I 

118TH CONGRESS 

2D SESSION H. R. 7929 

To amend title XX of the Social Security Act to provide for nursing home 

worker training grants. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 10, 2024 

Mr. HORSFORD (for himself and Mr. DAVIS of Illinois) introduced the 

following bill; which was referred to the Committee on Ways and Means 

A BILL 

To amend title XX of the Social Security Act to provide 

for nursing home worker training grants. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Nursing Home Work5 force Support and Expansion Act of 2024’’. 

6 SEC. 2. NURSING HOME WORKER TRAINING GRANTS. 

7 Section 2041 of the Social Security Act (42 U.S.C. 

8 1397m) is amended to read as follows: 

9 ‘‘SEC. 2041. NURSING HOME WORKER TRAINING GRANTS. 

10 ‘‘(a) IN GENERAL.— 


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1 ‘‘(1) STATE ENTITLEMENT.— 

2 ‘‘(A) IN GENERAL.—Each State shall be 

3 entitled to receive from the Secretary for each 

4 fiscal year specified in subsection (e)(1) a grant 

5 in an amount equal to the amount allotted to 

6 the State under subparagraph (B). 

7 ‘‘(B) STATE ALLOTMENTS.— 

8 ‘‘(i) IN GENERAL.—Subject to clauses 

9 (ii) and (iii), the amount allotted to a 

10 State under this subparagraph for a fiscal 

11 year shall be— 

12 ‘‘(I) the number of State resi13 dents who have attained 65 years of 

14 age or are under a disability (as de15 fined in section 216(i)(1)), as deter16 mined by the Secretary using the 

17 most recent version of the American 

18 Community Survey published by the 

19 Bureau of the Census or a successor 

20 data set; divided by 

21 ‘‘(II) the total number of such 

22 residents of all States. 

23 ‘‘(ii) LIMITATION.—The amount allot24 ted to a State under this subparagraph for 

25 a fiscal year shall be not less than 0.25 


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1 percent of the available amount for the fis2 cal year. 

3 ‘‘(iii) ADJUSTMENT OF STATE ALLOT4 MENTS.—Subject to clause (ii), the Sec5 retary shall proportionately increase or de6 crease the amounts allotted under this sub7 paragraph for a fiscal year as necessary to 

8 ensure that the available amount for the 

9 fiscal year is allotted among the States. 

10 ‘‘(iv) REDETERMINATIONS.— 

11 ‘‘(I) FREQUENCY.—The Sec12 retary shall make the determination 

13 referred to in clause (i)(I) every 5 

14 years. 

15 ‘‘(II) LIMITATION.—Subject to 

16 clause (ii), the amount allotted to a 

17 State under this subparagraph, on the 

18 basis of such a determination, for a 

19 fiscal year after fiscal year 2029 shall 

20 be— 

21 ‘‘(aa) not less than 90 per22 cent of the amount of the grant 

23 made to the State under this 

24 subparagraph for the then pre25 ceding fiscal year; and 


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1 ‘‘(bb) not more than 110 

2 percent of the amount referred to 

3 in item (aa). 

4 ‘‘(2) GRANTS TO INDIAN TRIBES AND TRIBAL

5 ORGANIZATIONS.— 

6 ‘‘(A) IN GENERAL.—The Secretary, in con7 sultation with the Secretary of the Interior, 

8 shall make grants in accordance with this sec9 tion to Indian tribes and tribal organizations 

10 who operate at least 1 eligible setting. 

11 ‘‘(B) GRANT FORMULA.—The Secretary, in 

12 consultation with the Secretary of the Interior, 

13 shall devise a formula for distributing among 

14 Indian tribes and tribal organizations the 

15 amount required to be reserved by subsection 

16 (e)(1) for each fiscal year. 

17 ‘‘(3) SUB-GRANTS.—A State, Indian tribe, or 

18 tribal organization to which an amount is paid under 

19 this section may use the amount to make sub-grants 

20 to local organizations, including community organi21 zations, local non-profits, elder rights and justice 

22 groups, and workforce development boards for any 

23 purpose described in paragraph (1) or (2) of sub24 section (b). 

25 ‘‘(b) USE OF FUNDS.— 


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1 ‘‘(1) REQUIRED USES.—A State to which an 

2 amount is paid under this section shall use the 

3 amount to— 

4 ‘‘(A) provide wage subsidies to eligible in5 dividuals; 

6 ‘‘(B) provide student loan repayment or 

7 tuition assistance to eligible individuals for a 

8 degree or certification in a field relevant to 

9 their position referred to in subsection (f)(2); 

10 ‘‘(C) guarantee affordable and accessible 

11 child care for eligible individuals, including help 

12 with referrals, co-pays, or other direct assist13 ance; and 

14 ‘‘(D) provide assistance where necessary 

15 with obtaining appropriate transportation, in16 cluding public transportation if available, or gas 

17 money if public transportation is unavailable or 

18 impractical based on work hours or location. 

19 ‘‘(2) AUTHORIZED USES.—A State to which an 

20 amount is paid under this section may use the 

21 amount to— 

22 ‘‘(A) establish a reserve fund for financial 

23 assistance to eligible individuals in emergency 

24 situations; 


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1 ‘‘(B) provide in-kind resource donations, 

2 such as interview clothing and conference at3 tendance fees; 

4 ‘‘(C) provide assistance with programs and 

5 activities, including legal assistance, deemed 

6 necessary to address arrest or conviction 

7 records that are an employment barrier; 

8 ‘‘(D) support employers operating an eligi9 ble setting in the State in providing employees 

10 with not less than 2 weeks of paid leave per 

11 year; or 

12 ‘‘(E) provide other support services the 

13 Secretary deems necessary to allow for success14 ful recruitment and retention of workers. 

15 ‘‘(3) PROVISION OF FUNDS ONLY FOR THE

16 BENEFIT OF ELIGIBLE INDIVIDUALS IN ELIGIBLE

17 SETTINGS.—A State to which an amount is paid 

18 under this section may provide the amount to only 

19 an eligible individual or a partner organization serv20 ing an eligible individual. 

21 ‘‘(4) NONSUPPLANTATION.—A State to which 

22 an amount is paid under this section shall not use 

23 the amount to supplant the expenditure of any State 

24 funds for recruiting or retaining employees in an eli25 gible setting. 


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1 ‘‘(5) OBLIGATION DEADLINE.—A State, Indian 

2 tribe, or tribal organization shall remit to the Sec3 retary for reallotment under this section any amount 

4 paid under this section for a fiscal year that is not 

5 obligated within 2 years after the end of the fiscal 

6 year. 

7 ‘‘(c) ADMINISTRATION.—A State to which a grant is 

8 made under this section shall reserve not more than 10 

9 percent of the grant to— 

10 ‘‘(1) administer subgrants in accordance with 

11 this section; 

12 ‘‘(2) provide technical assistance and support 

13 for applying for and accessing such a subgrant op14 portunity; 

15 ‘‘(3) publicize the availability of the subgrants; 

16 ‘‘(4) carry out activities to increase the supply 

17 of eligible individuals; and 

18 ‘‘(5) provide technical assistance to help sub19 grantees find and train individuals to provide the 

20 services for which they are contracted. 

21 ‘‘(d) REPORTS.— 

22 ‘‘(1) STATE REPORTS.—Not less frequently 

23 than annually, each State to which a grant has been 

24 made under this section shall transmit to the Sec25 retary a written report describing the activities unVerDate Sep 11 2014 00:30 Apr 21, 2024 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7929.IH H7929

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1 dertaken by the State pursuant to this section dur2 ing the period covered by the report, which shall in3 clude— 

4 ‘‘(A) the total amount expended in the 

5 State for each type of use described in para6 graph (1) or (2) of subsection (b); 

7 ‘‘(B) the total number of non-State organi8 zations in the State to which grant funds were 

9 provided, and the amount so provided to each 

10 such organization; 

11 ‘‘(C) the change in the number of individ12 uals working in each job category described in 

13 subsection (f)(2) in an eligible setting in the 

14 State; 

15 ‘‘(D) the average duration of employment 

16 for each such job category; 

17 ‘‘(E) the average annual wage of workers 

18 in each job category described in subsection 

19 (f)(2) in an eligible setting in the State; 

20 ‘‘(F) the average amount of paid time off 

21 to which a worker in each job category de22 scribed in subsection (f)(2) in an eligible setting 

23 in the State is entitled by their contract; and 

24 ‘‘(G) such other data elements as the Sec25 retary deems relevant. 


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1 ‘‘(2) REPORT TO THE CONGRESS.—Not later 

2 than 3 years after the date of the enactment of this 

3 section, and every 4 years thereafter, the Secretary 

4 shall submit to the Congress a written report out5 lining how the States have used the grants made 

6 under this section during the period covered by the 

7 report, which shall include— 

8 ‘‘(A) the total amount expended in each 

9 State for each type of use described in para10 graph (1) or (2) of subsection (b); 

11 ‘‘(B) the total number of non-State organi12 zations in each State to which grant funds were 

13 provided, and the amount so provided to each 

14 such organization; 

15 ‘‘(C) the change in the number of individ16 uals working in each job category described in 

17 subsection (f)(2) in an eligible setting; 

18 ‘‘(D) the average duration of employment 

19 for each such job category, by State; 

20 ‘‘(E) the average annual wage of workers 

21 in each job category described in subsection 

22 (f)(2) in an eligible setting; 

23 ‘‘(F) the average amount of paid time off 

24 to which a worker in each job category deVerDate Sep 11 2014 00:30 Apr 21, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H7929.IH H7929

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1 scribed in subsection (f)(2) in an eligible setting 

2 is entitled by their contract; and 

3 ‘‘(G) such other data elements as the Sec4 retary deems relevant. 

5 ‘‘(e) APPROPRIATION.—Out of any funds in the 

6 Treasury not otherwise appropriated, there is appro7 priated to the Secretary $400,000,000 for each of fiscal 

8 years 2025 through 2028 to carry out this section, of 

9 which 2 percent shall be reserved for grants to Indian 

10 tribes and tribal organizations. 

11 ‘‘(f) DEFINITIONS.—In this section: 

12 ‘‘(1) AVAILABLE AMOUNT.—The term ‘available 

13 amount’ means, with respect to a fiscal year, the 

14 amount specified in subsection (e) that remains after 

15 the reservation required by such subsection for the 

16 fiscal year, plus all amounts remitted to the Sec17 retary under subsection (b)(5) that have not been 

18 reallotted under subsection (a)(1)(B)(iii). 

19 ‘‘(2) ELIGIBLE INDIVIDUAL.—The term ‘eligible 

20 individual’ means an individual who— 

21 ‘‘(A)(i) is a qualified home health aide, as 

22 defined in section 484.80(a) of title 42, Code of 

23 Federal Regulations; 

24 ‘‘(ii) is a nurse aide approved by the State 

25 as meeting the requirements of sections 


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1 483.150 through 483.154 of such title, and is 

2 listed in good standing on the State nurse aide 

3 registry; 

4 ‘‘(iii) is a personal care aide approved by 

5 the State, and furnishes personal care services, 

6 as defined in section 440.167 of such title; 

7 ‘‘(iv) is a qualified hospice aide, as defined 

8 in section 418.76 of such title; 

9 ‘‘(v) is a licensed practical nurse or a li10 censed or certified social worker; or 

11 ‘‘(vi) is receiving training to be certified or 

12 licensed as such an aide, nurse, or social work13 er; and 

14 ‘‘(B) provides (or, in the case of a trainee, 

15 intends to provide) services as such an aide, 

16 nurse, or social worker in an eligible setting. 

17 ‘‘(3) ELIGIBLE SETTING.—The term ‘eligible 

18 setting’ means— 

19 ‘‘(A) a skilled nursing facility, as defined 

20 in section 1819; 

21 ‘‘(B) a nursing facility, as defined in sec22 tion 1919; 

23 ‘‘(C) a home health agency, as defined in 

24 section 1891; 


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1 ‘‘(D) a facility approved to deliver home or 

2 community-based services authorized under 

3 State options described in subsection (c) or (i) 

4 of section 1915 or, as relevant, demonstration 

5 projects authorized under section 1115; 

6 ‘‘(E) a hospice, as defined in section 1814; 

7 or 

8 ‘‘(F) a tribal assisted living facility. 

9 ‘‘(4) TRIBAL ORGANIZATION.—The term ‘tribal 

10 organization’ has the meaning given the term in sec11 tion 4 of the Indian Self-Determination and Edu12 cation Assistance Act.’’. 

Æ 


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