[Congressional Record Volume 150, Number 126 (Thursday, October 7, 2004)]
[Senate]
[Pages S10705-S10708]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FEINGOLD:
  S. 2913. A bill to establish a demonstration project to train 
unemployed workers for employment as health care professionals, and for 
other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. FEINGOLD. Mr. President, over the past year, I have come to this 
floor on a number of occasions to discuss the loss of manufacturing 
jobs in Wisconsin and around the country and ways in which I think that 
Congress should act to stem the flow of these jobs to foreign 
countries.
  According to the Wisconsin Department of Workforce Development, 
Wisconsin has lost more than 80,000 manufacturing jobs since 2000. 
Nationally, according to the Bureau of Labor Statistics, the country 
has lost more than 2.8 million manufacturing jobs during that same time 
period. In addition to the loss of manufacturing jobs, I am deeply 
troubled by the Bush administration's contention that the outsourcing 
of American service sector and other jobs is good for the economy. I am 
concerned about the message that this policy sends to Wisconsinites and 
all Americans who are currently employed in these sectors.
  There is something of a silver lining to the looming cloud of 
manufacturing and other jobs loss: the country's workforce development 
system.
  In spite of stretched resources and long waiting lists for services, 
our workforce development boards are making a tremendous effort to 
retrain laid-off workers and other job seekers for new jobs. And this 
effort is clearly evident in Wisconsin, where my State's 11 workforce 
development boards are leading the way in finding innovative solutions 
to retraining workers for new careers on shoestring budgets.
  I strongly support the work of these agencies, and have urged the 
administration and Senate appropriators to provide adequate funding for 
the job training programs authorized by the Workforce Investment Act. I 
regret that the administration's budget request for fiscal year 2005 
does not provide adequate funding for WIA, and I will continue to work 
to ensure that the workforce development boards in my State and across 
our country receive the resources that they need to help job seekers 
get the training they need to be successful.
  I am committed to finding resources to retrain those who have been 
laid off from the manufacturing and service sectors and who wish to 
find new jobs in high-demand fields such as health care.
  As most of my colleagues know all too well, we are facing a 
significant shortage of health care workers. Congress has made some 
progress in addressing the nursing shortage, but we need to expand our 
efforts. Shortages of health professionals pose a real threat to the 
health of our communities by impacting access to timely, high-quality 
health care. Studies have shown that shortages of nurses in our 
hospitals and health facilities increase medical errors, which directly 
affects patient health.
  As our population ages, and the baby-boomers need more health care, 
our need for all types of health professionals is only going to 
increase. This is particularly true for the field of long-term care. 
According to the Bureau of Labor Statistics, we are going to need an 
additional 1.2 million nursing aides, home health aides, and other 
health professionals in long-term care before the year 2010.
  As our demand for health care workers grows, so does the number of 
jobs available within this sector. Currently, health services is the 
largest industry in the country, providing 12.9 million jobs in 2002. 
It is estimated that 16 percent of all new jobs created between 2002 
and 2012 will be in health services. This accounts for 3.5 million new 
jobs--more than any other industry.
  Workforce development agencies in my home State of Wisconsin are 
already working to support displaced workers in their communities by 
training them for health care jobs, since there is a real need for 
workers in these fields. These agencies are helping communities get and 
maintain access to high-quality health care by ensuring that there are 
enough health care workers to care for their communities.
  As the executive director of one of the workforce development boards 
in my State put it, ``[t]here are simply not many good quality jobs to 
replace manufacturing jobs lost to rural communities. The medical 
professions, by offering a `living wage' and good benefits, provide an 
excellent alternative to manufacturing for sustaining a higher, family-
oriented standard of living.''
  I believe we need to support our communities in these efforts by 
providing them with the resources they need to establish, sustain, or 
expand these important programs. For that reason, today I am 
introducing the Community-Based Health Care Retraining Act. This bill 
would amend the Workforce Investment Act to authorize a demonstration 
project to provide grants to community-based coalitions, led by local 
workforce development boards, to create programs to retrain unemployed 
workers who wish to obtain new jobs in the health care professions. My 
bill would authorize a total of $25 million for grants between $100,000 
and $500,000, and, in the interest of fiscal responsibility, it ensures 
that these grants would be offset.
  This bill will help provide communities with the resources they need 
to run retraining programs for the health professions. The funds could 
be used for a variety of purposes--from increasing the capacity of our 
schools and training facilities, to providing financial and social 
support for workers who are in retraining programs. This bill is 
flexible in what the grant funds could be used for, because I believe 
that communities know best about the resources they need to run an 
efficient program.
  This bill represents a nexus in my efforts to support workers whose 
jobs have been shipped overseas and to ensure that all Americans have 
access to the high-quality health care that they deserve. By providing 
targeted assistance to train laid-off workers who wish to obtain new 
jobs in the health care sector, we can both help unemployed Americans 
and improve the availability and quality of health care that is 
available in our communities.
  I am pleased that this bill is supported by a variety of 
organizations that are committed to providing high-quality job training 
and health care services, including: the National Association of 
Workforce Boards, the American Health Care Association, the Wisconsin 
Association of Job Training Executives, Northwest Wisconsin 
Concentrated Employment Program, the

[[Page S10706]]

Northwest Wisconsin Workforce Investment Board, and the Southwestern 
Wisconsin Workforce Development Board.
  I ask unanimous consent that the full text of this bill, and the text 
of the letters of support from the above-mentioned groups, be printed 
in the Record at the conclusion of my remarks.
  In order to ensure that our workers are able to compete in the new 
economy, we must ensure that they have the tools they need to be 
trained or retrained for high-demand jobs such as those in the health 
care field. My bill is a small step toward providing the resources 
necessary to achieve this goal. I will continue to work to strengthen 
the American manufacturing sector and to support those workers who have 
been displaced due to bad trade agreements and other policies that have 
led to the loss of American jobs.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 2913

       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 ``Community-Based Health Care 
     Retraining Act''.

     SEC. 2. HEALTH PROFESSIONS TRAINING DEMONSTRATION PROJECT.

       Section 171 of the Workforce Investment Act of 1998 (29 
     U.S.C. 2916) is amended by adding at the end the following:
       ``(e) Health Professions Training Demonstration Project.--
       ``(1) Definitions.--In this subsection:
       ``(A) Covered community.--The term `covered community' 
     means a community or region that--
       ``(i) has experienced a significant percentage decline in 
     positions in the manufacturing or service sectors; and
       ``(ii)(I) is eligible for designation under section 332 of 
     the Public Health Service Act (42 U.S.C. 254e) as a health 
     professional shortage area;
       ``(II) is eligible to be served by a health center under 
     section 330 or a grantee under section 330(h) (relating to 
     homeless individuals) of the Public Health Service Act (42 
     U.S.C. 254b, 254b(h));
       ``(III) has a shortage of personal health services, as 
     determined under criteria issued by the Secretary of Health 
     and Human Services under section 1861(aa)(2) of the Social 
     Security Act (relating to rural health clinics) (42 U.S.C. 
     1395x(aa)(2)); or
       ``(IV) is designated by a Governor (in consultation with 
     the medical community) as a shortage area or medically 
     underserved community.
       ``(B) Covered worker.--The term `covered worker' means an 
     individual who--
       ``(i)(I) has been terminated or laid off, or who has 
     received a notice of termination or layoff, from employment 
     in a manufacturing or service sector;
       ``(II)(aa) is eligible for or has exhausted entitlement to 
     unemployment compensation; or
       ``(bb) has been employed for a duration sufficient to 
     demonstrate, to the appropriate entity at a one-stop center 
     referred to in section 134(c), attachment to the workforce, 
     but is not eligible for unemployment compensation due to 
     insufficient earnings or having performed services for an 
     employer that were not covered under a State unemployment 
     compensation law; and
       ``(III) is unlikely to return to a previous industry or 
     occupation; or
       ``(ii)(I) has been terminated or laid off, or has received 
     a notice of termination or layoff, from employment in a 
     manufacturing or service sector as a result of any permanent 
     closure of, or any substantial layoff at, a plant, facility, 
     or enterprise; or
       ``(II) is employed in a manufacturing or service sector at 
     a facility at which the employer has made a general 
     announcement that such facility will close within 180 days.
       ``(C) Health care professional.--The term `health care 
     professional'--
       ``(i) means an individual who is involved with--

       ``(I) the delivery of health care services, or related 
     services, pertaining to--

       ``(aa) the identification, evaluation, and prevention of 
     diseases, disorders, or injuries; or
       ``(bb) home-based or community-based long-term care;

       ``(II) the delivery of dietary and nutrition services; or
       ``(III) rehabilitation and health systems management; and

       ``(ii) includes nurses, home health aides, nursing 
     assistants, physician assistants, dental hygienists, 
     diagnostic medical sonographers, dietitians, medical 
     technologists, occupational therapists, physical therapists, 
     radiographers, respiratory therapists, emergency medical 
     service technicians, and speech-language pathologists.
       ``(2) Establishment of project.--In accordance with 
     subsection (b), the Secretary shall establish and carry out a 
     health professions training demonstration project.
       ``(3) Grants.--In carrying out the project, the Secretary, 
     after consultation with the Secretary of Health and Human 
     Services, shall make grants to eligible entities to enable 
     the entities to carry out programs in covered communities to 
     train covered workers for employment as health care 
     professionals. The Secretary shall make each grant in an 
     amount of not less than $100,000 and not more than $500,000.
       ``(4) Eligible entities.--Notwithstanding subsection 
     (b)(2)(B), to be eligible to receive a grant under this 
     subsection to carry out a program in a covered community, an 
     entity shall be a partnership that is--
       ``(A) under the direction of a local workforce investment 
     board established under section 117 that is serving the 
     covered community; and
       ``(B) composed of members serving the covered community, 
     such as--
       ``(i) a community college;
       ``(ii) a vocational or technical school;
       ``(iii) a health clinic or hospital;
       ``(iv) a home-based or community-based long-term care 
     facility or program; or
       ``(v) a health care facility administered by the Secretary 
     of Veterans Affairs.
       ``(5) Applications.--To be eligible to receive a grant 
     under this subsection, an entity shall submit an application 
     to the Secretary at such time, in such manner, and containing 
     such information as the Secretary may require, including, at 
     a minimum--
       ``(A) a proposal to use the grant funds to establish or 
     expand a training program in order to train covered workers 
     for employment as health care professionals or 
     paraprofessionals;
       ``(B) information demonstrating the need for the training 
     and support services to be provided through the program;
       ``(C) information describing the manner in which the entity 
     will expend the grant funds, and the activities to be carried 
     out with the funds; and
       ``(D) information demonstrating that the entity meets the 
     requirements of paragraph (4).
       ``(6) Selection.--In making grants under paragraph (3), the 
     Secretary, after consultation with the Secretary of Health 
     and Human Services, shall select--
       ``(A) eligible entities submitting applications that meet 
     such criteria as the Secretary of Labor determines to be 
     appropriate; and
       ``(B) among such entities, the eligible entities serving 
     the covered communities with the greatest need for the grants 
     and the greatest potential to benefit from the grants.
       ``(7) Use of funds.--
       ``(A) In General.--An entity that receives a grant under 
     this subsection shall use the funds made available through 
     the grant for training and support services that meet the 
     needs described in the application submitted under paragraph 
     (5), which may include--
       ``(i) increasing capacity at an educational institution or 
     training center to train individuals for employment as health 
     professionals, such as by--

       ``(I) expanding a facility, subject to subparagraph (B);
       ``(II) expanding course offerings;
       ``(III) hiring faculty;
       ``(IV) providing a student loan repayment program for the 
     faculty;
       ``(V) establishing or expanding clinical education 
     opportunities;
       ``(VI) purchasing equipment, such as computers, books, 
     clinical supplies, or a patient simulator; or
       ``(VII) conducting recruitment; or

       ``(ii) providing support services for covered workers 
     participating in the training, such as--

       ``(I) providing tuition assistance;
       ``(II) establishing or expanding distance education 
     programs;
       ``(III) providing transportation assistance; or
       ``(IV) providing child care.

       ``(B) Limitation.--To be eligible to use the funds to 
     expand a facility, the eligible entity shall demonstrate to 
     the Secretary in an application submitted under paragraph (5) 
     that the entity can increase the capacity described in 
     subparagraph (A)(i) only by expanding the facility.
       ``(8) Funding.--Of the amounts appropriated to, and 
     available at the discretion of, the Secretary or the 
     Secretary of Health and Human Services for programmatic and 
     administrative expenditures, a total of $25,000,000 shall be 
     used to establish and carry out the demonstration project 
     described in paragraph (2) in accordance with this 
     subsection.''.
                                  ____

                                           National Association of


                                             Workforce Boards,

                               Washington, DC, September 28, 2004.
     Hon. Russell Feingold,
     U.S. Senate,
     Washington, DC.
       Dear Senator Feingold: This letter is in regards to your 
     bill, the Community-Based Health Care Retraining Act, which 
     seeks to establish a demonstration project to train 
     unemployed workers for employment as health care 
     professionals. The National Association of Workforce Boards 
     (NAWB) would like to support your efforts in linking 
     America's workforce investment boards with health care 
     training. Our members can be a valuable resource in the 
     transition of manufacturing workers to the numerous 
     employment opportunities in the health care field.
       NAWB is the national association that represents the 
     interests of the 650 workforce investment boards across the 
     country. These boards consist of over 15,000 private sector

[[Page S10707]]

     business leaders, appointed by their Governors and local 
     elected officials, who provide leadership and governance for 
     the public workforce development system. In existence since 
     1979, NANWB has been a leader in the effort to create a 
     public workforce system. that is responsive to businesses and 
     job seekers alike.
       As you know, meeting the ever-increasing needs of America's 
     workers and employers is critical for prosperity in the 
     United States. Developing an educated and skilled workforce 
     to attract and retain business is a challenge facing all 
     communities. The growing education and workforce skills 
     mismatch between what the current American workforce offers 
     and what employers need is particularly acute in high-skill 
     industry sectors. However, these are the very industries that 
     hold the most economic promise for our current workers and 
     the emerging workforce, our nation's young people. The 
     challenge posed for policy makers is aligning America's 
     workforce with rapidly changing economic conditions and 
     opportunities, while simultaneously maintaining 
     competitiveness to minimize off-shoring.
       Four of five U.S. manufacturers struggled to find 
     candidates for skilled jobs, according to a 2003 survey by 
     the National Association of Manufacturers. Ironically, this 
     search for skilled workers occurred while many plants were 
     going thorough layoffs. The United States has seen 3 million 
     manufacturing jobs disappear.
       Workers have permanently lost the jobs they once held at 
     these factories. New opportunities must be made to allow a 
     transition into new employment, especially for those who 
     cannot recover their job if demand increases. But in order to 
     do this, training dollars must be made available to those 
     employees who cannot regain employment within the 
     manufacturing industry.
       Through your bill, employers in the health care industry 
     that desperately need skilled workers can find the human 
     capital they desire in those who have been permanently laid 
     off from their manufacturing job. There has been an enormous 
     increase in the number of nursing and direct care 
     professional opportunities within the long-term care arena, 
     particularly within home-based care. These opportunities are 
     not only based on the number of employees needed. They 
     require a high level of skill, knowledge and compassion to 
     work in long-term care. Training dollars must be available to 
     introduce educated employees to the health care industry.
       Employers on the lay-off end of manufacturing employment 
     and employers on the hiring end of health care industries 
     need to tap all available employment and training resources. 
     NAWB can assist both sides of the equation by connecting 
     employers with their local workforce boards. Investing in 
     training our workers is critical.
       Our CEO, Ms. Stephanie Powers, is available to provide your 
     staff with any information you may require (phone: (202) 775-
     0960 or email: [email protected]). Thank you for your interest 
     in our organization and the members we represent. The 
     National Association of Workforce Boards remains committed to 
     working with Congress as we continue our mission to build a 
     stronger, more competitive American workforce.
           Sincerely,
     J. Michael Zelley,
       President, The Disability Network, Flint, MI, and Co-Chair, 
     Policy Committee, National Association of Workforce Boards.
     Jeffrey Howe,
       Vice President, Manager, Indiana Commercial Banking, First 
     Indiana Bank, N.A., Indianapolis, IN, and Chair, National 
     Association of Workforce Boards.
                                  ____



                             American Health Care Association,

                               Washington, DC, September 29, 2004.
     Hon. Russell D. Feingold,
     U.S. Senate,
     Washington, DC.
       Dear Senator Feingold: On behalf of the American Health 
     Care Association, the nation's largest association of long 
     term care providers, and the National Center for Assisted 
     Living, I am writing you to offer our support for enactment 
     of the ``Community-Based Health Care Retraining Act'' you are 
     introducing.
       Today, there is a critical shortage of health and long term 
     care professionals and paraprofessionals and it is growing. 
     In our nation's nursing facilities, there is a need for more 
     than 90,000 nurses and certified nursing assistants right now 
     to provide the hands-on care needed by the frail and elderly. 
     The need for these direct care workers will grow dramatically 
     in the future as the baby boom population moves into 
     retirement. America's high standard for quality can only be 
     maintained if there are enough front-line workers to provide 
     the direct hands-on care that will be needed. This is not a 
     job that can be handled off-shore.
       Your legislation will help to address this shortage by 
     providing the means for a growing number of displaced 
     manufacturing and service sector workers to begin building 
     new careers in the health and long term care sectors. It does 
     so by utilizing federal dollars to redirect these displaced 
     workers into health care careers. It provides for expanding 
     the nation's training capacity and by increasing number of 
     educators that are and will be needed to make this transition 
     successful.
       Senator Feingold, we commend you for the leadership you are 
     providing with the introduction of this legislation and look 
     forward to working with you to see this legislation passed 
     and enacted at the earliest opportunity.
           Sincerely,
                                                         Hal Daub,
     President & CEO.
                                  ____

                                          Wisconsin Association of


                                      Job Training Executives,

                                                  August 10, 2004.
     Senator Russ Feingold,
     Hart Senate Office Building, Washington, DC.
       Dear Senator Feingold: On behalf of the Wisconsin 
     Association of Job Training Executives (WAJTE), I am writing 
     to express our strong support for the proposed legislation 
     designed to address two significant workforce issues--the 
     loss of large numbers of manufacturing and service sector 
     jobs and the critical shortage of health care professionals. 
     As you know, both of these issues currently challenge the 
     workforce development delivery systems in Wisconsin.
       Our association members are the chief executives of each of 
     Wisconsin's eleven Workforce Development Boards who have the 
     responsibility for overseeing the health of the local 
     economies in partnership with business, education, and local 
     governments. The proposed legislation offers these specific 
     strengths.
       Ensures that eligible entities shall be a partnership under 
     the direction of a local board.
       Limits grant funds to training programs for health care 
     professionals.
       Allows for the use of grant funds for support services as 
     well as training.
       Allows for capacity expansion in educational institutions.
       If WAJTE members can be of assistance to you as this 
     legislation is introduced, please do not hesitate to contact 
     us.
           Sincerely,
                                                Francisco Sanchez,
     Chairman.
                                  ____



                                                     CEP--WIB,

                                  Ashland, WI, September 30, 2004.
     Senator Russ Feingold,
     Hart Senate Building, Washington, DC.
       Dear Senator Feingold: On behalf of the Northwest Wisconsin 
     Concentrated Employment Program, Inc. and the Northwest 
     Wisconsin Workforce Investment Board, Inc., I want to express 
     our enthusiastic support in the Community-Based Health Care 
     Retraining Act in Wisconsin.
       This initiative will help to strengthen the economy of our 
     area. Some of our counties in Northwest Wisconsin are 
     experiencing high labor shortages particularly in the health 
     care industries. Further, our area wages are approximately 
     24% less than the State average, which adds to a poverty 
     situation made worse by rural isolation. This Community-Based 
     Health Care Retraining Act will address these serious 
     economic issues and help to alleviate the severe shortage of 
     health care workers.
       This Act provides hope for the future economy and people of 
     our State. Please contact me if we can be of any further 
     assistance.
           Sincerely yours,
                                                     Fred Schnook,
     Executive Director.
                                  ____

                                               Southwest Wisconsin


                                  Workforce Development Board,

                                   Dodgeville, WI, August 4, 2004.
     Hon. Russ Feingold,
     Hart Senate Office Building, Washington, DC.
       Dear Senator Feingold: I would like to take this 
     opportunity to comment on your proposed legislation regarding 
     health-care retraining. I believe it is an excellent proposal 
     that will address a serious need particularly within rural 
     communities. Please allow me to elaborate on several points 
     that support this legislation.
       First, as executive director for a primarily rural 
     workforce development area, I can tell you how difficult it 
     is to replace manufacturing jobs. There simply are not many 
     good quality jobs to replace manufacturing jobs lost to rural 
     communities. The medical professions, by offering a ``living 
     wage'' and good benefits, provide an excellent alternative to 
     manufacturing for sustaining a higher, family-oriented 
     standard of living. Health-care is also a regional scope, 
     providing job opportunities for workers in surrounding 
     communities. Furthermore, medical professions are not 
     exportable and there is virtually no chance that health-care 
     jobs will be shipped out-of-country or overseas.
       Second, I am chairperson of a small, rural community 
     hospital. For many years we have struggled to survive in a 
     very competitive market surrounded by large, corporate 
     medical organizations/hospitals in Janesville and Madison. I 
     believe that our hospital has a unique role within our 
     community--as a community-based facility we are closer to our 
     patients and can provide personalized ``hometown'' care. One 
     of our biggest problems is our ability to attract and retain 
     qualified, experienced health-care workers. With the 
     impending shortage caused by the retirement of ``baby 
     boomers'' we will find ourselves in an even more difficult 
     role as larger facilities offer higher salaries, better 
     benefits, incentive and sign-on bonuses, etc. to attract and 
     retain the workers they need. Rural hospitals will find 
     themselves left out and unable to compete for the caregivers 
     we need.
       Third, there are several key organizations that lie at the 
     core of any community that

[[Page S10708]]

     are vital to the quality of life within that community. 
     Schools are one example of this type of organizations. 
     Hospitals, nursing homes and other types of medical 
     facilities are other examples of key organizations that 
     support a higher standard of life within a rural community.
       And finally, I would like to thank the Senator for 
     recognizing the vital role that Workforce Development Boards 
     (WDBs) play in our areas. The WDBs are regional organizations 
     providing oversight and coordination for economic and 
     workforce development activities. Furthermore, there are few 
     organizations today that are advocates for the ``worker''. I 
     believe that WDBs are an example of such an organization. 
     And, I believe it is critical to the success of a program 
     that the WDBs serve as the coordinating agency for the 
     delivery of this type of program.
       For the reasons stated above, I strongly support your 
     proposed Health-Care Retraining Bill. Thank you for the 
     chance to offer my comments. I look forward to the 
     opportunity to participate in, what I believe to be, a 
     meaningful and critically important program particularly for 
     the rural communities.
       Sincerely,
                                              Robert T. Borremans,
                                               Executive Director.
                                 ______