118 HR 4720 IH: Direct CARE Opportunity Act of 2023
U.S. House of Representatives
2023-07-18
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
I
118th CONGRESS
1st Session
H. R. 4720
IN THE HOUSE OF REPRESENTATIVES
July 18, 2023
Mr. Scott of Virginia (for himself, Ms. Wild, Ms. Lee of Nevada, Mr. DeSaulnier, and Ms. Bonamici) 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 direct the Secretary of Labor to award grants for the recruitment, retention, and advancement of direct care workers.
1.

Short title
This Act may be cited as the “Direct Creation, Advancement, and Retention of Employment Opportunity Act of 2023” or the “Direct CARE Opportunity Act of 2023”.
2.

Findings
Congress finds the following:
(1)
Nearly 25,000,000 adults in the United States require assistance completing self-care and other daily tasks due to physical, cognitive, developmental, or behavioral conditions. This number includes approximately 22,700,000 individuals living in the community, 1,300,000 residing in nursing homes, and 900,000 in residential care.
(2)
According to the PHI, direct care workers provide most of the paid, hands-on care for older individuals and individuals with disabilities.
(3)
The assistance of direct care workers allows older individuals and individuals with disabilities to live with dignity and safety, and to exercise their right to live independently in their own homes and communities, in keeping with what is most appropriate for their needs and preferences. Older individuals and individuals with disabilities may also participate in the direct care workforce, further supporting their ability to live independently.
(4)
The direct care workforce is diverse. Almost 9 in 10 direct care workers are women, and 61 percent are people of color, with women of color growing as a share of the workforce across every long-term care setting between 2009 and 2019.
(5)
From 2021 to 2031, home care occupations are projected to create nearly a million new jobs. Home care is also among the fastest-growing occupations, and with the projected growth in the population over age 65, this may underestimate the number of home care workers that will be needed to provide care for this growing population.
(6)
Due to transitions to other occupations or exits from the labor force, there will be an estimated 7,900,000 total job openings in direct care from 2020 to 2030.
(7)
Many direct care workers lack access to a career pathway or advanced training opportunities. This limits their ability to build competency and expertise in their field that, when gained, may lead to an increase in their earning capacity. According to PHI, more than half of home care workers have completed no formal education beyond high school, making high-quality, transferable training essential to success on the job.
(8)
The median wage for direct care workers is $14.27 per hour, and wages and earnings for home care workers are even lower in rural areas. Because of low wages, variable work hours, and the inability to access workplace-based benefits, 40 percent of direct care workers live in low-income households, and 14 percent of the workers from such households live below the poverty line. Nearly half of direct care workers rely on some form of public assistance to support themselves and their families.
(9)
Direct care workers face high injury rates, as they are up to three or more times likelier to experience workplace injuries than the typical worker in the United States.
(10)
The poor quality of these jobs contribute to high turnover, low job satisfaction, and workforce shortages. This impacts the quality of care and availability of supports for older individuals and individuals with disabilities.
(11)
The Institute of Medicine found that to ensure that the United States is prepared to meet the health care needs of older individuals during the 21st century, it is essential that the capacity of the direct care workforce be enhanced in both the number of workers available and their ability to meet their own health care and quality of life needs.
(12)
Training has been shown to reduce worker turnover, reduce rates of injury, and lead to increased job satisfaction.
(13)
Wraparound services, such as career navigation support, mentoring, and vouchers for child care or transportation, have been shown to have a positive effect on program completion and employment outcomes, like increased wages.
(14)
Career pathways are an evidence-based approach to workforce development that aligns secondary and postsecondary education to labor market needs. It involves articulated steps of education, training, and employment within an industry sector or occupation that leads to the progressive attainment of skills and wages.
3.

Definitions
In this Act:
(1)

Apprenticeship program
The term apprenticeship program means an apprenticeship program registered under the Act of August 16, 1937 (commonly known as the “National Apprenticeship Act”; 50 Stat. 664, chapter 663; 29 U.S.C. 50 et seq.).
(2)

Direct care worker
The term direct care worker means—
(A)
a direct support professional;
(B)
a worker providing direct care services, which may include palliative care, in a home or community-based setting;
(C)
a respite care provider who provides short-term support and care to an individual in order to provide relief to a family caregiver;
(D)
a direct care worker, as defined in section 799B of the Public Health Service Act (42 U.S.C. 295p); or
(E)
an individual in any other position or job related to those described in subparagraphs (A) through (D), as determined by the Secretary of Labor, in consultation with the Secretary of Health and Human Services.
(3)

Direct support professional
The term direct support professional means a worker who provides services, in a home or community-based setting, to individuals with disabilities that promote their independence, well-being, and community inclusion, including—
(A)
providing services related to coaching and career development, employment assistance, or the pursuit of personal goals;
(B)
aiding activities of daily living;
(C)
supporting communication; or
(D)
providing habilitation services or other supports.
(4)

Eligible entity
The term eligible entity means an entity that is—
(A)
a State;
(B)
a labor organization or a joint labor-management organization;
(C)
a nonprofit organization with experience in aging, disability, supporting the rights and interests of direct care workers, or training or educating direct care workers;
(D)
an Indian Tribe or Tribal organization;
(E)
an urban Indian organization;
(F)
a State board or local board;
(G)
a nonprofit or governmental organization—
(i)
with expertise in identifying and addressing the care needs of older individuals and individuals with disabilities and their caregivers; and
(ii)
which may include one or more of the following—
(I)
an area agency on aging (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002));
(II)
a center for independent living (as described in part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.)); or
(III)
an Aging and Disability Resource Center (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002));
(H)
a partnership between or among—
(i)
(I)
an institution of higher education; or
(II)
an area career and technical education school; and
(ii)
(I)
an entity described in any of subparagraphs (A) through (G); or
(II)
a consortium described in subparagraph (I); or
(I)
a consortium of entities listed in any of subparagraphs (A) through (G).
(5)

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.).
(6)

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).
(7)

Individual with a significant disability
The term individual with a significant disability has the meaning given the term in section 7 of the Rehabilitation Act of 1973 (29 U.S.C. 705).
(8)

Institution of higher education
The term institution of higher education has the meaning given the term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001) or section 102(a)(1)(B) of such Act (20 U.S.C. 1002(a)(1)(B)).
(9)

Secretary; Secretary of Labor
The terms Secretary and Secretary of Labor means the Secretary of Labor, acting through the Assistant Secretary for Employment and Training.
(10)

Secretary of Health and Human Services
The term Secretary of Health and Human Services means the Secretary of Health and Human Services, acting through the Administrator for the Administration for Community Living.
(11)

State
The term State has the meaning given the term in section 3 of the Carl D. Perkins Career and Technical Education Act of 2006 (20 U.S.C. 2302).
(12)

Supportive services
The term supportive services means services such as transportation, child care, dependent care, food, housing, and needs-related payments, that are necessary to enable an individual to participate in a strategy to be funded with a grant under this Act.
(13)

Workforce Innovation and Opportunity Act terms
The terms area career and technical education school, career pathway, career planning, eligible youth, in-demand industry sector or occupation, individual with a barrier to employment, individual with a disability, local board, older individual, one-stop center, on-the-job training, recognized postsecondary credential, region, and State board have the meanings given such terms in section 3 of the Workforce Innovation and Opportunity Act (29 U.S.C. 3102).
(14)

Work-based learning
The term work-based learning has the meaning given the term in section 3 of the Carl D. Perkins Career and Technical Education Act of 2006 (20 U.S.C. 2302).
4.

Authority to award grants; duration
(a)

Authority To award grants
Not later than 12 months after the date of enactment of this Act, from the amounts appropriated under section 10(a) (and not reserved under paragraph (2) of such section), the Secretary of Labor in consultation with the Secretary of Health and Human Services, shall award grants to eligible entities to assist such entities in developing and implementing strategies for the recruitment, retention, or advancement of direct care workers.
(b)

Interagency cooperation
(1)

In general
To receive assistance from the Secretary of Health and Human Services in administering or awarding grants, or providing technical assistance under this Act, the Secretary of Labor may—
(A)
enter into an agreement with the Secretary of Health and Human Services;
(B)
transfer to the Secretary of Health and Human Services a portion of the amounts appropriated under section 10(a); or
(C)
receive from the Secretary of Health and Human Services a portion of the amounts appropriated under section 10(b).
(2)

Procedures and criteria
An agreement entered into under paragraph (1)—
(A)
shall specify whether the procedures of the Secretary of Labor or the Secretary of Health and Human Services, or whether a single set of criteria developed by both Secretaries, shall be used to administer or award grants, or provide technical assistance, under this Act; and
(B)
may require that applicants for a grant under this Act submit a single application for joint review by the Secretary of Labor and the Secretary of Health and Human Services.
(c)

Duration
A grant under this Act shall be for not less than 5 years.
5.

Applications; consultation
(a)

Applications
(1)

In general
An eligible entity seeking a grant under this Act shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary, in consultation with the Secretary of Health and Human Services, may require, which shall include the information listed in paragraph (2).
(2)

Contents
An application submitted under paragraph (1) by an eligible entity seeking a grant under this Act shall include each of the following:
(A)
Information with respect to the State or geographic area to be served by such grant, including the following:
(i)
Demographic information regarding the population, including a description of the populations likely to need direct care services, such as the aging population and individuals with significant disabilities.
(ii)
Projections of unmet need for direct care services, which may include, enrollment on waiting lists under home and community-based waivers under section 1115 of the Social Security Act (42 U.S.C. 1315) or section 1915(c) of such Act (42 U.S.C. 1396n(c)), demand for long-term care provided through the Department of Veterans Affairs, demand for services provided under title III of the Older Americans Act of 1965 (42 U.S.C. 3021 et seq.), and other relevant data to the extent practicable.
(iii)
Current and projected job openings for direct care workers and relevant labor market information related to such workers, and the geographic scope of the workforce to be served.
(B)
A description of each specific strategy that the eligible entity will develop and implement using the grant to reduce barriers to recruitment, retention, or advancement of direct care workers, including—
(i)
a description of how the eligible entity will consult and coordinate with the entities described in subsection (b) on the development and implementation of the strategy; and
(ii)
an assurance that the eligible entity will implement the strategy in consultation with—
(I)
individuals receiving direct care services, including the aging population and individuals with disabilities; and
(II)
individuals performing direct care services, which may include family caregivers.
(C)
In the case in which a strategy described in subparagraph (B) will include the provision of wages (or other compensation or benefits) to direct care workers (or individuals training to become such workers) participating in activities carried out under the strategy—
(i)
an assurance that the provision of such wages will result in a wage for such workers that is not less than the greater of—
(I)
the minimum wage required under section 6(a) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(a)); or
(II)
the applicable wage required by other applicable Federal or State law, or a collective bargaining agreement; and
(ii)
an assessment of the wages (or other compensation or benefits) necessary to recruit, retain, or advance direct care workers.
(D)
An assurance that the eligible entity will take such steps as may be necessary to reduce or eliminate barriers, including financial barriers, to recipients of direct care services or other benefits provided by any individual who is participating in an activity carried out under the strategy.
(E)
An assurance that the eligible entity will not charge any participant of such an activity who is a direct care worker or an individual training to be such a worker for any education, training, or supportive services or other benefits provided under the activity.
(F)
A description of any supportive services and other benefits that will be provided by such grant to enable individuals to participate in any of the activities to be carried out under the strategy.
(G)
An assurance that the eligible entity will provide adequate and safe equipment or facilities for the training and supervision of direct care workers participating in any activity carried out under the strategy, including an assurance that the eligible entity will provide—
(i)
a safe work environment (which may include the provision of personal protective equipment and other necessary equipment to prevent the spread of infectious disease among workers and recipients of direct care services);
(ii)
a work environment that is free from discrimination, retaliation, and violence; and
(iii)
adequate training for mentors and qualified instructors to ensure compliance with this subparagraph, including any equipment that may be provided under clause (i).
(H)
In the case of an eligible entity that will use the grant to offer an education and training program described in section 6(a)(2)(A)—
(i)
a description of such program, including any curricula, models, and standards used under the program, and any associated recognized postsecondary credentials for which the program provides preparation, as applicable, and the training services, if any, provided under the program; and
(ii)
an assurance that such program will meet the applicable requirements under section 6(a)(2)(A).
(I)
In the case of an eligible entity that will use such grant for the provision of the career planning described in section 6(a)(2)(C), a description of such career planning and how such career planning will meet the requirements of section 6(a)(2)(C).
(J)
In the case of an eligible entity that will use such grant to develop or implement an innovative model or process to support the retention and career advancement of direct care workers, a description of such model or process.
(K)
A description of the outreach efforts that the eligible entity will use to identify individuals who may benefit from participating in an activity to be carried out under a strategy described in subparagraph (B), including targeted outreach efforts to—
(i)
individuals who are recipients of assistance under a State program funded under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.) or individuals who are eligible for such assistance; and
(ii)
individuals with barriers to employment.
(L)
How the eligible entity will collect and submit to the Secretary workforce data and outcomes of each strategy funded under such grant, including for purposes of evaluating or reviewing the strategy under section 7.
(3)

Considerations
In selecting eligible entities to receive a grant under this Act, the Secretary shall—
(A)
ensure—
(i)
to the extent practicable based on the applications submitted under this subsection, equitable geographic and demographic diversity, including among rural and urban areas; and
(ii)
that selected eligible entities will serve areas where direct care work, or a related occupation, is an in-demand industry sector or occupation; and
(B)
give priority to eligible entities proposing to predominantly serve the individuals described in clauses (i) and (ii) of paragraph (2)(K).
(b)

Consultation
Each eligible entity receiving a grant under this Act shall consult on the development and implementation of any strategy for the recruitment, retention, or advancement of direct care workers to be funded with such grant, and coordinate the implementation of such strategy with—
(1)
each applicable State board or local board; and
(2)
to the extent practicable—
(A)
institutions of higher education in the State or local areas to be served by the grant;
(B)
the State Apprenticeship Agency recognized under the Act of August 16, 1937 (commonly known as the “National Apprenticeship Act”; 50 Stat. 664, chapter 663; 29 U.S.C. 50 et seq.), for the State or region to be served by the grant or, if no such agency has been recognized in the State or region, the Office of Apprenticeship of the Department of Labor;
(C)
the State agency responsible for administering the State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (or waiver of the plan), or the State agency with primary responsibility for providing services and supports for individuals with intellectual disabilities and individuals with developmental disabilities;
(D)
in the case of an eligible entity that uses the grant to carry out an education and training program described in section 6(a)(2)(A), a nonprofit organization with demonstrated experience in the development or delivery of curricula or coursework;
(E)
an organization that fosters the professional development and collective engagement of direct care workers, including labor organizations or joint labor-management organizations;
(F)
a nonprofit or governmental organization described in section 3(4)(G);
(G)
the State Developmental Disability Council (as such term is used in subtitle B of title I of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15021 et seq.);
(H)
a nonprofit State provider association that represents providers who employ direct care workers, where such associations exist; and
(I)
an entity that employs direct care workers.
6.

Uses of funds; administrative costs; supplement, not supplant
(a)

Uses of funds
(1)

In general
Each eligible entity receiving a grant under this Act shall use such grant to develop and implement a strategy for the recruitment, retention, or advancement of direct care workers by carrying out at least one of the activities described in paragraph (2).
(2)

Activities
The activities described in this paragraph are as follows:
(A)
Developing and implementing an education and training program that—
(i)
shall provide each program participant relevant training regarding the rights of recipients of direct care services, including the rights of such recipients to—
(I)
receive such services in the most integrated setting;
(II)
exercise self-determination; and
(III)
be free from physical, sexual, and financial abuse, and discrimination;
(ii)
may include any of the following training services, which are provided primarily in-person and not online—
(I)
training on the in-demand skills and competencies of direct care occupations, including the provision of culturally competent services to recipients of direct care; or
(II)
an apprenticeship program, work-based learning, experiential learning, or on-the-job training opportunities; and
(iii)
in the case in which such program includes on-the-job training, shall provide a progressively increasing, clearly defined schedule of wages to be paid to participants of such training that—
(I)
is consistent with skill gains or attainment of a recognized postsecondary credential to be received as a result of participation in or completion of such program; and
(II)
ensures that the wage for such participants is not less than the greater of—
- (aa)
the minimum wage required under section 6(a) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(a)); or
- (bb)
the applicable wage required by other applicable Federal or State law, or a collective bargaining agreement.
(B)
In the case of an eligible entity described in section 3(3)(H), developing and implementing a career pathway program that leads to higher wages and benefits for participating direct care workers, which shall include—
(i)
the planning and implementation of the career pathways program between employers who hire such participants and such eligible entity;
(ii)
the development and expansion of new or existing programs that utilize career pathway design elements, and which may include the development and expansion of—
(I)
dual-enrollment approaches for secondary students or eligible youth seeking to participate in a career pathway program;
(II)
multiple entry and exit points into pathways for participants;
(III)
sequenced, connected curricula, and the establishment of stackable credentials; or
(IV)
supports that help working students and other nontraditional and adult student populations persist along pathways and attain recognized postsecondary credentials;
(iii)
the provision of training services as described in subparagraph (A)(ii);
(iv)
the provision of supportive services; or
(v)
any other evidence-based activities identified by the eligible entity or employer partners as necessary to support the development or implementation of such career pathway program.
(C)
Providing career planning to support the identification of advancement opportunities and career pathways for direct care workers, in coordination with employers, in the State or region to be served by the grant.
(D)
Providing wages (or other compensation or benefits), supportive services, mentoring, or other career supports to direct care workers (or individuals training to be such workers), which provided alone, or in combination with any of the activities listed in this paragraph, facilitates the recruitment, retention, or advancement of such workers.
(E)
Any other activity that the Secretary determines appropriate for implementing a strategy for the recruitment, retention, or advancement of direct care workers.
(3)

Continuation of existing strategies
An eligible entity receiving a grant under this Act may use such grant to continue to implement a strategy for the recruitment, retention, or advancement of direct care workers, if such a strategy was being implemented by an eligible entity as of the first day on which the grant program under this Act is announced in the Federal Register.
(b)

Administrative costs
Each eligible entity receiving a grant under this Act may not use more than 7 percent of the funds of such grant for costs associated with the administration of the strategies implemented using the grant, and the evaluations and reports of such strategies under section 7.
(c)

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 for the recruitment, retention, or advancement of direct care workers in the State or region served by the grant.
7.

Evaluations and reports
(a)

Eligible entities
(1)

In general
Each eligible entity receiving a grant under this Act shall submit to the Secretary of Labor and the Secretary of Health and Human Services, with respect to each strategy for the recruitment, retention, or advancement of direct care workers funded with such grant—
(A)
for each year of the grant period, an annual report on the progress and outcomes of the strategy; and
(B)
not later 6 months after the completion of such strategy, a final report on the progress and outcomes of the strategy.
(2)

Contents
Each report submitted under paragraph (1) by an eligible entity receiving a grant under this Act shall include each of the following, which shall be disaggregated in accordance with paragraph (3):
(A)
A description of each strategy funded by the grant, including—
(i)
the number of individuals who are direct care workers or training to be direct care workers who participated in the activities carried out under such strategy;
(ii)
a description of each activity carried out under such strategy; and
(iii)
the outcomes of such strategy, including the number of individuals or families receiving direct care services or other benefits provided by participants of any such activities.
(B)
In the case of such a strategy that includes an education and training program—
(i)
the number of participants in such program who complete such program, disaggregated by the type of education and training completed (including work-based learning, on-the-job training, an apprenticeship program, and a professional development or mentoring program);
(ii)
the number of such participants who complete such program and who attain employment as a direct care worker after participating in such program, disaggregated in accordance with clause (i); and
(iii)
the submission of the data necessary (as defined by the Secretary of Labor) to measure employment outcomes for each such program with respect to the indicators of performance on unsubsidized employment, median earnings, credential attainment, measurable skill gains, and employer satisfaction, as determined in accordance with subclauses (I) through (VI), respectively, of section 116(b)(2)(A)(i) of the Workforce Innovation and Opportunity Act (29 U.S.C. 3141(b)(2)(A)(i)).
(C)
In the case of such a strategy that includes the provision of supportive services—
(i)
the number of participants of such strategy who—
(I)
needed supportive services and received such services; and
(II)
needed supportive services and did not receive such services; and
(ii)
a description of the supportive services provided.
(D)
How the eligible entity evaluates satisfaction with respect to—
(i)
participants of an activity carried out under the strategy funded by such grant;
(ii)
individuals receiving direct care services or other benefits provided by such participants, including—
(I)
any impact on the health or health outcomes of such individuals; and
(II)
any impact on the ability of individuals to transition to or remain in the community in an environment that meets the criteria established in section 441.301(c)(4) of title 42, Code of Federal Regulations (or successor regulations); and
(iii)
employers of such participants, 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)).
(3)

Disaggregation
(A)

In general
Subject to subparagraph (B), the information described in paragraph (2) shall be disaggregated—
(i)
by race, disability, ethnicity, sex, and age;
(ii)
by each subpopulation listed in subparagraphs (A) through (N) of section 3(24) of the Workforce Innovation and Opportunity Act (29 U.S.C. 3102(24)); and
(iii)
by the individuals described in clauses (i) and (ii) of section 5(a)(2)(K).
(B)

Exceptions
The disaggregation described in clause (i), (ii), or (iii) of subparagraph (A) shall not be required in a case in which the number of individuals in a category or subpopulation is insufficient to yield statistically reliable information or the results would reveal personally identifiable information about an individual.
(b)

Report to Congress
Not later than 1 year after the completion of the final strategy funded by the last grant awarded under this Act, the Secretary shall prepare and submit to Congress, and make publicly available, a report containing—
(1)
the progress and outcomes of the strategies identified in the final reports submitted by eligible entities under subsection (a)(1)(B);
(2)
any specific successful strategies (as determined on the basis of such final reports) that can also support family caregivers;
(3)
an analysis of the workforce supply, current and projected shortages, and distribution of direct care workers at the national, regional, and State levels; and
(4)
recommendations for legislative or administrative action.
8.

GAO report
Not later than 1 year after the Secretary submits to Congress the report under section 7(b), the Comptroller General of the United States shall conduct a study and submit to Congress a report including—
(1)
an assessment of the effect that the strategies in the recruitment, retention, or advancement of direct care workers funded under this Act had on the supply of such workers in the labor market;
(2)
any specific successful strategies (as determined on the basis of the assessment in paragraph (1)) that can also support family caregivers; and
(3)
recommendations for legislative or administrative actions.
9.

Technical assistance
(a)

In general
Not later than 5 months after the date of enactment of this Act, from the amounts reserved under section 10(a)(2), the Secretary of Labor, in coordination with the Secretary of Health and Human Services, shall provide technical assistance to eligible entities receiving a grant under this Act, including technical assistance to—
(1)
ensure that such entities carry out one or more of the activities described in section 6(a)(2); or
(2)
assist such entities in complying with the—
(A)
the data collection requirements of section 7(a)(2)(B)(iii); or
(B)
the disaggregation requirements of section 7(a)(3).
(b)

National technical assistance center
In addition to activities authorized under section 411(a)(13) of the Older Americans Act of 1965 (42 U.S.C. 3032(a)(13)) and the activities authorized under subtitle E of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15081 et seq.), the amounts appropriated under section 10(b) of this Act shall be used by the Assistant Secretary for Aging of the Administration for Community Living of the Department of Health and Human Services to—
(1)
provide the technical assistance described in subsection (a);
(2)
disseminate tools, resources, information, and best practices to assist State systems (including Medicaid, aging, disability, and workforce agencies), as well as service providers, and aging, disability, and labor stakeholders, to support the development and coordination of policies and programs that contribute to a stable, robust direct care workforce;
(3)
bolster partnerships and support collaboration between or among the State systems, service providers, and stakeholders described in paragraph (2) to support the direct care workforce; and
(4)
any other activities that are necessary to strengthen the direct care workforce, as determined by the Assistant Secretary.
10.

Authorization of appropriations
(a)

Grant program
(1)

In general
There are authorized to be appropriated $300,000,000 to carry out this Act (other than section 9(b)) for each of the fiscal years 2024 through 2029.
(2)

Reservation of funds for technical assistance
Of the amounts appropriated under paragraph (1) for a fiscal year, the Secretary of Labor shall reserve up to 2 percent to provide the technical assistance described in section 9(a).
(b)

National technical assistance center
There are authorized to be appropriated $6,000,000 for each of the fiscal years 2024 through 2029 to carry out—
(1)
the activities authorized under section 411(a)(13) of the Older Americans Act of 1965 (42 U.S.C. 3032(a)(13));
(2)
the activities authorized under subtitle E of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15081 et seq.); and
(3)
the activities described in section 9(b) of this Act.