 2012, and 2013.</text>
</subsection></section><section id="H90B3BD6F0B8141E4A0D1C45FF19D0600"><enum>104.</enum><header>Geriatric
Career Incentive Awards</header><text display-inline="no-display-inline">Section 753 of the Public Health Service Act
(42 U.S.C. 294), as amended by section 102, is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="H0A638FEE691749FA8CA0F59C592DF09D" style="OLC">
<subsection id="H104DC0A6A723470D8F791DE1110068AE"><enum>(f)</enum><header>Geriatric Career
Incentive Awards</header>
<paragraph id="H9DADE4F182794BA999A29F1757271DFD"><enum>(1)</enum><header>In
general</header><text>The Secretary shall award grants or contracts under this
section to individuals described in paragraph (2) to foster greater interest
among a variety of health professionals in entering the field of geriatrics,
long-term care, and chronic care management.</text>
</paragraph><paragraph id="H4C31A78721A540129B3654BB03D0FC5C"><enum>(2)</enum><header>Eligible
individuals</header><text>To be eligible to received an award under paragraph
(1), an individual shall—</text>
<subparagraph id="HFE68B74E89A940C2BC217E3D90E80128"><enum>(A)</enum><text>be an advanced
practice nurse (such as a clinical nurse specialist or nurse practitioner), a
clinical social worker, a pharmacist, or student of psychology who is pursuing
a doctorate or other advanced degree approved by the Secretary in geriatrics,
long-term care, geropsychology, or chronic care management in an accredited
health professions school that is approved by the Secretary; and</text>
</subparagraph><subparagraph id="H0D30E9050D04414EADCD3197C700F3E"><enum>(B)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</subparagraph></paragraph><paragraph id="HF25604FE70D54CA7BB0837E900AE855B"><enum>(3)</enum><header>Condition of
award</header><text>As a condition of receiving an award under this subsection,
an individual shall agree that, following completion of the award period, the
individual will teach or practice in the field of geriatrics, long-term care,
or chronic care management for a minimum of 5 years under guidelines set by the
Secretary.</text>
</paragraph><paragraph id="H57C7AD3F897C4A6585B48FC59076CFFD"><enum>(4)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this subsection, $10,000,000 for the period of fiscal years 2011 through
2013.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H871EFCBBF8BD4A378FF22C49EB0BAFF"><enum>105.</enum><header>National Center
for Health Workforce Analysis</header><text display-inline="no-display-inline">Part E of Title VII of the Public Health
Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HCB5EFD978BAF47B9AF2552E691848821" style="OLC">
<subpart id="HC83D3E0B759F446D843DBC001CE00FD"><enum>3</enum><header>National Center for
Health Workforce Analysis</header>
<section id="H9BCC54B014364ED092785EA2A100AE3D"><enum>774.</enum><header>Activities of
the National Center for Health Workforce Analysis</header><text display-inline="no-display-inline">In addition to any activities being carried
out at the National Center for Health Workforce Analysis of the Health
Resources and Services Administration as of the day before the date of
enactment of the <short-title>Retooling the Health Care
Workforce for an Aging America Act of 2009</short-title>, the head of such
Center shall analyze—</text>
<paragraph id="HF677E8E7D1F44B2E9493F99060360301"><enum>(1)</enum><text>current and
projected needs for health and long-term care workforce demand and supply, and
training and education needs specific to older adults and adults with
functional limitations;</text>
</paragraph><paragraph id="HF536C0BDA5344A7986CEE76720B7D335"><enum>(2)</enum><text>turnover and
retention for professionals and paraprofessionals in these fields, including
administrators, medical directors and direct care staff of nursing homes,
assisted living facilities and home and community-based settings, or any other
setting or provider the Secretary determines appropriate; and</text>
</paragraph><paragraph id="H8099617D55AD4195A01E019C9C960181"><enum>(3)</enum><text>diversity of
racial and ethnic minority groups represented by professionals and
paraprofessionals in these fields.</text>
</paragraph></section><section id="H5512F1343D554D5D843FA405B9EB6D23"><enum>775.</enum><header>Authorization
of appropriations</header>
<subsection id="H1E869FE9FE3C484AA572CA06336E001C"><enum></enum><text>There is
authorized to be appropriated to the National Center for Workforce Analysis to
carry out this subpart $6,000,000 for the period of fiscal years 2011 through
2013.</text>
</subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</section></subtitle><subtitle id="HE9F236600D0E459DB7888B62B5F7044"><enum>B</enum><header>Improved nursing
services</header>
<section id="H18B15A404FBA465CA2EFD33C84AAB8DE"><enum>121.</enum><header>Comprehensive
geriatric education nursing grant program</header><text display-inline="no-display-inline">Section 855 of the Public Health Service Act
(42 U.S.C. 298) is amended—</text>
<paragraph id="H5CEE54BDF6C14F22B5007769F7BE0C4"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (b)—</text>
<subparagraph id="HBEF475E4048C4BADBBF3006F7155D872"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (3), by striking
<quote>or</quote>;</text>
</subparagraph><subparagraph id="HF747966FA4474AD2B4C674E641AAA8A9"><enum>(B)</enum><text>in paragraph (4),
by striking the period and inserting <quote>; or</quote>; and</text>
</subparagraph><subparagraph id="H754D10FA435B4FB0985B747603252167"><enum>(C)</enum><text>by inserting after
paragraph (4) the following:</text>
<quoted-block display-inline="no-display-inline" id="H6926319111EC44AA95C3C8E64D66F7B" style="OLC">
<paragraph id="HCBE2A0CE2EB242BEAFF99753BE87B5D2"><enum>(5)</enum><text>establish Federal
traineeships to individuals who are preparing for advanced degrees in geriatric
nursing, long-term care, and gero-psychiatric
nursing.</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H6750859726D64D07A3E657E77DD624D1"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (e), by inserting before the
period the following: <quote>, $12,000,000 for each of fiscal years 2011
through 2013 to provide assistance under this section to support additional
training for nurses who care for the elderly and individuals with disabilities
and for the development and dissemination of curricula relating to geriatric
nursing care, the training of nursing faculty in geriatrics, and the provision
of continuing education for nurses practicing in geriatrics, and $25,000,000
for each of fiscal years 2011 through 2013 to provide assistance under this
section to support the Federal traineeships established under subsection
(b)(5)</quote>.</text>
</paragraph></section></subtitle><enum>II</enum><header>Amendments to the
Workforce Investment Act of 1998</header>
<section id="HA94363FE6E834FE1A06591614E7D2800"><enum>201.</enum><header>Core
services</header><text display-inline="no-display-inline">Section
134(d)(2)(E)(iii) of the Workforce Investment Act of 1998 (29 U.S.C.
2864(d)(2)(E)(iii)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H93D19B3C861E4D53881E9E0013F93382" style="OLC">
<clause id="HB4E6A783693F404E841BA81FCEBCA4B1"><enum>(iii)</enum><text>information
relating to local occupations in demand, including health care and long-term
care occupations, and the earnings and skill requirements for such local
occupations;</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H941EB6DAC619474AACC7E561BB04B0B0"><enum>202.</enum><header>Individual
training accounts</header><text display-inline="no-display-inline">Section
134(d)(4)(G)(iii) of the Workforce Investment Act of 1998 (29 U.S.C.
2864(d)(4)(G)(iii)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H246FFBFF4D0542A08B426DB7949C5EBA" style="OLC">
<clause id="H56000304B7D74B2FB66B43AEF14F1C21"><enum>(iii)</enum><header>Linkage to
occupations in demand</header><text>Training services provided under this
paragraph shall be directly linked to occupations, including health care and
long-term care occupations, that are in demand in the local area, or in another
area to which an adult or dislocated worker receiving such services is willing
to relocate, except that a local board may approve training services for
occupations determined by the local board to be in sectors of the economy that
have a high potential for sustained demand or growth in the local area. In
making determinations of demand or potential demand or growth under this
clause, a local board shall consult local and State health agencies, employers,
and other organizations that the local board determines to be
appropriate.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H509CA4001F35459391D45E1FABE389B0"><enum>203.</enum><header>Collaboration
between State boards and the veterans agencies of the States</header><text display-inline="no-display-inline">Section 112(b) of the Workforce Investment
Act of 1998 (29 U.S.C. 2822(b)) is amended—</text>
<paragraph id="H72EF6FB33ED34BCF0068A886967C9E3F"><enum>(1)</enum><text>in paragraph (17),
by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="HB10C8A466DA04EE9B5B68D2149166BF7"><enum>(2)</enum><text>in paragraph (18),
by striking the period and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="HABEF0A7B7250432787009BA29E77FCA8"><enum>(3)</enum><text>by adding at the
end the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H3FF6CD50DF30488EB28808D9663392EB" style="OLC">
<paragraph id="H3513934CA32A4B9DB91661E2B1E7D205"><enum>(19)</enum><text>a description of
how the State board will collaborate with the veterans agency of the State,
including entering into a memorandum of understanding with the veterans agency
of the State specifying—</text>
<subparagraph id="HA4FB8D0C7C4E4DFD86F924F1A89A827"><enum>(A)</enum><text>the manner in which
the State board and the veterans agency of the State will provide information
on health care workforce employment and training opportunities available to
individuals, including veterans who are receiving core services described in
section 134(d)(2) at a one-stop center and are receiving assistance from the
Veterans' Employment and Training Service of the Department of Labor;
and</text>
</subparagraph><subparagraph id="H1C48949EDF1B4B44846B6800769EC32F"><enum>(B)</enum><text>the manner in
which the State board and the veterans agency of the State will obtain and
provide information to one-stop operators in the State, for distribution
through one-stop centers, about training, internship, and employment
opportunities in geriatrics, gerontology, and long-term care, including, as
available, opportunities at geriatric research, education and clinical centers
operated by the Department of Veterans
Affairs.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HF04724994BF34B2F8300192BB9C8B351"><enum>204.</enum><header>Collaboration
between Department of Labor and Department of Veterans Affairs</header><text display-inline="no-display-inline">The Secretary of Labor, acting through the
Assistant Secretary for Veterans' Employment and Training, and the Secretary of
Veterans Affairs, shall develop memoranda of understanding outlining how
veterans seeking employment information through the Local Veterans' Employment
Representative Program and the Transition Assistance Program will be provided
with information about training, internship, and employment opportunities in
geriatrics, gerontology, and long-term care, including opportunities at
geriatric research, education and clinical centers operated by the Department
of Veterans Affairs.</text>
</section><section id="HF52D0B2EE1324FA094BF79ED87EF6D01"><enum>205.</enum><header>Training
opportunities for direct care workers</header>
<subsection id="H5713A2EC29524F8185DF14E34BFA4650"><enum>(a)</enum><header>In
general</header><text>Section 171 of the Workforce Investment Act of 1998 (29
U.S.C. 2916) is amended by adding at the end the following new
subsection:</text>
<quoted-block display-inline="no-display-inline" id="HD56AC1DBA3A542CCB2A2AEF8D59731DA" style="OLC">
<subsection id="H7BEBFC3231C542759C5F388E032CA3DD"><enum>(f)</enum><header>Training
opportunities for direct care workers</header>
<paragraph id="H09DA1010C3E5456E9662C21C5C621232"><enum>(1)</enum><header>In
general</header><text>The Secretary shall award grants to eligible entities to
enable such entities to provide new training opportunities for direct care
workers (including certified nursing assistants, home health aides, and
personal or home care aides) who are employed in long-term care settings such
as nursing homes (as defined in section 1908(e)(1) of the Social Security Act
(42 U.S.C. 1396g(e)(1)), assisted living facilities, home care settings, and
any other setting the Secretary determines to be appropriate.</text>
</paragraph><paragraph id="H59DE52ADC43D45DAB5DD48073415E171"><enum>(2)</enum><header>Eligibility</header><text>To
be eligible to receive a grant under paragraph (1), an entity shall—</text>
<subparagraph id="H40106C3BDB324F14B5DA6223C9AFF8C"><enum>(A)</enum><text>be an institution
of higher education (as defined in section 102 of the Higher Education Act of
1965 (20 U.S.C. 1002)) that—</text>
<clause id="H910A5718AFD64D38BA9E002C177418E6"><enum>(i)</enum><text>is
accredited by a nationally recognized accrediting agency or association listed
under section 101(c) of the Higher Education Act of 1965 (20 U.S.C. 1001(c));
and</text>
</clause><clause id="H34101F8740CB4948ADA802B81C07E357"><enum>(ii)</enum><text>has established a
public-private educational partnership with a nursing home, home health agency,
or other long-term care provider; and</text>
</clause></subparagraph><subparagraph id="H0D2B7517DF724849B9E42BABACAF24B4"><enum>(B)</enum><text>submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require.</text>
</subparagraph></paragraph><paragraph id="H0666A515DCF44FDE9B00A9FD407043D0"><enum>(3)</enum><header>Priority</header><text>In
making grants to eligible entities, the Secretary shall give priority to
entities that demonstrate that the entities will coordinate activities with
one-stop operators and one-stop partners at local one-stop centers referred to
in section 134(c).</text>
</paragraph><paragraph id="HAED1C5CF313E438F0069C4C1156D1971"><enum>(4)</enum><header>Use of
funds</header><text>An eligible entity shall use amounts awarded under a grant
under paragraph (1) to provide assistance to eligible individuals to offset the
cost of tuition and required fees for enrollment in academic programs provided
by such entity, including—</text>
<subparagraph id="HAA3B2FB0320C4CD09DDA2082502017AB"><enum>(A)</enum><text>the provision of
stipends to such individuals for a period of not to exceed 2 years;</text>
</subparagraph><subparagraph id="HC3BD8C9E4D724FDFB91B03B93B82FEF1"><enum>(B)</enum><text>the lowering of
fees assessed with respect to eligible individuals who are enrolled in programs
leading to a licensed practical nursing degree, a registered nursing degree, or
any other advanced nursing degree; and</text>
</subparagraph><subparagraph id="H29F55673FF3F440AB30700C3F1A44FBD"><enum>(C)</enum><text>the lowering of
fees assessed with respect to eligible individuals who are enrolled in courses
aimed at improving direct care skills for the treatment of specialized
conditions that are common in the long-term care sector, such as wound care,
brain trauma, immobility, incontinence, functional impairment, and
dementia.</text>
</subparagraph></paragraph><paragraph id="H77F8F5890F8446DE009EEB19E0AF79E8"><enum>(5)</enum><header>Eligible
individual</header>
<subparagraph id="H514A4C2BF34944A5981054C41169C609"><enum>(A)</enum><header>Eligibility</header><text>To
be eligible for assistance under paragraph (4), an individual shall be enrolled
in courses provided by a grantee under this subsection and maintain
satisfactory academic progress in such courses.</text>
</subparagraph><subparagraph id="HF8A561B3578041799EB14F36E756EDA0"><enum>(B)</enum><header>Condition of
assistance</header><text>As a condition of receiving assistance under paragraph
(4), an individual shall agree that, following completion of the assistance
period, the individual will work in the field of geriatrics, long-term care, or
chronic care management for a minimum of 2 years under guidelines set by the
Secretary.</text>
</subparagraph></paragraph><paragraph id="H0D6F957B408B44D5B3879BE034D5DB44"><enum>(6)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated to carry
out this subsection, $10,000,000 for the period of fiscal years 2011 through
2013.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H14DAC590843B4B43B7F1BE5E58FDD53C"><enum>(b)</enum><header>Conforming
amendments</header>
<paragraph id="H03060A419D40457D94747D5BCDE77BA7"><enum>(1)</enum><text>Section 174(b)(1)
of the Workforce Investment Act of 1998 (29 U.S.C. 2919(b)(1)) is amended by
inserting <quote>and except as provided in section 171(f),</quote> after
<quote>paragraph (2),</quote>.</text>
</paragraph><paragraph id="HEB3659D4DD9A45A29712DA848B7276DA"><enum>(2)</enum><text>Section
174(b)(2)(B)(ii) of the Workforce Investment Act (29 U.S.C. (b)(2)(B)(ii)) is
amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H670ED865D64040F59BFF971E7488E4DB" style="OLC">
<clause id="HB069328E8D2A4CD684ED161BF4BFE9D5"><enum>(ii)</enum><text>except as
provided in section 171(f), for each of the fiscal years 2000 through 2003,
reserve not less than 45 percent for carrying out section
171;</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><enum>III</enum><header>Amendments to
the Older Americans Act of 1965</header>
<section id="HCB9B8D290D3C42C686FDE8C455431DBA"><enum>301.</enum><header>Family
caregiver training</header>
<subsection id="H743644A7824C43ACAFBCEB8EF4B681D6"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Part E of title III
of the Older Americans Act of 1965 (42 U.S.C. 3030s et seq.) is amended by
adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HC0730425904843B9AF53F5FB1BC9CE89" style="OLC">
<section id="H7896E9437A0E4DE9864BBF70B0C767A1"><enum>375.</enum><header>Family
caregiver training</header>
<subsection id="H9CA35910780E4D90B4880024845F00F6"><enum>(a)</enum><header>Development of
materials</header>
<paragraph id="HF52208C0197046F0B83383663B58FFE6"><enum>(1)</enum><header>In
general</header><text>The Assistant Secretary shall, directly or by contract,
develop family caregiver training materials, working with an advisory
committee, comprised of experts on matters related to family caregivers,
including researchers, clinicians, representatives of nursing homes and State
Long-Term Care Ombudsman programs, representatives of community colleges and
vocational schools, family caregivers, and representatives of organizations for
family caregivers. The materials shall be suitable to provide online training
for family caregivers, and grandparents or older individuals who are relative
caregivers, in providing personal care to care recipients.</text>
</paragraph><paragraph id="HBB55AAEBE544426D817F007833A3C7E0"><enum>(2)</enum><header>Content</header><text>The
materials shall include written materials and videos, designed to be easily
downloaded, that demonstrate techniques for key personal care activities. The
materials shall demonstrate ways of safely lifting and transferring individuals
with disabilities, means of preventing falls, and other means of providing
assistance with activities of daily living, and instrumental activities of
daily living such as medication management. The materials shall provide
information on behavioral management and communication techniques for care
recipients that are individuals with Alzheimer's disease or a related disorder
with neurological and organic brain dysfunction.</text>
</paragraph></subsection><subsection id="H15B768BD3E7849B5AD120581BDFDBF00"><enum>(b)</enum><header>Distribution of
materials</header><text>The Assistant Secretary shall make the training
described in subsection (a)(1) available online, free of cost to users.</text>
</subsection><subsection id="H4FB14A91F00142FFA36CFD6265E48F65"><enum>(c)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HD96EB77AEC894764BD9916EF374BA8C"><enum>(1)</enum><header>Care
recipient</header><text>The term <term>care recipient</term>—</text>
<subparagraph id="H84899A889E0E48479B0631B53107E923"><enum>(A)</enum><text>used with respect
to a family caregiver, means an older individual or an individual with
Alzheimer's disease or a related disorder with neurological and organic brain
dysfunction; and</text>
</subparagraph><subparagraph id="H519566D28BB64017AD04B37E1382146D"><enum>(B)</enum><text>used with respect
to a grandparent or older individual who is a relative caregiver, means an
individual with a disability.</text>
</subparagraph></paragraph><paragraph id="H384DA14B021E4DF2B12F8211951C7995"><enum>(2)</enum><header>Community
college</header><text>The term <term>community college</term> means an
institution of higher education (as defined in section 101(a) of the Higher
Education Act of 1965 (20 U.S.C. 1001(a))) that offers a 2-year program of
study.</text>
</paragraph><paragraph id="H9857DC0BD9E54D8CA3A45162E3083F7F"><enum>(3)</enum><header>Individual with
a disability</header><text>The term <term>individual with a disability</term>
means an individual with a disability, within the meaning of section
372(a)(1).</text>
</paragraph><paragraph id="HBA01B3908FCD493FBE5B080066666E7E"><enum>(4)</enum><header>Vocational
school</header><text>The term <term>vocational school</term> means an area
career and technical education school, as defined in section 3 of the Carl D.
Perkins Career and Technical Education Act of 2006 (20 U.S.C.
2302).</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H28E1354137D74DEB88546691D09F4F05"><enum>(b)</enum><header>Authorization of
appropriations</header><text>Section 303(e) of the Older Americans Act of 1965
(42 U.S.C. 3023(e)) is amended—</text>
<paragraph id="H2ADF31FB76814449AD00D4512575CC26"><enum>(1)</enum><text>in paragraph (2),
by inserting <quote>, other than section 375</quote> after <quote>part
E</quote>; and</text>
</paragraph><paragraph id="H9C3A19AFFECB48069E2407784166B2B2"><enum>(2)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H250FBB677CA84043B8EAD7F1BE5816B4" style="OLC">
<paragraph id="HCBF89C219EB84EF6A9003D6FB199CD00" indent="up1"><enum>(4)</enum><text>There is authorized to be
appropriated to carry out section 375, $5,000,000 for the period of fiscal
years 2011 through
2013.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="H10476DBE562D4A32B0E097E6912228EA"><enum>302.</enum><header>Redesignations
in provisions for multigenerational and civic engagement activities</header>
<subsection id="HDABF0DAAF7144542B6C344FAA103D309"><enum>(a)</enum><header>Redesignations</header><text display-inline="yes-display-inline">Section 417 of the Older Americans Act of
1965 is amended—</text>
<paragraph id="HA31BC88E2CD945BE00D83CE4D054EA0"><enum>(1)</enum><text>in
subsection (a)—</text>
<subparagraph id="HBED63383A99F498E8C807FA4AEAFE4F"><enum>(A)</enum><text>in paragraph (1),
by redesignating subparagraphs (A) and (B) as clauses (i) and (ii),
respectively, and indenting accordingly;</text>
</subparagraph><subparagraph id="H8063B9E032C2436482EA72579985E5CB"><enum>(B)</enum><text>by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="H5ED59B55C1AD49AAA0A0273D80C7A200"><enum>(C)</enum><text>by inserting all
that precedes <quote>The Assistant Secretary</quote> and inserting the
following:</text>
<quoted-block display-inline="no-display-inline" id="HEAD5E4325DDE4D439807E8A4CE30F489" style="OLC">
<subsection id="H833B291E133942589500A1D400418200"><enum>(a)</enum><header>Demonstration,
support, and research projects</header>
<paragraph id="H6F5665C0A1E746B3BBADC585E3B87CCB"><enum>(1)</enum><header>Grants and
contracts</header>
</paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H7CB65BE9046E42B6A59C7542B3A5C2E1"><enum>(2)</enum><text>in subsection
(b)—</text>
<subparagraph id="H257AE0E9CBD64B1690DA7DAEDF1F8937"><enum>(A)</enum><text>by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="H30C4002F91284265B286350640E7FBC1"><enum>(B)</enum><text>by inserting all
that precedes <quote>An eligible</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H3E8CE283620A40DAAF39D31258261473" style="OLC">
<paragraph id="HE0F14D22A8454876B8508BDB3D00FB5F"><enum>(2)</enum><header>Use of
funds</header>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H6589155F87EF4CDEA44B489448C11290"><enum>(3)</enum><text>in subsection
(c)—</text>
<subparagraph id="H7EB323DB95C94720A646B5B2E9317DA7"><enum>(A)</enum><text>by redesignating
paragraphs (1) through (4) as subparagraphs (A) through (D), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="H010909CC0E024742AE50912E22A0C0BE"><enum>(B)</enum><text>by striking all
that precedes <quote>In awarding</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H70D79585FA544CAABCD297FB232779A8" style="OLC">
<paragraph id="H4E7563EB8177414D801F306C2CA14237"><enum>(3)</enum><header>Preference</header>
</paragraph><after-quoted-block>;
</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H3F3C349EF84B4C10938C775813E755B8"><enum>(4)</enum><text>in subsection (d),
by striking all that precedes <quote>To be</quote> and inserting the
following:</text>
<quoted-block display-inline="no-display-inline" id="H2ABD08B0D42D4924BF42376531DFF2C2" style="OLC">
<paragraph id="H2B44FD59D5204D6698FB37DED52D40EE"><enum>(4)</enum><header>Application</header>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H6FD16CF3FDE748BB8F4DDB418FDE791D"><enum>(5)</enum><text>in subsection
(e)—</text>
<subparagraph id="HF8F52A3AB0B74AA2A26B4200AFFEC660"><enum>(A)</enum><text>by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="HAA1183F7395247FD9328CC8689588C89"><enum>(B)</enum><text>by inserting all
that precedes <quote>Organizations</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HC249A8F6F2304A70BE2F5281464817B2" style="OLC">
<paragraph id="H3EF756F17EC546AEB02545D48B93484E"><enum>(5)</enum><header>Eligible
organizations</header>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HEF668E679C96434B84B606A0061A09"><enum>(6)</enum><text>in
subsection (f)—</text>
<subparagraph id="HD0D49E284DF042BEA69FCC6055A93895"><enum>(A)</enum><text>in paragraph (1),
by redesignating subparagraphs (A), (B), and (C) as clauses (i), (ii), and
(iii), respectively, and indenting accordingly;</text>
</subparagraph><subparagraph id="HFA4F142A4073404197D0C3F10689421E"><enum>(B)</enum><text>by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="HAB9F0FDA1BDE4055AF5300FD2665C0B3"><enum>(C)</enum><text>by inserting all
that precedes subparagraph (A) (as redesignated by subparagraph (B) of this
paragraph) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HD7A52E39A7534251AE6FDDA6FD1200D3" style="OLC">
<paragraph id="H4829A95244CF4C20B77294EA69FEAD9D"><enum>(6)</enum><header>Local evaluation
and report</header>
</paragraph><after-quoted-block>;
</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H8558167A79914AE0A505D3A13139234D"><enum>(7)</enum><text>in subsection
(g)—</text>
<subparagraph id="H5E27144BE02443A580B6D773FCE215E3"><enum>(A)</enum><text>by redesignating
paragraphs (1) through (8) as subparagraphs (A) through (H), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="H736B11449A904E0DB1CFF3A7E0753F46"><enum>(B)</enum><text>by inserting all
that precedes <quote>Not later</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H4C30D1AFB757436CB36D0046E51EFA93" style="OLC">
<paragraph id="HBBEB2BF1335244458E2F484000277299"><enum>(7)</enum><header>Report to
congress</header>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HBC52C9BD3FD44BA1BE855B07D7BED870"><enum>(8)</enum><text>in subsection
(h)—</text>
<subparagraph id="H74E42EA2E6F44A28A7147F4C9B79B798"><enum>(A)</enum><text>in paragraph
(2)—</text>
<clause id="HF6CD1F539D2D4914B0FFBC6F1B96DA22"><enum>(i)</enum><text>in
subparagraph (B), by redesignating clauses (i) and (ii) as subclauses (I) and
(II), respectively, and indenting accordingly; and</text>
</clause><clause id="HCFC349559B38472EA4A96253C851354"><enum>(ii)</enum><text>by
redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively,
and indenting accordingly;</text>
</clause></subparagraph><subparagraph id="H61659E4818C14C4788C4016B03DD005F"><enum>(B)</enum><text>by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and
indenting accordingly; and</text>
</subparagraph><subparagraph id="H87FCF6AA906246DCA258A6C0D0319788"><enum>(C)</enum><text>by inserting all
that precedes <quote>As used</quote> and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H20A41D62CAF64CDA9BE6643327CEDC5E" style="OLC">
<paragraph id="H2ECD9862981B4C12B055C8272B8D4514"><enum>(8)</enum><header>Definitions</header>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="HBA5C083E8F1E4FDD88000061F34EEF16"><enum>(b)</enum><header>Conforming
amendments</header><text>Section 417 of the Older Americans Act of 1965 is
amended—</text>
<paragraph id="HEC47B41F7F29434DB7F93234F936CA7C"><enum>(1)</enum><text>by striking
<quote>this section</quote> each place it appears and inserting <quote>this
subsection</quote>;</text>
</paragraph><paragraph id="H4DFC00CB4577417181287C6377C3008F"><enum>(2)</enum><text>by striking
<quote>subsection (a)(1)</quote> each place it appears and inserting
<quote>paragraph (1)(A)</quote>;</text>
</paragraph><paragraph id="H1DFC28B3762E4B45984000666CF27D18"><enum>(3)</enum><text>by striking
<quote>subsection (a)(2)</quote> each place it appears and inserting
<quote>paragraph (1)(B)</quote>;</text>
</paragraph><paragraph id="HC9E932E246004DD8AA07DF605256F42B"><enum>(4)</enum><text>except as provided
in paragraphs (2) and (3), by striking <quote>subsection (a)</quote> each place
it appears and inserting <quote>paragraph (1)</quote>; and</text>
</paragraph><paragraph id="H713B0B71378544DFB5305D044845C42C"><enum>(5)</enum><text>in subsection (a)
(as redesignated by subsection (a) of this section)—</text>
<subparagraph id="H2A039F77A6BC404D93823F19D5FDCC"><enum>(A)</enum><text>in paragraph (2)(B),
by striking <quote>subsection (f)</quote> and inserting <quote>paragraph
(6)</quote>; and</text>
</subparagraph><subparagraph id="H1F7D809ABCDE40CBB9002609E122C89C"><enum>(B)</enum><text>in paragraph
(7)—</text>
<clause id="HBF5CE08C82CD47EDB784588E21929E19"><enum>(i)</enum><text>in
the matter preceding subparagraph (A), by striking <quote>subsection
(f)(2)</quote> and inserting <quote>paragraph (6)(B)</quote>; and</text>
</clause><clause id="H47AC9B9075CB4AF39E66D2A250CCF45"><enum>(ii)</enum><text>in
subparagraph (G), by striking <quote>paragraph (1)</quote> and inserting
<quote>subparagraph (A)</quote>.</text>
</clause></subparagraph></paragraph></subsection></section><section id="H2821B36E39BB4665A978895CE684FDC"><enum>303.</enum><header>National
Resource Center on Volunteers, Students, and Seniors</header><text display-inline="no-display-inline">Section 417 of the Older Americans Act of
1965 (42 U.S.C. 3032f), as amended by section 302, is further amended by adding
at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HFB7A43D87CE94EF985755CCDB96075E8" style="OLC">
<subsection id="HD6785395A5964439A16E6F8395B76182"><enum>(b)</enum><header>National
Resource Center on Volunteers, Students, and Seniors</header>
<paragraph id="HC3B1EAD58CC64AD2AE9BB538D99FAAA"><enum>(1)</enum><header>In
general</header>
<subparagraph id="H63AC2AEAFA6D49A59510CDFDAEEDFE0"><enum>(A)</enum><header>Grant</header><text display-inline="yes-display-inline">The Assistant Secretary shall award a grant
for the establishment and operation of a National Resource Center on
Volunteers, Students, and Seniors (referred to in this subsection as the
<quote>Center</quote>). The Center shall—</text>
<clause id="H4486AA905286418AA4C516FBA5B8A31F"><enum>(i)</enum><text display-inline="yes-display-inline">promote partnerships between entities in
the aging network, and institutions of higher education and secondary schools,
in order to expand the capacity of individuals to serve in, and in order to
attract new leaders for and professionals into, the aging network; and</text>
</clause><clause id="HEE2DCDB5CED045C1BEC3DF46002F1997"><enum>(ii)</enum><text>encourage
projects that involve underserved communities, including rural communities and
racial and ethnic minority communities.</text>
</clause></subparagraph><subparagraph id="H563831E3824B4BA7B1A65CCF910719B1"><enum>(B)</enum><header>Partnerships</header><text display-inline="yes-display-inline">Such partnerships may involve—</text>
<clause id="H7CA78BF089814CEF944355E9CAB33946"><enum>(i)</enum><text display-inline="yes-display-inline">State agencies, area agencies on aging, or
other local government agencies, Aging and Disability Resource Centers, tribal
organizations, nonprofit health or social service organizations, community
clinics, adult day care centers, senior housing providers, and other providers
that provide direct services to older individuals and that are determined to be
appropriate by the Assistant Secretary; and</text>
</clause><clause id="HC837B6551E3F49EC0012A440EC961500"><enum>(ii)</enum><text display-inline="yes-display-inline">local institutions of higher education and
secondary schools.</text>
</clause></subparagraph></paragraph><paragraph id="HBB383F3E9D384BC2BD353E54F31F00D7"><enum>(2)</enum><header>Center</header><text display-inline="yes-display-inline">The Center shall use the funds made
available through the grant to—</text>
<subparagraph id="HF1FC107EB04A48779E78E2AE25551FEF"><enum>(A)</enum><text display-inline="yes-display-inline">identify and disseminate information
(including information about best practices) concerning how entities described
in paragraph (1)(B) can establish partnerships in a manner that provides
volunteers and students in nursing, social work, gerontology, psychology,
dental hygiene, music and recreational therapy, nutrition, and other
disciplines identified by the Assistant Secretary with opportunities, approved
by the Assistant Secretary, to gain experience working with older individuals,
including older individuals with dementia or cognitive impairment, receiving
services under this Act;</text>
</subparagraph><subparagraph id="H4D5821805B7B4CE8801673B951E72F82"><enum>(B)</enum><text>develop and
implement a model demonstration grant program to—</text>
<clause id="HF2EC502195D64713AD6E11457CA29307"><enum>(i)</enum><text>promote new
partnerships between the entities described in paragraph (1)(B) and incorporate
activities of the partnerships into established curricula of institutions of
higher education and secondary schools; and</text>
</clause><clause id="H5875DCFC614A42D59B6D3E40D000811C"><enum>(ii)</enum><text>promote and
sponsor internship programs, career development seminars, and continuing
education and lifelong learning programs; and</text>
</clause></subparagraph><subparagraph id="H6973B1BA6D394B86B073D756C425BDA8"><enum>(C)</enum><text>develop and
implement a model career ladder program that will disseminate information on
best practices designed to enable mid-level professionals to advance in the
field of aging.</text>
</subparagraph></paragraph><paragraph id="HB7BFBF2C2A26428CADD18E4FB230FE23"><enum>(3)</enum><header>Definition</header><text>In
this subsection, the term <term>secondary school</term> has the meaning given
the term in section 9101 of the Elementary and Secondary Education Act of 1965
(20 U.S.C. 8801).</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H597487626E8648B18004AE331F34B51"><enum>(4)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">There is
authorized to be appropriated to carry out this subsection $3,000,000 for
fiscal year 2011, $3,500,000 for fiscal year 2012, and $4,000,000 for fiscal
year
2013.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>IV</enum><header>Amendments to the
Social Security Act</header>
<section id="H68FD7D1548064B0AAEC2AC4FBA0341C"><enum>401.</enum><header>Demonstration
program for personal or home care aides, nurse aides, and home health aides in
long-term care settings</header>
<subsection id="H28B443BB410042539EE39EFA61DEB37C"><enum>(a)</enum><header>Establishment</header>
<paragraph id="H01CFB91F943340ABA753BCDAA1C7803C"><enum>(1)</enum><header>In
general</header><text>The Secretary shall establish a demonstration program (in
this section referred to as the <quote>program</quote>) to make grants to
participating States to develop core training competencies for eligible
personal or home care aides and additional training content for nurse aides and
home health aides to supplement training for nurse aides and home health aides
that is required under Federal law or regulation, and to evaluate the
effectiveness of such competencies and additional training content. Such
program shall evaluate the efficacy of—</text>
<subparagraph id="HDB5E4F2276854DDDA5FE62121EEE5653"><enum>(A)</enum><text>the core training
competencies developed under subsection (b)(2)(A);</text>
</subparagraph><subparagraph id="H1060C81E7CE241D68BE431FC084F5B28"><enum>(B)</enum><text>the additional
training content developed under subsection (b)(2)(B); and</text>
</subparagraph><subparagraph id="H31E867C5E09B41279F5C743661547BB5"><enum>(C)</enum><text>the method of
implementation of such core training competencies and additional training
content against a <quote>control</quote> group being trained under a
participating State’s existing training protocols.</text>
</subparagraph></paragraph><paragraph id="HA041CEB8F772446AACA806E4BCE8A5EA"><enum>(2)</enum><header>Duration</header><text>The
program shall be conducted for not less than 4 years.</text>
</paragraph></subsection><subsection id="H2E79998A262F46B8AC8F550537FF490"><enum>(b)</enum><header>Establishment of
expert panel</header>
<paragraph id="H3091AF1D423945DCB243ECFB1FCD32"><enum>(1)</enum><header>In
general</header><text>Not later than 120 days after the date of enactment of
this Act, the Secretary shall establish a panel of long-term care workforce
experts (in this section referred to as the <quote>expert
panel</quote>).</text>
</paragraph><paragraph id="H01329E052B804365B15B334F5260AB7D"><enum>(2)</enum><header>Duties</header><text>The
expert panel shall carry out the following duties:</text>
<subparagraph id="H3D9C163E4F52465191A3AD48EEFE49"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="H30F971BC6B3F446883E78E54692BFB06"><enum>(i)</enum><text>Subject to clause (ii),
developing core training competencies for personal or home care aides,
including such competencies with respect to the following areas:</text>
<subclause id="HC380F0084AC547D800977991F048C4F7" indent="up1"><enum>(I)</enum><text>The role of the personal or home care
aide (including differences between a personal or home care aide employed by an
agency and a personal or home care aide employed directly by the health care
consumer or an independent provider).</text>
</subclause><subclause id="H7AFFF6768D8649A88437AF4F3B06808B" indent="up1"><enum>(II)</enum><text>Consumer rights, ethics, and
confidentiality (including the role of proxy decision-makers in the case where
a health care consumer has impaired decision-making capacity).</text>
</subclause><subclause id="HE0C3F74C60504563804B45D382458892" indent="up1"><enum>(III)</enum><text>Communication, cultural and linguistic
competence and sensitivity, problem solving, behavior management, and
relationship skills.</text>
</subclause><subclause id="HDB1704E727174ABFBA6EC56C3937EF86" indent="up1"><enum>(IV)</enum><text>Personal care skills.</text>
</subclause><subclause id="HF3E0EBC377004951ADD61B5CD984CFF5" indent="up1"><enum>(V)</enum><text>Health care support.</text>
</subclause><subclause id="H234D655C8BCA4115A5C15C2CA25D00DD" indent="up1"><enum>(VI)</enum><text>Nutritional support.</text>
</subclause><subclause id="H8C61B7B0B1534506834C2009E9871F3C" indent="up1"><enum>(VII)</enum><text>Infection control.</text>
</subclause><subclause id="H3790B16E6F184501A130001E8E63F208" indent="up1"><enum>(VIII)</enum><text>Safety and emergency training.</text>
</subclause><subclause id="HDF28ADDC744E4B14911EF6B5CD07DB17" indent="up1"><enum>(IX)</enum><text>Training specific to an individual
consumer’s needs (including older individuals, younger individuals with
disabilities, individuals with developmental disabilities, individuals with
dementia, and individuals with mental and behavioral health needs).</text>
</subclause><subclause id="H4A39341576E940F58BDBAB4CE55494FE" indent="up1"><enum>(X)</enum><text>Self-Care.</text>
</subclause></clause><clause id="HF4E76F50281049C9A76CE71F92816CA0" indent="up1"><enum>(ii)</enum><text>For purposes of the program, the
core training competencies developed under clause (i) shall only apply with
respect to newly hired personal or home care aides.</text>
</clause></subparagraph><subparagraph id="H1BD08748453F4745AF5066598B7DC779"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="H006F3DA445DA419E96A1C78199F30082"><enum>(i)</enum><text>Subject to clause (ii),
developing additional training content for home health aides and nurse aides
which is not required under Federal law as of the date of enactment of this
Act, including such content with respect to the following areas:</text>
<subclause id="H788EFFB955844A0D86EDA8F3F3EA6BA" indent="up1"><enum>(I)</enum><text>Culturally and linguistically competent
practice.</text>
</subclause><subclause id="H33F6BF0C1F71441C9059045DBBDC37C9" indent="up1"><enum>(II)</enum><text>Standardized direct care worker
communication protocols (such as Situation, Background, Assessment, and
Recommendation communication tools).</text>
</subclause><subclause id="HA5A2AA35D2344E0CBCD9EB1D8AD9D08" indent="up1"><enum>(III)</enum><text>Palliative and end-of-life care.</text>
</subclause><subclause id="HCE3918B8AE95402C859BD279AC04CAD" indent="up1"><enum>(IV)</enum><text>Injury prevention.</text>
</subclause><subclause id="H4AD2414FAE2847F8B07D664EAB65C6C" indent="up1"><enum>(V)</enum><text>Wound and decubitus care.</text>
</subclause><subclause id="HA7CEAD76DB204E379FF06197FBAF015" indent="up1"><enum>(VI)</enum><text>Medication management, adherence, and
safe disposal.</text>
</subclause><subclause id="HF162290245CC401486006050034F9649" indent="up1"><enum>(VII)</enum><text>Mental and behavioral health.</text>
</subclause><subclause id="HD51AE4F587854B109BCE36FB1FD7FC08" indent="up1"><enum>(VIII)</enum><text>Additional aspects of dementia care
training (such as understanding dementia and Alzheimer's disease, dealing with
challenging behavior, developing communication skills, working with family
caregivers, and ensuring physical health and safety).</text>
</subclause><subclause id="H5143A2B84A244268B2AB58003B66B330" indent="up1"><enum>(IX)</enum><text>Prevention and reporting of abuse and
caregiver burnout.</text>
</subclause></clause><clause id="HC35EDB77320D4CA0B6CF634EA048C64C" indent="up1"><enum>(ii)</enum><text>For purposes of the program, the
additional training content developed under clause (i) shall only apply with
respect to newly hired home health aides and nurse aides.</text>
</clause></subparagraph><subparagraph id="H8C55968571264F4EA326911050FB0301"><enum>(C)</enum><clause commented="no" display-inline="yes-display-inline" id="H2BE065A4A49E44ACA0CC94AE4926B08"><enum>(i)</enum><text>Subject to clause (ii),
making recommendations regarding how training shall be provided under the
program, including recommendations with respect to the following:</text>
<subclause id="H67CCE5B18914413D9494D61990A0B1D9" indent="up1"><enum>(I)</enum><text>The length of the training.</text>
</subclause><subclause id="H9C06679C2B354D3E8534F65FFE5E287" indent="up1"><enum>(II)</enum><text>The appropriate trainer to student
ratio.</text>
</subclause><subclause id="H9E505FF0F499493DBCFC8BCB97E1169D" indent="up1"><enum>(III)</enum><text>The amount of instruction time spent in
the classroom as compared to on-site in the home or a facility.</text>
</subclause><subclause id="H4AAD206B66794877B4B35DD532AF0064" indent="up1"><enum>(IV)</enum><text>Trainer qualifications.</text>
</subclause><subclause id="HC971F7EE791B474EA2FD1D92A5CF10A4" indent="up1"><enum>(V)</enum><text>Content for a <quote>hands-on</quote> and
written certification exam.</text>
</subclause><subclause id="HBADF0CDF9F51472DBC90EF44E4F1AA09" indent="up1"><enum>(VI)</enum><text>Continuing education
requirements.</text>
</subclause><subclause id="H9D3D7073F93A416CA9404020DCEF3CFC" indent="up1"><enum>(VII)</enum><text>Ways to integrate the core training
competencies developed for personal and home care aides under subparagraph (A)
with the additional training content developed for home health aides and nurse
aides under subparagraph (B).</text>
</subclause></clause><clause id="H20CC21FD426D405D89EE4BF5571BABBB" indent="up1"><enum>(ii)</enum><text>The recommendations under clause
(i) shall ensure that the number of hours of training provided under the
program are not less than the number of hours of training required under any
applicable State or Federal law or regulation.</text>
</clause></subparagraph></paragraph><paragraph id="HFF2524BD00BF497CBE84549DEECDE5C1"><enum>(3)</enum><header>Membership</header>
<subparagraph id="H6B8A0F5B8CD64486B8646D652EA68DBB"><enum>(A)</enum><header>In
general</header><text>Subject to subparagraph (B), the expert panel shall be
composed of 11 members appointed by the Secretary from among leading experts in
the long-term care field, including representatives of—</text>
<clause id="HA3EDC6FFCE5549D6B1B8CEBC16FBBD9"><enum>(i)</enum><text>personal or home
care agencies;</text>
</clause><clause id="HA69BB642B09F46DBA64EA1CDAFF61D6"><enum>(ii)</enum><text>home
health care agencies;</text>
</clause><clause id="HFDDC216451894ACEAF77F79FD694E5C"><enum>(iii)</enum><text>nursing homes and
residential care facilities;</text>
</clause><clause id="H1CB65E5D3A1D418A9192A5994DECD62"><enum>(iv)</enum><text>the
disability community (including the mental retardation and developmental
disability communities);</text>
</clause><clause id="H23D3542DBF62442799A8CA80E0023FC4"><enum>(v)</enum><text>the
nursing community;</text>
</clause><clause id="H5729C817FED54353B5BE8F3DCFE93BD6"><enum>(vi)</enum><text>national advocacy
organizations and unions that represent direct care workers;</text>
</clause><clause id="HFFE82E29A53E441F8FDB600877C2EB5"><enum>(vii)</enum><text>older individuals
and family caregivers;</text>
</clause><clause id="H88A1A3474D11451D8DB2891B60C4FB00"><enum>(viii)</enum><text>State Medicaid
waiver program officials;</text>
</clause><clause id="H44DEF35C0AA940D9A47CAA91A28069C7"><enum>(ix)</enum><text>curriculum
developers with expertise in adult learning;</text>
</clause><clause id="H91D83CD3933F4E56A143E1DA69F226F"><enum>(x)</enum><text>researchers on
direct care workers and the long-term care workforce; and</text>
</clause><clause id="H97D1A086B53642B1BE6166FCE12E09E1"><enum>(xi)</enum><text>geriatric
pharmacists.</text>
</clause></subparagraph><subparagraph id="H32D3AFD5BD6E43AA9F791D2ED5B3D5ED"><enum>(B)</enum><header>Inclusion of
representatives of certain individuals</header><text>Not less than 2 of the 11
members appointed by the Secretary under subparagraph (A) shall represent the
interests of individuals who rely on long-term care services, including the
interests of those individuals described in clause (vii) of such
subparagraph.</text>
</subparagraph></paragraph><paragraph id="HA9677BFCA2F94157B08B854B743B50B9"><enum>(4)</enum><header>Report</header><text>Not
later than 1 year after the date of enactment of this Act, the expert panel
shall submit to the Secretary a report containing—</text>
<subparagraph id="HACA39201C2E14E168FF221E7FE00E2A"><enum>(A)</enum><text>the core training
competencies developed under paragraph (2)(A);</text>
</subparagraph><subparagraph id="HDBE0D3A230854E238CFDAD53AA6BF972"><enum>(B)</enum><text>the additional
training content developed under paragraph (2)(B);</text>
</subparagraph><subparagraph id="HBC39DBEF6BE34F92A6EA8D4B76E38010"><enum>(C)</enum><text>any
recommendations of the expert panel under paragraph (2)(C); and</text>
</subparagraph><subparagraph id="H3E9AC1417D8A49BBB60090AF65BBEBFF"><enum>(D)</enum><text>recommendations
for such legislation or administrative action as the expert panel determines
appropriate.</text>
</subparagraph></paragraph><paragraph id="H16EDEBAA2FB7422190AAD29CA329C5F"><enum>(5)</enum><header>Termination</header><text>The
expert panel shall terminate 180 days after it submits the report under
paragraph (4).</text>
</paragraph></subsection><subsection id="HC226A2AF050F40C2BEDE5EA77588CEA0"><enum>(c)</enum><header>Application and
selection criteria</header>
<paragraph id="HA7FD060026E44C20893E5E82E0001ED9"><enum>(1)</enum><header>In
general</header>
<subparagraph id="HB0524C89576F46A5A27871D5966516D"><enum>(A)</enum><header>Solicitation</header><text>Not
later than 2 years after the date of enactment of this Act, the Secretary shall
issue a proposal soliciting States to voluntarily participate in the
program.</text>
</subparagraph><subparagraph id="H86B98F1551A04524B1FA6BD528C09B7"><enum>(B)</enum><header>Agreements</header><text>The
Secretary shall enter into agreements with not more than 4 States to conduct
the program in such States.</text>
</subparagraph><subparagraph id="H5260E2A138014D508D0763CD6EEBB70"><enum>(C)</enum><header>Requirements for
States</header><text>An agreement entered into under subparagraph (B) shall
require that a participating State—</text>
<clause id="HE7F77A66888D4CDE00CEE6527D8291A6"><enum>(i)</enum><text>use
grant funds made available to the State under the program to recruit eligible
health and long-term care providers to—</text>
<subclause id="HE4873F5B0C6747B1ACE3965875ED0000"><enum>(I)</enum><text>participate in the
program; and</text>
</subclause><subclause id="H979170EB16F54261ACE510DC8160CFA1"><enum>(II)</enum><text>implement the
core training competencies developed under subsection (b)(2)(A) and the
additional training content developed under subsection (b)(2)(B); and</text>
</subclause></clause><clause id="HC652524BA46C4FABA96DE0E1AC31F70"><enum>(ii)</enum><text>develop written
materials and protocols for such core training competencies and such additional
training content, including the development of a certification test for
personal or home care aides who have completed such training competencies and,
if applicable, additional training content.</text>
</clause></subparagraph><subparagraph id="H9FF37DC170194EA28FFCBE3401BEED1"><enum>(D)</enum><header>Consultation and
collaboration with community and vocational colleges</header><text>The
Secretary shall encourage participating States to consult with community and
vocational colleges regarding the development of curricula to implement the
program, which may include consideration of such colleges as partners in such
implementation.</text>
</subparagraph></paragraph><paragraph id="HEDC8A56F49A448ACA9E3A9C9318B176B"><enum>(2)</enum><header>Application and
eligibility</header><text>A State seeking to participate in the program
shall—</text>
<subparagraph id="H5D99BAEAE7ED41DE97C9A33FC7ACE387"><enum>(A)</enum><text>submit an
application to the Secretary containing such information and at such time as
the Secretary may specify;</text>
</subparagraph><subparagraph id="HEF61C6C792F84B5284DFDC220096648B"><enum>(B)</enum><text>meet the selection
criteria established under paragraph (3); and</text>
</subparagraph><subparagraph id="H924E895F892D4232B400B341E4DA91C3"><enum>(C)</enum><text>meet such
additional criteria as the Secretary may specify.</text>
</subparagraph></paragraph><paragraph id="H53B11592A4574C0F96E49F84C2C769A7"><enum>(3)</enum><header>Selection
criteria</header><text>In selecting States to participate in the program, the
Secretary shall establish criteria to ensure—</text>
<subparagraph id="H45BF2D8584C74A1D8E95D91D00E4268"><enum>(A)</enum><text>geographic and
demographic diversity;</text>
</subparagraph><subparagraph id="H92E26AC1AF89404BB08BEB5134B5833B"><enum>(B)</enum><text>that participating
States offer medical assistance for personal care services under the State
Medicaid plan;</text>
</subparagraph><subparagraph id="HCF9F2241E10447E0BEF02C1EB5F9B89D"><enum>(C)</enum><text>that the existing
training standards for personal or home care aides, home health aides, and
nurse aides in each participating State—</text>
<clause id="HFCF85D0373BC4FF8954B720754562CC0"><enum>(i)</enum><text>are
different from such standards in the other participating States; and</text>
</clause><clause id="H138FCBEDA762404C828CC099001228E2"><enum>(ii)</enum><text>are
different from the core training competencies developed under subsection
(b)(2)(A) and the additional training content developed under subsection
(b)(2)(B);</text>
</clause></subparagraph><subparagraph id="HED3FD100D9954650B466FAE30380CE6E"><enum>(D)</enum><text>that participating
States do not reduce the number of hours of training required under applicable
State law or regulation after being selected to participate in the program;
and</text>
</subparagraph><subparagraph id="H41A5C7606834427EAC21F6BDF819FFE"><enum>(E)</enum><text>that States recruit
a minimum number of eligible health and long-term care providers to participate
in the program.</text>
</subparagraph></paragraph><paragraph id="H1A99C87CE591441690C8E72F4C5E195B"><enum>(4)</enum><header>Technical
assistance</header><text>The Secretary shall provide technical assistance to
States in developing written materials and protocols for such core training
competencies and such additional training content under paragraph
(1)(C)(ii).</text>
</paragraph></subsection><subsection id="H2017DA848F21470DACA97E0018B336D2"><enum>(d)</enum><header>Evaluation and
report</header>
<paragraph id="H8C88715788C049F0A6D7E8BBD4A9B7F"><enum>(1)</enum><header>Evaluation</header><text>The
Secretary shall develop an experimental or control group testing protocol in
consultation with an independent evaluation contractor selected by the
Secretary. Such contractor shall evaluate—</text>
<subparagraph id="HF939C8A295764CEBAD007FF000A30094"><enum>(A)</enum><text>the impact of core
training competencies developed under subsection (b)(2)(A), including curricula
developed to implement such core training competencies, for personal or home
care aides within each participating State on job satisfaction, mastery of job
skills, beneficiary and family caregiver satisfaction with services, and
additional measures determined by the Secretary in consultation with the expert
panel established under subsection (b);</text>
</subparagraph><subparagraph id="HE7E9C4DDA4244E3DB3ABE42D65E5209"><enum>(B)</enum><text>the impact of
incorporating the additional training content developed under subsection
(b)(2)(B) into existing training standards for home health aides and certified
nurse aides within each participating State;</text>
</subparagraph><subparagraph id="HF6BC4BE992AC462E884E9729B470EC2E"><enum>(C)</enum><text>the impact of
providing such core training competencies and additional training content on
the existing training infrastructure and resources of States;</text>
</subparagraph><subparagraph id="HEC8BE91DBAEB4FC9AA61B000953DB1C0"><enum>(D)</enum><text>whether the
minimum number of hours of initial training required for nurse aides under
sections 1819(f)(2)(A)(i)(II) and 1919(f)(2)(A)(i)(II) of the Social Security
Act (42 U.S.C. 1395i–3(f)(2)(A)(i)(II); 1396r(f)(2)(A)(i)(II)) should be
increased; and</text>
</subparagraph><subparagraph id="HF51D4712BD3E4DC69EA4A0CFCAA8E4D4"><enum>(E)</enum><text>whether a minimum
number of hours of initial training should be required for personal or home
care aides and, if so, what minimum number of hours should be required.</text>
</subparagraph></paragraph><paragraph id="HC3BC6348A69A4EC691E98DD5527B106F"><enum>(2)</enum><header>Report</header><text>Not
later than 1 year after the completion of the program, the Secretary shall
submit to Congress a report containing the results of the evaluations conducted
under paragraph (1), together with such recommendations for legislation or
administrative action as the Secretary determines appropriate.</text>
</paragraph></subsection><subsection id="H848B5FC58B944620931952AC82E8C84D"><enum>(e)</enum><header>Funding</header><text>Out
of any funds in the Treasury not otherwise appropriated, there are appropriated
to the Secretary to carry out the program under this section for the period of
fiscal years 2011 through 2016, $14,000,000.</text>
</subsection><subsection id="H00CD3FE52012485882C8A141451C1F52"><enum>(f)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H45B260CC8C18426F89D8093C37889BA4"><enum>(1)</enum><header>Eligible health
and long-term care provider</header><text>The term <term>eligible health and
long-term care provider</term> means a personal or home care agency (including
personal or home care public authorities), a nursing home, a home health agency
(as defined in section 1861(o)) of the Social Security Act (42 U.S.C.
1395x(o)), or any other health care provider the Secretary determines
appropriate which—</text>
<subparagraph id="H643C7F22F1564816997E39E5B197B6AB"><enum>(A)</enum><text>is licensed or
authorized to provide services in a participating State; and</text>
</subparagraph><subparagraph id="H220EF6FFB47C41F3B7D24814F379C2C0"><enum>(B)</enum><text>receives payment
for services under title XVIII or XIX of the Social Security Act.</text>
</subparagraph></paragraph><paragraph id="H462283DECF724C4BA9E07C12577BCD7B"><enum>(2)</enum><header>Home health
aide</header><text>The term <term>home health aide</term> has the meaning given
such term in section 1891(a)(3)(E) of the Social Security Act (42 U.S.C.
1395bbb(a)(3)(E)).</text>
</paragraph><paragraph id="H2463B6358E64482E8CF79C185462E700"><enum>(3)</enum><header>Nurse
aide</header><text>The term <term>nurse aide</term> has the meaning given such
term in section 1819(b)(5)(F) of the Social Security Act (42 U.S.C.
1395i–3(b)(5)(F)).</text>
</paragraph><paragraph id="H70052738D5144D2E00B5F337DA120559"><enum>(4)</enum><header>Personal care
services</header><text>The term <term>personal care services</term> has the
meaning given such term for purposes of title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.).</text>
</paragraph><paragraph id="H74357D97305343CB006322E19B2E0081"><enum>(5)</enum><header>Personal or home
care aide</header><text>The term <term>personal or home care aide</term> means
an individual who helps individuals who are elderly, disabled, ill, or mentally
disabled (including an individual with Alzheimer's disease or other dementia)
to live in their own home or a residential care facility (such as a nursing
home, assisted living facility, or any other facility the Secretary determines
appropriate) by providing routine personal care services and other appropriate
services to the individual.</text>
</paragraph><paragraph id="HBA3AF536E4924B3EA5FE9649808291A3"><enum>(6)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph></subsection></section><section id="HCBA9771DC4C7429CAD79A0F1BE8400A1"><enum>402.</enum><header>Medicare family
caregiver information and referral</header><text display-inline="no-display-inline">State health insurance assistance programs,
the Administrator of the Centers for Medicare & Medicaid Services, and the
Assistant Secretary of the Administration on Aging shall, in collaboration with
each other, directly or by contract, develop practical, easy-to-understand
information and referral protocols for health care providers, social workers,
and other appropriate individuals to provide to family caregivers of Medicare
beneficiaries either on admission to or discharge from a hospital (including a
discharge from a hospital emergency room or a hospital outpatient department
which has furnished a surgical service) or a post-acute care setting (including
a skilled nursing facility (as defined in section 1819(a) of the Social
Security Act (42 U.S.C. 1395i–3(a)), a comprehensive rehabilitation facility
(as defined in section 1861(cc)(2) of such Act (42 U.S.C. 1395x(cc)(2)) or a
rehabilitation agency, a provider of long-term care services, and a home health
agency (as defined in section 1861(o) of such Act (42 U.S.C. 1395x(o)).
Information developed under the preceding sentence shall—</text>
<paragraph id="H5E2A6C8E4B0648F1B0B007CFEFA0F0D5"><enum>(1)</enum><text>include
information on national, State, and community-based resources for seniors,
individuals with disabilities and their caregivers, which shall be updated on a
semi-annual basis (or as frequently as practicable);</text>
</paragraph><paragraph id="H9A48253644BF4375A2302388A708BB00"><enum>(2)</enum><text>be disseminated by
health care providers, social workers, and other appropriate individuals as
printed materials (including materials in Spanish and other languages (other
than English) as appropriate); and</text>
</paragraph><paragraph id="H7A10B9E22D7F4996ABDEB68B5CE78309"><enum>(3)</enum><text>be made available
on the Internet websites of State health insurance assistance programs, the
Centers for Medicare & Medicaid Services, and the Administration on
Aging.</text>
</paragraph></section><section id="H1651629B3499423FA96E14E75E7482DD"><enum>403.</enum><header>Medicaid
assessment of family caregiver support needs</header>
<subsection id="H06026311E66A45F5886F007681CDF283"><enum>(a)</enum><header>In
general</header><text>Section 1915 of the Social Security Act (42 U.S.C. 1396n)
is amended—</text>
<paragraph id="H19D4D5C7AC1B498E9EF7FB5E48176792"><enum>(1)</enum><text>in subsection
(c)(2)—</text>
<subparagraph id="HCC3F3C1DDF2144E5826646001FB0C949"><enum>(A)</enum><text>in subparagraph
(D), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HCE3976FA162D4155B501EBEEE7A77394"><enum>(B)</enum><text>in subparagraph
(E), by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="H605303709A8B47B8859EEB04E1CCA36"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HB8535CD951F04A4EB528300076EA64B" style="OLC">
<subparagraph id="HD61598F734384481B9DCC0D6C740613E"><enum>(F)</enum><text>under such waiver
the State may provide for an assessment of family caregiver support needs (in
accordance with subsection
(k)).</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="HC504A3E30ACC4E9C978D641165564CE4"><enum>(2)</enum><text>in subsection
(d)(2)—</text>
<subparagraph id="H9DD5BC8611BD403A8E88730099A7ADE9"><enum>(A)</enum><text>in subparagraph
(B), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="H838D4CE9CFD2430C9CCA93B7F3E223DA"><enum>(B)</enum><text>in subparagraph
(C), by striking the period at the end and inserting <quote>; and</quote>;
and</text>
</subparagraph><subparagraph id="HA8A759F4752F4704BB2185B9EB13102F"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H95F2F7DBF137473494FC18A3D103B3A7" style="OLC">
<subparagraph id="HE9BC54B966B24D5BB2FE9D67CA8FCDDE"><enum>(D)</enum><text>under such waiver
the State may provide for an assessment of family caregiver support needs (in
accordance with subsection
(k)).</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H47CDFFE0E2E64B19843B6902B743E5AF"><enum>(3)</enum><text>in subsection
(i)(1)(F), by adding at the end the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="H9637D7A57EF3417AA8D42C00E100C6EC" style="OLC">
<clause id="H28F0B2FA9EAC427FAA3FF143E7A38C59"><enum>(vii)</enum><text>Where
appropriate, an assessment of family caregiver support needs (in accordance
with subsection (k)).</text>
</clause><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="H488BC5B263AE4613A90064F942EB2A4"><enum>(4)</enum><text>by
adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H4693293BB8AF42E4A88496B0C9AD2680" style="OLC">
<subsection id="HBF2B1103142C40AA974546A1492FD0FC"><enum>(k)</enum><header>Assessment of
family caregiver support needs</header>
<paragraph id="H7AB65C5D689F495389611159EDDC11A8"><enum>(1)</enum><header>In
general</header><text>In the case of an individual who is determined to be
eligible for home and community-based services under a waiver under subsection
(c) or (d) or under section 1115, under a State plan amendment under subsection
(i), under an MFP demonstration project established under section 6071 of the
Deficit Reduction Act of 2005, or as part of self-directed personal assistance
services provided pursuant to a written plan of care in accordance with the
requirements of subsection (j), and who is dependent upon the assistance of a
family caregiver, the State may provide for an assessment of the family
caregiver support needs of the individual. Such assessment shall, to the extent
feasible, be conducted at the same time as, or closely coordinated with, the
determination of the eligibility of the individual for such services.</text>
</paragraph><paragraph id="H953CAF7D16894F1F835F60F61B4BC11E"><enum>(2)</enum><header>Questionnaire</header>
<subparagraph id="H46DB3290E2C04CB393D1AF23DD61C282"><enum>(A)</enum><header>In
general</header><text>Such assessment shall include asking the family caregiver
of the individual questions in order to determine whether they would benefit
from targeted support services (such as those services described in paragraph
(3)).</text>
</subparagraph><subparagraph id="H7A625C87647241E4B486A2C18BDBBCA9"><enum>(B)</enum><header>Completion on a
voluntary basis</header><text>The answering of questions under subparagraph (A)
by a family caregiver shall be on a voluntary basis.</text>
</subparagraph></paragraph><paragraph id="H322BD69207754E70AF20060010B0EE8F"><enum>(3)</enum><header>Targeted support
services described</header><text>The following targeted support services are
described in this paragraph:</text>
<subparagraph id="HFD8922038BA84FACB900254401F0F8AC"><enum>(A)</enum><text>Respite care and
emergency back-up services (including short-term help for the individual that
gives the family caregiver a break from providing such care).</text>
</subparagraph><subparagraph id="H73AFDE83F3CD4046B0C1AE8B00088FA5"><enum>(B)</enum><text>Individual
counseling (including advice and consultation sessions to bolster emotional
support for the family caregiver to make well-informed decisions about how to
cope with the strain of supporting the individual).</text>
</subparagraph><subparagraph id="HFED5C722AD1E4F7FAA4161E39FC7CF06"><enum>(C)</enum><text>Support groups,
including groups which provide help for family caregivers to—</text>
<clause id="H7B1742E9DEB9431E9E137B187F27A928"><enum>(i)</enum><text>locate a support
group either locally or online to share experiences and reduce
isolation;</text>
</clause><clause id="H6F0A1B345A7D4B11BC37D4DC1673A4D7"><enum>(ii)</enum><text>make
well-informed decisions about caring for the individual; and</text>
</clause><clause id="H53752198CADF4783BAE8ECEFB8F024E2"><enum>(iii)</enum><text>reduce
isolation.</text>
</clause></subparagraph><subparagraph id="HBADDBA44C36C463FB5F4A1D92B4CC84"><enum>(D)</enum><text>Information and
assistance (including brochures and online resources for researching a disease
or disability or learning and managing a regular caregiving role, new
technologies that can assist family caregivers, and practical assistance for
locating services).</text>
</subparagraph><subparagraph id="HE9D91198ED694FF28672598D88F8C4C"><enum>(E)</enum><text>Chore services
(such as house cleaning).</text>
</subparagraph><subparagraph id="HB1CCAFB8079E4AD6005F771F861230B3"><enum>(F)</enum><text>Personal care
(including outside help).</text>
</subparagraph><subparagraph id="H2328C417766B4D81BB75EB02B75F1B57"><enum>(G)</enum><text>Education and
training (including workshops and other resources available with information
about stress management, self-care to maintain good physical and mental health,
understanding and communicating with individuals with dementia, medication
management, normal aging processes, change in disease and disability, the role
of assistive technologies, and other relevant topics).</text>
</subparagraph><subparagraph id="H67791A188E7342D8BCD7C23DDD92EF7B"><enum>(H)</enum><text>Legal and
financial planning and consultation (including advice and counseling regarding
long-term care planning, estate planning, powers of attorney, community
property laws, tax advice, employment leave advice, advance directives, and
end-of-life care).</text>
</subparagraph><subparagraph id="HB11143B7AE23427A87C5CBCCBA2E6C2F"><enum>(I)</enum><text>Transportation
(including transportation to medical appointments).</text>
</subparagraph><subparagraph id="HFBE8E5049A6C4D54832E8023DD5DDD05"><enum>(J)</enum><text>Other targeted
support services the Secretary or the State determines appropriate.</text>
</subparagraph></paragraph><paragraph id="H74BF0A993D0D4C9CB6F3B18570674242"><enum>(4)</enum><header>Referrals</header><text>In
the case where a questionnaire completed by a family caregiver under paragraph
(2) indicates that the family caregiver would benefit from 1 or more of the
targeted support services described in paragraph (3), the State shall provide
referrals to the family caregiver for local, State, and private-sector family
caregiver programs and other resources that provide such targeted support
services.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H035A420EF9DA449B8780BAE91BA03764"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by subsection (a) shall apply to medical
assistance for home and community-based services that is provided on or after
the date of enactment of this Act.</text>
</subsection></section><enum>V</enum><header>Studies and
reports</header>
<section id="HA837CEAC5E544A9D00FBC732499DF7B2"><enum>501.</enum><header>Studies and
reports</header>
<subsection id="H5A4AEDC3941F4A22B200C7508EE05C4F"><enum>(a)</enum><header>IOM study and
report on mental health workforce needs</header>
<paragraph id="H9771CD45DDF14D339C3878138347DBDF"><enum>(1)</enum><header>Study</header><text>Not
later than 90 days after the date of enactment of this Act, the Secretary of
Health and Human Services shall enter into a contract with the Institute of
Medicine of the National Academies (in this section referred to as the
“Institute”) under which the Institute shall conduct a study on the specific
policy, workforce, economic, and implementation issues relevant to the mental
health workforce that need to be addressed to meet the current needs of older
individuals and the future needs of the aging boomer generation.</text>
</paragraph><paragraph id="H904693676BB4468BBE22169265DE8382"><enum>(2)</enum><header>Report</header><text>Not
later than 24 months after the effective date of the contract under paragraph
(1), the Institute, as part of such contract, shall submit a report to the
Secretary of Health and Human Services and the appropriate committees of
jurisdiction of Congress containing the results of the study conducted under
paragraph (1), together with recommendations for such legislation and
administrative action as the Institute determines appropriate.</text>
</paragraph><paragraph id="H20F7577ACF3441B9A8FE4431C70000F8"><enum>(3)</enum><header>Authorization</header><text>There
is authorized to be appropriated to carry out this subsection, $1,200,000 for
the period of fiscal years 2011 through 2012.</text>
</paragraph></subsection><subsection id="H44B4A2AD31EE4713AD1DF13FE0E717BF"><enum>(b)</enum><header>GAO study and
report on the needs of the aging network</header>
<paragraph id="HB4C9D94A49144B28AA9E7909E7C09843"><enum>(1)</enum><header>Study</header><text>The
Comptroller General of the United States (in this section referred to as the
<quote>Comptroller General</quote>) shall conduct a study on the aging network,
focusing on State agencies and area agencies on aging (as defined in section
102 of the Older Americans Act of 1965 (42 U.S.C. 3002)) to determine the
current capacity of such network and to identify challenges in providing
services to older adults, including older adults who are low-income and older
adults with functional disabilities, during the 10-year period beginning on the
date of enactment of this Act.</text>
</paragraph><paragraph id="HCB8CF3C0E303408AA7A919D8B4275199"><enum>(2)</enum><header>Report</header><text>Not
later than 18 months after the date of enactment of this Act, the Comptroller
General shall submit to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations—</text>
<subparagraph id="H8812F25805D74865A44D88FB85A500A6"><enum>(A)</enum><text>on the workforce
supply and capital resources needed by the aging network in order to meet the
demand for services by older adults during such 10-year period; and</text>
</subparagraph><subparagraph id="HE958DD49066A4BE7ACADA016F7CF3FA"><enum>(B)</enum><text>for such
legislation and administrative action as the Comptroller General determines
appropriate.</text>
</subparagraph></paragraph></subsection><subsection id="H9650A025FBD64FC5B05C5973E7BF9CBC"><enum>(c)</enum><header>GAO study and
report on the direct case workforce in long-term care settings</header>
<paragraph id="H62238A48C5C643E7B16FC4858C5DC954"><enum>(1)</enum><header>Study</header><text>The
Comptroller General shall conduct a study on the use of practices to reduce
turnover and improve retention and tenure of nurse aides and home health aides
in nursing homes, assisted living facilities, and home health agencies (as
defined in section 1861(o) of the Social Security Act (42 U.S.C. 1395x(o)).
Such study shall include an analysis of the reasons for the success of such
practices and how such practices could be replicated in other
facilities.</text>
</paragraph><paragraph id="H514D9D482BCE48949F1C2E439800E201"><enum>(2)</enum><header>Report</header><text>Not
later than 18 months after the date of enactment of this Act, the Comptroller
General shall submit to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations for such
legislation and administrative action as the Comptroller General determines
appropriate.</text>
</paragraph><paragraph id="H0B44AE47C25C4CC6B983E98894FF53D"><enum>(3)</enum><header>Definitions</header><text>In
this subsection:</text>
<subparagraph id="HC3D771B008BD451EAEE2D6FF528648D"><enum>(A)</enum><header>Home health
aide</header><text>The term <term>home health aide</term> has the meaning given
such term in section 1891(a)(3)(E) of the Social Security Act (42 U.S.C.
1395bbb(a)(3)(E)).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HCA0A2CCE4B1046260044E1EA7BF0002E"><enum>(B)</enum><header>Nurse
aide</header><text>The term <term>nurse aide</term> has the meaning given such
term in section 1819(b)(5)(F) of the Social Security Act (42 U.S.C.
1395i–3(b)(5)(F)).</text>
</subparagraph></paragraph></subsection><subsection id="HF77B069AB6044169B798C6345AE2CDA"><enum>(d)</enum><header>GAO study and
report on NIH spending and grants</header>
<paragraph id="H30AA65E09101442B85CF2336B08B94DF"><enum>(1)</enum><header>Study</header><text>The
Comptroller General shall conduct a study on spending by the National
Institutes of Health, including the number of grants made by the National
Institutes of Health, on conditions and illnesses that disproportionately
impact the physical and mental health of older individuals. Such study shall
include an analysis of the number of older individuals who are included in
clinical trials, including clinical trials assessing the prevalence and impact
of medication-related problems for older adults, that are supported by the
National Institutes of Health.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HFEA87ADF676F43398DEC3325857984B2"><enum>(2)</enum><header>Report</header><text>Not
later than 18 months after the date of enactment of this Act, the Comptroller
General shall submit to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations for such
legislation and administrative action as the Comptroller General determines
appropriate.</text>
</paragraph></subsection></section>