[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3778 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 3778

  To award grants for the recruitment, retention, and advancement of 
                          direct care workers.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 14, 2017

   Mr. Scott of Virginia (for himself and Mrs. Davis of California) 
 introduced the following bill; which was referred to the Committee on 
Education and the Workforce, and in addition to the Committee on Energy 
    and Commerce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To award grants for the recruitment, retention, and advancement of 
                          direct care workers.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Direct Creation, Advancement, and 
Retention of Employment Opportunity Act'' or the ``Direct CARE 
Opportunity Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Millions of seniors and persons with disabilities in 
        the United States require assistance with activities of daily 
        living in order to live independently and participate in their 
        communities.
            (2) The assistance of direct care workers allows seniors 
        and persons with disabilities to live with dignity, safety and 
        independence in their own homes and communities and in the most 
        integrated settings appropriate to their needs and preferences.
            (3) The Institute of Medicine has found that direct care 
        workers provide the bulk of services for older adults in 
        nursing homes, assisted living facilities, and individuals' 
        homes.
            (4) The Bureau of Labor Statistics projects that personal 
        care aides and home health aides will be two of the occupations 
        with the most new jobs created in the country by 2024.
            (5) Many direct care workers lack access to a career ladder 
        or advanced training opportunities and, according to PHI, more 
        than half of home care workers have completed no formal 
        education beyond high school, making quality, transferable 
        training essential to success on the job.
            (6) According to PHI, direct care workers earn a median 
        wage of just over $10 an hour and frequently are not provided 
        the workplace-based benefits that would allow them to care for 
        themselves and their families.
            (7) According to National Women's Law Center's analysis of 
        Census Bureau data, the vast majority of direct care workers 
        are women, and women of color represent nearly half of the 
        direct care workforce.
            (8) According to the Federal Commission on Long-Term Care, 
        there is high turnover and workforce shortages in direct care 
        occupations, which can contribute to reduced care quality.
            (9) The Institute of Medicine found that to ensure that the 
        United States is prepared to meet the health care needs of 
        older Americans during the 21st century, it is essential that 
        the capacity of the direct care workforce be enhanced in both 
        size and ability to meet their health care and quality of life 
        needs.

SEC. 3. GRANTS FOR RECRUITMENT, RETENTION, AND ADVANCEMENT OF DIRECT 
              CARE WORKERS.

    (a) Authority To Award Grants.--Not later than 12 months after the 
date of enactment of this section, the Secretary of Labor, in 
consultation with the Secretary of Health and Human Services, shall 
award grants to not more than 15 eligible entities to conduct projects 
for purposes of recruiting, retaining, or providing advancement 
opportunities to direct care workers.
    (b) Duration.--
            (1) Grant period.--A grant under this section shall be for 
        not less than 5 years.
            (2) Length of project.--A project assisted with a grant 
        awarded under this section shall be conducted for not less than 
        3 years.
    (c) Project Plans.--
            (1) In general.--To receive a grant under this section, an 
        eligible entity shall submit to the Secretary a project plan at 
        such time and in such manner as the Secretary may determine, 
        which shall contain the information described in paragraph (2).
            (2) Contents.--Each project plan submitted by an eligible 
        entity under paragraph (1) shall include a description of the 
        following:
                    (A) Current or projected workforce vacancies and 
                supply of direct care workers in the State or region to 
                be served by the eligible entity, and the geographic 
                scope of the workforce to be served.
                    (B) Specific efforts and strategies that the 
                project will undertake to reduce barriers to 
                recruitment, retention, and advancement of direct care 
                workers, including whether such efforts will include--
                            (i) assessment of the wages or other 
                        compensation or benefits necessary to recruit 
                        and retain direct care workers, conducted in 
                        consultation with individuals employed as 
                        direct care workers, representatives of such 
                        workers, individuals assisted by such workers, 
                        and the families of such individuals;
                            (ii) analysis of reliable data that has 
                        previously been collected with respect to such 
                        wages or other compensation or benefits;
                            (iii) validation and implementation of 
                        successful training models, standards, and 
                        curricula (such as the models, standards, and 
                        curricula used in the grants awarded under 
                        section 2008(b) of the Social Security Act for 
                        developing training competencies and 
                        certification programs for direct care workers 
                        (42 U.S.C. 1397g)) or through work-based 
                        learning strategies, career pathways, 
                        supervision, or mentoring; or
                            (iv) any other supportive services or 
                        benefits provided to create or sustain 
                        employment for direct care workers.
                    (C) The models, standards, and curricula the 
                eligible entity will carry out under subparagraph (B).
                    (D) Any other supportive services provided to 
                assist in the goals of the project, if applicable.
                    (E) Identification of advancement opportunities and 
                strategies to expand career pathways for direct care 
                workers in the State or region to be served by the 
                eligible entity, if applicable.
                    (F) How the eligible entity will collect and submit 
                to the Secretary workforce data and outcomes of the 
                project to be assisted with the grant under this 
                section.
                    (G) How the eligible entity will consult on the 
                implementation of the project, or coordinate the 
                project with, each of the following entities, to the 
                extent that each such entity is not a part of the 
                eligible entity:
                            (i) The State agency responsible for 
                        administering the State plan under title XIX of 
                        the Social Security Act (or waiver of the 
                        plan).
                            (ii) Local boards and State boards for the 
                        State or region to be served by the eligible 
                        entity.
                            (iii) Nonprofit organizations with 
                        demonstrated experience in the recruitment, 
                        training, employment, or career consultation of 
                        direct care workers or the development of 
                        curricula or coursework to be used in the 
                        training under the project.
                            (iv) Nonprofit organizations that foster 
                        the professional development and collective 
                        engagement of direct care workers, including 
                        labor organizations.
                            (v) Nonprofit organizations with an 
                        expertise in identifying and addressing the 
                        care needs of local seniors and people with 
                        disabilities and their caregivers (including 
                        area agencies on aging, centers for independent 
                        living, and aging and disability resource 
                        centers).
                            (vi) Nonprofit State provider associations 
                        that represent providers who employ direct care 
                        workers, where such associations exist.
                    (H) How the eligible entity will consult with 
                individuals employed as direct care workers, 
                representatives of such workers, individuals assisted 
                by such workers, and the families of such individuals 
                throughout the project.
                    (I) Outreach efforts to individuals for 
                participation in such project, including targeted 
                outreach to recipients of assistance under a State 
                program funded under part A of title IV of the Social 
                Security Act or individuals who are eligible for such 
                assistance.
            (3) Evaluation.--In selecting eligible entities to receive 
        a grant under this section, the Secretary shall--
                    (A) ensure--
                            (i) geographic and demographic diversity, 
                        including rural and urban areas; and
                            (ii) that selected eligible entities will 
                        serve areas where direct care, or related 
                        occupations, is considered an in-demand 
                        industry sector or occupation; and
                    (B) evaluate the efficacy of each project plan 
                submitted under paragraph (2)--
                            (i) for recruiting, retaining, and 
                        providing advancement opportunities for direct 
                        care workers; and
                            (ii) on the methods used to recruit, 
                        retain, and provide advancement opportunities 
                        to direct care workers.
    (d) Consultation.--The Secretary shall encourage each eligible 
entity receiving a grant under this section--
            (1) in developing and carrying out a project under this 
        section, to consult with--
                    (A) institutions of higher education;
                    (B) entities that employ direct care workers;
                    (C) the State Apprenticeship Agency recognized 
                under the Act of August 16, 1937 (commonly known as the 
                ``National Apprenticeship Act''), for the State or 
                region to be served by the eligible entity or, if no 
                such agency has been recognized in the State or region, 
                the Office of Apprenticeship of the Department of 
                Labor; and
                    (D) one-stop centers; and
            (2) in carrying out a project under this section, to 
        coordinate, to the extent practicable, activities under the 
        project with activities under the grants awarded under section 
        2008 of the Social Security Act (42 U.S.C. 1397g).
    (e) Uses of Funds.--Each eligible entity receiving a grant under 
this section shall use such funds to carry out a project or to continue 
a project commenced prior to receipt of such grant that develops and 
implements a strategy for the recruitment, retention, or advancement of 
direct care workers, which includes the activities described in 
subsection (c)(2), and that provides compensation to each eligible 
direct care worker for any training received under the project.
    (f) Supplement, Not Supplant.--An eligible entity receiving a grant 
under this Act shall use such grant only to supplement, and not 
supplant, the amount of funds that, in the absence of such grant, would 
be available to address the recruitment, retention, and advancement of 
direct care workers in the State or region served by the eligible 
entity.
    (g) Reports.--
            (1) Eligible entities.--
                    (A) In general.--Not later 6 months after the 
                completion of each project assisted with a grant under 
                this section, the eligible entity that received such 
                grant shall submit to the Secretary of Labor and the 
                Secretary of Health and Human Services a report on the 
                progress and outcomes of the project, which data shall 
                be disaggregated in the manner described in 
                subparagraph (B), and shall include the following:
                            (i) The number of individuals served by the 
                        project, including--
                                    (I) the number of individuals 
                                recruited to be employed as an direct 
                                care worker; and
                                    (II) the number of individuals who 
                                attained employment as an direct care 
                                worker.
                            (ii) The percentage of individuals 
                        described in clause (i)(II) employed as an 
                        direct care worker in the manner described in 
                        subclause (I) of section 116(b)(2)(A)(i) of the 
                        Workforce Innovation and Opportunity Act (29 
                        U.S.C. 3141(b)(2)(A)(i)).
                            (iii) The percentage of individuals 
                        described in clause (i)(II) employed in the 
                        manner described in subclause (II) of section 
                        116(b)(2)(A)(i) of such Act (29 U.S.C. 
                        3141(b)(2)(A)(i)).
                            (iv) The number of individuals or families 
                        assisted by direct care workers.
                            (v) The number of direct care workers who 
                        received and completed the following training 
                        or education in the field of direct care, if 
                        applicable:
                                    (I) Entry-level training.
                                    (II) Advanced-level training.
                                    (III) Continuing education.
                                    (IV) Professional development, 
                                mentoring, or supervision.
                            (vi) The median earnings of individuals 
                        completing each type training or education 
                        described in clause (v), as determined in 
                        accordance with section 116(b)(2)(A)(i)(III) of 
                        the Workforce Innovation and Opportunity Act 
                        (29 U.S.C. 3141(b)(2)(A)(i)(III)).
                            (vii) How the project assessed satisfaction 
                        with respect to--
                                    (I) direct care workers assisted by 
                                the project;
                                    (II) individuals receiving services 
                                delivered by such workers, including 
                                any impact on the health care outcomes 
                                of such individuals; and
                                    (III) employers of such workers, as 
                                determined in accordance with section 
                                116(b)(2)(A)(i)(VI) of the Workforce 
                                Innovation and Opportunity Act (29 
                                U.S.C. 3141(b)(2)(A)(i)(VI)).
                            (viii) Other services, benefits, or 
                        supports (other than the services, benefits, or 
                        supports described in clause (v)) provided to 
                        assist in the recruitment, retention, and 
                        advancement of direct care workers, the number 
                        of individuals who accessed such services, 
                        benefits, or supports, and the impact of such 
                        services, benefits, or supports.
                    (B) Disaggregation.--The data collected under 
                clauses (i) through (vi) of subparagraph (A) shall be 
                disaggregated by race, ethnicity, sex, and age in 
                accordance with section 116(d)(2)(B) of the Workforce 
                Innovation and Opportunity Act (29 U.S.C. 3141(d)(2)).
                    (C) Supplemental outcomes information.--Eligible 
                entities shall submit supplemental information 
                detailing the outcomes of the project, including 
                explanations of the information provided in accordance 
                with (A).
            (2) Secretaries.--Not later than 1 year after the 
        completion of each project assisted with a grant under this 
        section, the Secretary of Labor, in consultation with the 
        Secretary of Health and Human Services, shall prepare and 
        submit to Congress a report containing--
                    (A) the progress and outcomes of the project 
                submitted by the eligible entity under paragraph (1);
                    (B) an analysis of the workforce supply, current 
                and projected shortages, and distribution of direct 
                care workers at a national, regional, and State level; 
                and
                    (C) recommendations for such legislative or 
                administrative action as the Secretaries determine 
                appropriate.
            (3) GAO report.--Not later than 1 year after the completion 
        of each project assisted with a grant under this section, the 
        Comptroller General of the United States shall conduct a study 
        and submit to Congress a report including--
                    (A) an assessment of how the project assisted in 
                the recruitment, retention, and advancement of direct 
                care workers; and
                    (B) such recommendations for legislative or 
                administrative changes as the Comptroller General 
                determines are appropriate.
    (h) Technical Assistance.--Not later than 6 months after the date 
of enactment of this Act, the Secretary of Labor shall provide 
technical assistance to eligible entities, for purposes of compliance 
with subsection (g)(1) of this section, on--
            (1) the disaggregation requirements of section 116(d)(2)(B) 
        of the Workforce Innovation and Opportunity Act (29 U.S.C. 
        3141(d)(2)); and
            (2) the data collection requirements of section 
        116(b)(2)(A)(i) of such Act (29 U.S.C. 3141(b)(2)(A)(i)).
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated such funds as may be necessary to carry out this section 
for each of fiscal years 2018 through 2022.
    (j) Definitions.--In this Act:
            (1) Career pathway.--The term ``career pathway'' has the 
        meaning given the term in section 3 of the Workforce Innovation 
        and Opportunity Act (29 U.S.C. 3102).
            (2) Direct care worker.--The term ``direct care worker'' 
        has the meaning given the term in section 799B of the Public 
        Health Service Act (42 U.S.C. 295p).
            (3) Eligible entity.--The term ``eligible entity'' means--
                    (A) a State;
                    (B) a nonprofit organization, labor organization, 
                or an entity with shared labor-management oversight--
                            (i) with an established record of 
                        recruiting or providing training to direct care 
                        workers; or
                            (ii) that established a training program in 
                        consultation with an organization with an 
                        established record of providing training to 
                        direct care workers;
                    (C) a local board;
                    (D) a nonprofit entity carrying out a registered 
                apprenticeship program;
                    (E) Indian tribe or tribal organization; or
                    (F) a consortium of entities listed in subparagraph 
                (A), (B), (C), (D), or (E) which may include an 
                institution of higher education.
            (4) Employ; employer.--The terms ``employ'' and 
        ``employer'' have the meanings given the terms in section 3 of 
        the Fair Labor Standards Act (29 U.S.C. 203 et seq.).
            (5) Indian tribe; tribal organization.--The terms ``Indian 
        tribe'' and ``tribal organization'' have the meanings given 
        such terms in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 5304).
            (6) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given the 
        term in section 101(a) of the Higher Education Act of 1965 (20 
        U.S.C. 1001(a)).
            (7) Local board.--The term ``local board'' has the meaning 
        given the term in section 3 of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3102).
            (8) In-demand industry sector or occupation.--The term 
        ``in-demand industry sector or occupation'' has the meaning 
        given the term in section 3 of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3102).
            (9) One-stop center.--The term ``one-stop center'' has the 
        meaning given the term in section 3 of the Workforce Innovation 
        and Opportunity Act (29 U.S.C. 3102).
            (10) Region.--The term ``region'' has the meaning given the 
        term in section 3 of the Workforce Innovation and Opportunity 
        Act (29 U.S.C. 3102).
            (11) Registered apprenticeship program.--The term 
        ``registered apprenticeship program'' has the meaning given the 
        term in section 171(b) of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3226(b)).
            (12) Secretary.--The term ``Secretary'' means the Secretary 
        of Labor.
            (13) State.--The term ``State'' means any State of the 
        United States or the District of Columbia District of Columbia, 
        and any commonwealth, possession, or other territory of the 
        United States.
            (14) State board.--The term ``State board'' has the meaning 
        given the term in section 3 of the Workforce Innovation and 
        Opportunity Act (29 U.S.C. 3102).
            (15) Work-based learning strategy.--The term ``work-based 
        learning strategy'' means a strategy (which may be a registered 
        apprenticeship) that provides workers with paid work experience 
        and corresponding classroom instruction, as appropriate, 
        delivered in an employment relationship that both the employer 
        and worker intend to be permanent.
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