II 

118TH CONGRESS 

1ST SESSION S. 3449 

To provide low-income individuals with opportunities to enter and follow 

a career pathway in the health professions, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 7, 2023 

Mr. HEINRICH (for himself, Mr. WYDEN, Ms. KLOBUCHAR, Mr. MURPHY, Mr. 

LUJA ́N, Mr. BLUMENTHAL, and Ms. CORTEZ MASTO) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To provide low-income individuals with opportunities to enter 

and follow a career pathway in the health professions, 

and for other purposes. 

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 section may be cited as the ‘‘Pathways to Health 

5 Careers Act’’. 

2 

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1 SEC. 2. CAREER PATHWAYS THROUGH HEALTH PROFES2 SION OPPORTUNITY GRANTS. 

3 Effective October 1, 2023, section 2008 of the Social 

4 Security Act (42 U.S.C. 1397g) is amended to read as 

5 follows: 

6 ‘‘SEC. 2008. CAREER PATHWAYS THROUGH HEALTH PRO7 FESSION OPPORTUNITY GRANTS. 

8 ‘‘(a) APPLICATION REQUIREMENTS.—An eligible en9 tity desiring a grant under this section for a project shall 

10 submit to the Secretary an application for the grant, that 

11 includes the following: 

12 ‘‘(1) A description of how the applicant will use 

13 a career pathways approach to train eligible individ14 uals for health professions that pay well or will put 

15 eligible individuals on a career path to an occupation 

16 that pays well, under the project. 

17 ‘‘(2) A description of the adult basic education 

18 and literacy activities, work readiness activities, 

19 training activities, and case management and career 

20 coaching services that the applicant will use to assist 

21 eligible individuals to gain work experience, connec22 tion to employers, and job placement, and a descrip23 tion of the plan for recruiting, hiring, and training 

24 staff to provide the case management, mentoring, 

25 and career coaching services, under the project diVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 rectly or through local governmental, apprenticeship, 

2 educational, or charitable institutions. 

3 ‘‘(3) In the case of an application for a grant 

4 under this section for a demonstration project de5 scribed in subsection (c)(2)(B)(i)(I)— 

6 ‘‘(A) a demonstration that the State in 

7 which the demonstration project is to be con8 ducted has in effect policies or laws that permit 

9 certain allied health and behavioral health care 

10 credentials to be awarded to people with certain 

11 arrest or conviction records (which policies or 

12 laws shall include appeals processes, waivers, 

13 certificates, and other opportunities to dem14 onstrate rehabilitation to obtain credentials, li15 censure, and approval to work in the proposed 

16 health careers), and a plan described in the ap17 plication that will use a career pathway to as18 sist participants with such a record in acquiring 

19 credentials, licensing, and employment in the 

20 specified careers; 

21 ‘‘(B) a discussion of how the project or fu22 ture strategic hiring decisions will demonstrate 

23 the experience and expertise of the project in 

24 working with job seekers who have arrest or 

25 conviction records or employers with experience 

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1 working with people with arrest or conviction 

2 records; 

3 ‘‘(C) an identification of promising innova4 tions or best practices that can be used to pro5 vide the training; 

6 ‘‘(D) a proof of concept or demonstration 

7 that the applicant has done sufficient research 

8 on workforce shortage or in-demand jobs for 

9 which people with certain types of arrest or 

10 conviction records can be hired; 

11 ‘‘(E) a plan for recruiting students who 

12 are eligible individuals into the project; and 

13 ‘‘(F) a plan for providing post-employment 

14 support and ongoing training as part of a ca15 reer pathway under the project. 

16 ‘‘(4) In the case of an application for a grant 

17 under this section for a demonstration project de18 scribed in subsection (c)(2)(B)(i)(II)— 

19 ‘‘(A) a description of the partnerships, 

20 strategic staff hiring decisions, tailored program 

21 activities, or other programmatic elements of 

22 the project, such as training plans for doulas 

23 and other community health workers and train24 ing plans for midwives and other allied health 

25 professions, that are designed to support a caVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 reer pathway in pregnancy, birth, or post2 partum services; and 

3 ‘‘(B) a demonstration that the State in 

4 which the demonstration project is to be con5 ducted recognizes doulas or midwives, as the 

6 case may be. 

7 ‘‘(5) A demonstration that the applicant has ex8 perience working with low-income populations, or a 

9 description of the plan of the applicant to work with 

10 a partner organization that has the experience. 

11 ‘‘(6) A plan for providing post-employment sup12 port and ongoing training as part of a career path13 way under the project. 

14 ‘‘(7) A description of the support services that 

15 the applicant will provide under the project, includ16 ing a plan for how child care and transportation 

17 support services will be guaranteed and, if the appli18 cant will provide a cash stipend or wage supplement, 

19 how the stipend or supplement would be calculated 

20 and distributed. 

21 ‘‘(8) A certification by the applicant that the 

22 project development included— 

23 ‘‘(A) consultation with a local workforce 

24 development board established under section 

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1 107 of the Workforce Innovation and Oppor2 tunity Act; 

3 ‘‘(B) consideration of apprenticeship and 

4 pre-apprenticeship models registered under the 

5 Act of August 16, 1937 (also known as the 

6 ‘National Apprenticeship Act’); 

7 ‘‘(C) consideration of career pathway pro8 grams in the State in which the project is to be 

9 conducted; and 

10 ‘‘(D) a review of the State plan under sec11 tion 102 or 103 of the Workforce Innovation 

12 and Opportunity Act. 

13 ‘‘(9) A description of the availability and rel14 evance of recent labor market information and other 

15 pertinent evidence of in-demand jobs or worker 

16 shortages. 

17 ‘‘(10) A certification that the applicant will di18 rectly provide or contract for the training services 

19 described in the application. 

20 ‘‘(11) A commitment by the applicant that, if 

21 the grant is made to the applicant, the applicant 

22 will— 

23 ‘‘(A) during the planning period for the 

24 project, provide the Secretary with any informa25 tion needed by the Secretary to establish adeVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 quate data reporting and administrative struc2 ture for the project; 

3 ‘‘(B) hire a person to direct the project not 

4 later than the end of the planning period appli5 cable to the project; 

6 ‘‘(C) accept all technical assistance offered 

7 by the Secretary with respect to the grant; 

8 ‘‘(D) participate in peer technical assist9 ance conferences as are regularly scheduled by 

10 the Secretary; and 

11 ‘‘(E) provide all data required by the Sec12 retary under subsection (g). 

13 ‘‘(b) PREFERENCES IN CONSIDERING APPLICA14 TIONS.—In considering applications for a grant under this 

15 section, the Secretary shall give preference to— 

16 ‘‘(1) applications submitted by applicants to 

17 whom a grant was made under this section or any 

18 predecessor to this section; 

19 ‘‘(2) applications submitted by applicants who 

20 have business and community partners in each of 

21 the following categories: 

22 ‘‘(A) State and local government agencies 

23 and social service providers, including a State 

24 or local entity that administers a State program 

25 funded under part A of this title; 

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1 ‘‘(B) institutions of higher education, ap2 prenticeship programs, and local workforce de3 velopment boards established under section 107 

4 of the Workforce Innovation and Opportunity 

5 Act; and 

6 ‘‘(C) health care employers, health care in7 dustry or sector partnerships, labor unions, and 

8 labor-management partnerships; 

9 ‘‘(3) applications that include opportunities for 

10 mentoring or peer support, and make career coach11 ing available, as part of the case management plan; 

12 ‘‘(4) applications which describe a project that 

13 will serve a rural area in which— 

14 ‘‘(A) the community in which the individ15 uals to be enrolled in the project reside is lo16 cated; 

17 ‘‘(B) the project will be conducted; or 

18 ‘‘(C) an employer partnership that has 

19 committed to hiring individuals who successfully 

20 complete all activities under the project is lo21 cated; 

22 ‘‘(5) applications that include a commitment to 

23 providing project participants with a cash stipend or 

24 wage supplement; and 

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1 ‘‘(6) applications which have an emergency cash 

2 fund to assist project participants financially in 

3 emergency situations. 

4 ‘‘(c) GRANTS.— 

5 ‘‘(1) COMPETITIVE GRANTS.— 

6 ‘‘(A) GRANT AUTHORITY.— 

7 ‘‘(i) IN GENERAL.—The Secretary, in 

8 consultation with the Secretary of Labor 

9 and the Secretary of Education, may make 

10 a grant in accordance with this paragraph 

11 to an eligible entity whose application for 

12 the grant is approved by the Secretary, to 

13 conduct a project designed to train low-in14 come individuals for allied health profes15 sions, health information technology, physi16 cians assistants, nursing assistants, reg17 istered nurse, advanced practice nurse, 

18 emergency medical technicians, para19 medics, and other professions considered 

20 part of a health care career pathway 

21 model. 

22 ‘‘(ii) GUARANTEE OF GRANTEES IN

23 EACH STATE AND THE DISTRICT OF CO24 LUMBIA.—For each grant cycle, the Sec25 retary shall award a grant under this paraVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 graph to at least 2 eligible entities in each 

2 State that is not a territory, to the extent 

3 there are a sufficient number of applica4 tions submitted by the entities that meet 

5 the requirements applicable with respect to 

6 such a grant. If, for a grant cycle, there 

7 are fewer than 2 such eligible entities in a 

8 State, the Secretary shall include that in9 formation in the report required by sub10 section (g)(2) that covers the fiscal year. 

11 ‘‘(B) GUARANTEE OF GRANTS FOR INDIAN

12 POPULATIONS.—From the amount reserved 

13 under subsection (i)(2)(B) for each fiscal year, 

14 the Secretary shall award a grant under this 

15 paragraph to at least 10 eligible entities that 

16 are an Indian tribe, a tribal organization, or a 

17 tribal college or university, to the extent there 

18 are a sufficient number of applications sub19 mitted by the entities that meet the require20 ments applicable with respect to such a grant. 

21 ‘‘(C) GUARANTEE OF GRANTEES IN THE

22 TERRITORIES.—From the amount reserved 

23 under subsection (i)(2)(C) for each fiscal year, 

24 the Secretary shall award a grant under this 

25 paragraph to at least 2 eligible entities that are 

11 

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1 located in a territory, to the extent there are a 

2 sufficient number of applications submitted by 

3 the entities that meet the requirements applica4 ble with respect to such a grant. 

5 ‘‘(2) GRANTS FOR DEMONSTRATION

6 PROJECTS.— 

7 ‘‘(A) GRANT AUTHORITY.—The Secretary, 

8 in consultation with the Secretary of Labor and 

9 the Secretary of Education (and, with respect 

10 to demonstration projects of the type described 

11 in subparagraph (B)(i)(I), the Attorney Gen12 eral) shall make a grant in accordance with this 

13 subsection to an eligible entity whose applica14 tion for the grant is approved by the Secretary, 

15 to conduct a demonstration project that meets 

16 the requirements of subparagraph (B). 

17 ‘‘(B) REQUIREMENTS.—The requirements 

18 of this subparagraph are the following: 

19 ‘‘(i) TYPE OF PROJECT.—The dem20 onstration project shall be of 1 of the fol21 lowing types: 

22 ‘‘(I) INDIVIDUALS WITH ARREST

23 OR CONVICTION RECORDS DEM24 ONSTRATION.—The demonstration 

25 project shall be of a type designed to 

12 

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1 provide education and training for eli2 gible individuals with arrest or convic3 tion records to enter and follow a ca4 reer pathway in the health professions 

5 through occupations that pay well and 

6 are expected to experience a labor 

7 shortage or be in high demand. 

8 ‘‘(II) MATERNAL MORTALITY CA9 REER PATHWAY DEMONSTRATION.— 

10 The demonstration project shall be of 

11 a type designed to provide education 

12 and training for eligible individuals to 

13 enter and follow a career pathway in 

14 the field of pregnancy, childbirth, and 

15 post-partum, in a State that recog16 nizes doulas or midwives and that 

17 provides payment for services provided 

18 by doulas or midwives, as the case 

19 may be, under private or public health 

20 insurance plans. 

21 ‘‘(ii) DURATION.—The demonstration 

22 project shall be conducted for not less than 

23 5 years. 

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1 ‘‘(C) MINIMUM ALLOCATION OF FUNDS

2 FOR EACH TYPE OF DEMONSTRATION

3 PROJECT.— 

4 ‘‘(i) INDIVIDUALS WITH ARREST OR

5 CONVICTION RECORDS DEMONSTRA6 TIONS.—Not less than 25 percent of the 

7 amounts made available for grants under 

8 this paragraph shall be used to make 

9 grants for demonstration projects of the 

10 type described in subparagraph (B)(i)(I). 

11 ‘‘(ii) MATERNAL MORTALITY CAREER

12 PATHWAY DEMONSTRATIONS.—Not less 

13 than 25 percent of the amounts made 

14 available for grants under this paragraph 

15 shall be used to make grants for dem16 onstration projects of the type described in 

17 subparagraph (B)(i)(II). 

18 ‘‘(3) GRANT CYCLE.—The grant cycle under 

19 this section shall be not less than 5 years, with a 

20 planning period of not more than the 1st 12 months 

21 of the grant cycle. During the planning period, the 

22 amount of the grant shall be in such lesser amount 

23 as the Secretary determines appropriate. 

24 ‘‘(d) USE OF GRANT.— 

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1 ‘‘(1) IN GENERAL.—An entity to which a grant 

2 is made under this section shall use the grant in ac3 cordance with the approved application for the 

4 grant. 

5 ‘‘(2) SUPPORT TO BE PROVIDED.— 

6 ‘‘(A) REQUIRED SUPPORT.—A project for 

7 which a grant is made under this section shall 

8 include the following: 

9 ‘‘(i) An assessment for adult basic 

10 skill competency, and provision of adult 

11 basic skills education if necessary for 

12 lower-skilled eligible individuals to enroll in 

13 the project and go on to enter and com14 plete post-secondary training, through 

15 means including the following: 

16 ‘‘(I) Establishing a network of 

17 partners that offer pre-training activi18 ties for project participants who need 

19 to improve basic academic skills or 

20 English language proficiency before 

21 entering a health occupational train22 ing career pathway program. 

23 ‘‘(II) Offering resources to enable 

24 project participants to continue ad25 vancing adult basic skill proficiency 

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1 while enrolled in a career pathway 

2 program. 

3 ‘‘(III) Embedding adult basic 

4 skill maintenance as part of ongoing 

5 post-graduation career coaching and 

6 mentoring. 

7 ‘‘(ii) A guarantee that child care is an 

8 available and affordable support service for 

9 project participants through means such as 

10 the following: 

11 ‘‘(I) Referral to, and assistance 

12 with, enrollment in a subsidized child 

13 care program. 

14 ‘‘(II) Direct payment to a child 

15 care provider if a slot in a subsidized 

16 child care program is not available or 

17 reasonably accessible. 

18 ‘‘(III) Payment of co-payments 

19 or associated fees for child care. 

20 ‘‘(iii) Case management plans that in21 clude career coaching (with the option to 

22 offer appropriate peer support and men23 toring opportunities to help develop soft 

24 skills and social capital), which may be of25 fered on an ongoing basis before, during, 

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1 and after initial training as part of a ca2 reer pathway model. 

3 ‘‘(iv) A plan to provide project partici4 pants with transportation through means 

5 such as the following: 

6 ‘‘(I) Referral to, and assistance 

7 with enrollment in, a subsidized trans8 portation program. 

9 ‘‘(II) If a subsidized transpor10 tation program is not reasonably 

11 available, direct payments to subsidize 

12 transportation costs. 

13 ‘‘(v) In the case of a demonstration 

14 project of the type described in subsection 

15 (c)(2)(B)(i)(I), access to legal assistance 

16 for project participants for the purpose of 

17 addressing arrest or conviction records and 

18 associated workforce barriers. 

19 ‘‘(B) ALLOWED SUPPORT.—The goods and 

20 services provided under a project for which a 

21 grant is made under this section may include 

22 the following: 

23 ‘‘(i) A cash stipend. 

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1 ‘‘(ii) A reserve fund for financial as2 sistance to project participants in emer3 gency situations. 

4 ‘‘(iii) Tuition, and training materials 

5 such as books, software, uniforms, shoes, 

6 and hair nets, and personal protective 

7 equipment. 

8 ‘‘(iv) In-kind resource donations such 

9 as interview clothing and conference at10 tendance fees. 

11 ‘‘(v) Assistance with accessing and 

12 completing high school equivalency or adult 

13 basic education courses as necessary to 

14 achieve success in the project and make 

15 progress toward career goals. 

16 ‘‘(vi) Assistance with programs and 

17 activities, including legal assistance, 

18 deemed necessary to address arrest or con19 viction records as an employment barrier. 

20 ‘‘(vii) Other support services as 

21 deemed necessary for family well-being, 

22 success in the project, and progress toward 

23 career goals. 

24 ‘‘(3) TRAINING.—A project for which a grant is 

25 made under this section shall train project particiVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 pants to earn a recognized postsecondary credential 

2 (including an industry-recognized credential, and a 

3 certificate awarded by a local workforce development 

4 board established under section 107 of the Work5 force Innovation and Opportunity Act) that is 

6 awarded in recognition of attainment of measurable 

7 technical or occupational skills necessary to gain em8 ployment or advance within an occupation, and shall 

9 provide each project participant with a number of 

10 hours of the training equal to— 

11 ‘‘(A) not less than the number of hours of 

12 training required for certification in that level 

13 of skill by the State in which the project is con14 ducted; or 

15 ‘‘(B) if there is no such requirement, such 

16 number of hours of training as the Secretary 

17 finds is necessary to achieve that skill level. 

18 ‘‘(4) INCLUSION OF TANF RECIPIENTS.—In the 

19 case of a project for which a grant is made under 

20 this section that is conducted in a State that has a 

21 program funded under part A of title IV, at least 10 

22 percent of the eligible individuals to whom support 

23 is provided under the project shall meet the income 

24 eligibility requirements under that State program, 

25 without regard to whether the individuals receive 

19 

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1 benefits or services directly under that State pro2 gram. 

3 ‘‘(5) INCOME LIMITATION.—An entity to which 

4 a grant is made under this section shall not use the 

5 grant to provide support to a person who is not an 

6 eligible individual. 

7 ‘‘(6) PROHIBITION.—An entity to which a grant 

8 is made under this section shall not use the grant 

9 for purposes of entertainment, except that case man10 agement and career coaching services may include 

11 celebrations of specific career-based milestones such 

12 as completing a semester, graduation, or job place13 ment. 

14 ‘‘(e) TECHNICAL ASSISTANCE.— 

15 ‘‘(1) IN GENERAL.—The Secretary shall provide 

16 technical assistance— 

17 ‘‘(A) to assist eligible entities in applying 

18 for grants under this section; 

19 ‘‘(B) that is tailored to meet the needs of 

20 grantees at each stage of the administration of 

21 projects for which grants are made under this 

22 section; 

23 ‘‘(C) that is tailored to meet the specific 

24 needs of Indian tribes, tribal organizations, and 

25 tribal colleges and universities; 

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1 ‘‘(D) that is tailored to meet the specific 

2 needs of the territories; 

3 ‘‘(E) that is tailored to meet the specific 

4 needs of eligible entities in carrying out dem5 onstration projects for which a grant is made 

6 under this section; and 

7 ‘‘(F) to facilitate the exchange of informa8 tion among eligible entities regarding best prac9 tices and promising practices used in the 

10 projects. 

11 ‘‘(2) PEER TECHNICAL ASSISTANCE CON12 FERENCES.—The Secretary shall hold peer technical 

13 assistance conferences for entities to which a grant 

14 is made under this section or was made under the 

15 immediate predecessor of this section. 

16 ‘‘(f) EVALUATION OF DEMONSTRATION PROJECTS.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall, by 

18 grant, contract, or interagency agreement, conduct 

19 rigorous and well-designed evaluations of the dem20 onstration projects for which a grant is made under 

21 this section. 

22 ‘‘(2) REQUIREMENT APPLICABLE TO INDIVID23 UALS WITH ARREST OR CONVICTION RECORDS DEM24 ONSTRATION.—In the case of a project of the type 

25 described in subsection (c)(2)(B)(i)(I), the evaluaVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 tion shall include identification of successful activi2 ties for creating opportunities for developing and 

3 sustaining, particularly with respect to low-income 

4 individuals with arrest or conviction records, a 

5 health professions workforce that has accessible 

6 entry points, that meets high standards for edu7 cation, training, certification, and professional devel8 opment, and that provides increased wages and af9 fordable benefits, including health care coverage, 

10 that are responsive to the needs of the workforce. 

11 ‘‘(3) REQUIREMENT APPLICABLE TO MATERNAL

12 MORTALITY CAREER PATHWAY DEMONSTRATION.— 

13 In the case of a project of the type described in sub14 section (c)(2)(B)(i)(II), the evaluation shall include 

15 identification of successful activities for creating op16 portunities for developing and sustaining, particu17 larly with respect to low-income individuals and 

18 other entry-level workers, a career pathway that has 

19 accessible entry points, that meets high standards 

20 for education, training, certification, and profes21 sional development, and that provides increased 

22 wages and affordable benefits, including health care 

23 coverage, that are responsive to the needs of the 

24 birth, pregnancy, and post-partum workforce. 

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1 ‘‘(4) RULE OF INTERPRETATION.—Evaluations 

2 conducted pursuant to this subsection may include a 

3 randomized controlled trial, but this subsection shall 

4 not be interpreted to require an evaluation to include 

5 such a trial. 

6 ‘‘(g) REPORTS.— 

7 ‘‘(1) TO THE SECRETARY.—An eligible entity 

8 awarded a grant to conduct a project under this sec9 tion shall submit interim reports to the Secretary on 

10 the activities carried out under the project, and, on 

11 the conclusion of the project, a final report on the 

12 activities. Each such report shall include data on 

13 participant outcomes related to graduation rate, 

14 graduation timeliness, credential attainment, em15 ployment in health professions, overall employment, 

16 earnings, participant demographics, and other data 

17 specified by the Secretary. 

18 ‘‘(2) TO THE CONGRESS.—During each Con19 gress, the Secretary shall submit to the Committee 

20 on Ways and Means of the House of Representatives 

21 and the Committee on Finance of the Senate a re22 port— 

23 ‘‘(A) on the demographics of the partici24 pants in the projects for which a grant is made 

25 under this section; 

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1 ‘‘(B) on the rate of which project partici2 pants completed all activities under the 

3 projects; 

4 ‘‘(C) on the employment credentials ac5 quired by project participants; 

6 ‘‘(D) on the employment of project partici7 pants on completion of activities under the 

8 projects, and the earnings of project partici9 pants at entry into employment; 

10 ‘‘(E) on best practices and promising prac11 tices used in the projects; 

12 ‘‘(F) on the nature of any technical assist13 ance provided to grantees under this section; 

14 ‘‘(G) on, with respect to the period since 

15 the period covered in the most recent prior re16 port submitted under this paragraph— 

17 ‘‘(i) the number of applications sub18 mitted under this section, with a separate 

19 statement of the number of applications re20 ferred to in subsection (b)(5); 

21 ‘‘(ii) the number of applications that 

22 were approved, with a separate statement 

23 of the number of such applications referred 

24 to in subsection (b)(5); and 

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1 ‘‘(iii) a description of how grants were 

2 made in any case described in the last sen3 tence of subsection (c)(1)(A)(ii); and 

4 ‘‘(H) that includes an assessment of the ef5 fectiveness of the projects with respect to ad6 dressing health professions workforce shortages 

7 or in-demand jobs. 

8 ‘‘(h) DEFINITIONS.—In this section: 

9 ‘‘(1) ALLIED HEALTH PROFESSION.—The term 

10 ‘allied health profession’ has the meaning given in 

11 section 799B(5) of the Public Health Service Act. 

12 ‘‘(2) CAREER PATHWAY.—The term ‘career 

13 pathway’ has the meaning given that term in section 

14 3(7) of the Workforce Innovation and Opportunity 

15 Act. 

16 ‘‘(3) DOULA.—The term ‘doula’ means an indi17 vidual who— 

18 ‘‘(A) has completed 60 hours of 

19 foundational training; 

20 ‘‘(B) is certified by an organization that 

21 has been established for not less than 5 years 

22 and that requires the completion of continuing 

23 education to maintain the certification, to pro24 vide non-medical advice, information, emotional 

25 support, and physical comfort to an individual 

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1 during the individual’s pregnancy, childbirth, 

2 and post-partum period; and 

3 ‘‘(C) maintains the certification by com4 pleting the required continuing education. 

5 ‘‘(4) ELIGIBLE ENTITY.—The term ‘eligible en6 tity’ means any of the following entities that dem7 onstrates in an application submitted under this sec8 tion that the entity has the capacity to fully develop 

9 and administer the project described in the applica10 tion: 

11 ‘‘(A) A local workforce development board 

12 established under section 107 of the Workforce 

13 Innovation and Opportunity Act. 

14 ‘‘(B) A State or territory, a political sub15 division of a State or territory, or an agency of 

16 a State, territory, or such a political subdivi17 sion, including a State or local entity that ad18 ministers a State program funded under part A 

19 of this title. 

20 ‘‘(C) An Indian tribe, a tribal organization, 

21 or a tribal college or university. 

22 ‘‘(D) An institution of higher education (as 

23 defined in the Higher Education Act of 1965). 

24 ‘‘(E) A hospital (as defined in section 

25 1861(e)). 

26 

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1 ‘‘(F) A high-quality skilled nursing facility. 

2 ‘‘(G) A Federally qualified health center 

3 (as defined in section 1861(aa)(4)). 

4 ‘‘(H) A nonprofit organization described in 

5 section 501(c)(3) of the Internal Revenue Code 

6 of 1986, a labor organization, or an entity with 

7 shared labor-management oversight, that has a 

8 demonstrated history of providing health profes9 sion training to eligible individuals. 

10 ‘‘(I) In the case of a demonstration project 

11 of the type provided for in subsection 

12 (c)(2)(B)(i)(II) of this section, an entity recog13 nized by a State, Indian tribe, or tribal organi14 zation as qualified to train doulas or midwives, 

15 if midwives or doulas, as the case may be, are 

16 permitted to practice in the State involved. 

17 ‘‘(J) An opioid treatment program (as de18 fined in section 1861(jjj)(2)), and other high 

19 quality comprehensive addiction care providers. 

20 ‘‘(5) ELIGIBLE INDIVIDUAL.—The term ‘eligible 

21 individual’ means an individual whose family income 

22 does not exceed 200 percent of the Federal poverty 

23 level. 

24 ‘‘(6) FEDERAL POVERTY LEVEL.—The term 

25 ‘Federal poverty level’ means the poverty line (as deVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
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1 fined in section 673(2) of the Omnibus Budget Rec2 onciliation Act of 1981, including any revision re3 quired by such section applicable to a family of the 

4 size involved). 

5 ‘‘(7) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

6 The terms ‘Indian tribe’ and ‘tribal organization’ 

7 have the meaning given the terms in section 4 of the 

8 Indian Self-Determination and Education Assistance 

9 Act (25 U.S.C. 450b). 

10 ‘‘(8) INSTITUTION OF HIGHER EDUCATION.— 

11 The term ‘institution of higher education’ has the 

12 meaning given the term in section 101 or 

13 102(a)(1)(B) of the Higher Education Act of 1965. 

14 ‘‘(9) MIDWIFE.—The term ‘midwife’ means a 

15 midwife who meets, at a minimum, the international 

16 definition of the midwife and global standards for 

17 midwifery education as established by the Inter18 national Confederation of Midwives. 

19 ‘‘(10) TERRITORY.—The term ‘territory’ means 

20 the Commonwealth of Puerto Rico, the United 

21 States Virgin Islands, Guam, the Northern Mariana 

22 Islands, and American Samoa. 

23 ‘‘(11) TRIBAL COLLEGE OR UNIVERSITY.—The 

24 term ‘tribal college or university’ has the meaning 

28 

•S 3449 IS

1 given the term in section 316(b) of the Higher Edu2 cation Act of 1965. 

3 ‘‘(12) TRIBAL MIDWIFE.—The term ‘tribal mid4 wife’ means an individual who is recognized by an 

5 Indian tribe (as defined in section 4 of the Indian 

6 Health Care Improvement Act (25 U.S.C. 1603)) to 

7 practice midwifery for the tribe. 

8 ‘‘(i) FUNDING.— 

9 ‘‘(1) IN GENERAL.—Out of any funds in the 

10 Treasury of the United States not otherwise appro11 priated, there are appropriated to the Secretary to 

12 carry out this section $425,000,000 for each of fis13 cal years 2024 through 2028. 

14 ‘‘(2) ALLOCATION OF FUNDS.—Of the amount 

15 appropriated for a fiscal year under paragraph (1) 

16 of this subsection— 

17 ‘‘(A) 75 percent shall be available for 

18 grants under subsection (c)(1)(A); 

19 ‘‘(B) 4 percent shall be reserved for grants 

20 under subsection (c)(1)(B); 

21 ‘‘(C) 5 percent shall be reserved for grants 

22 under subsection (c)(1)(C); 

23 ‘‘(D) 6 percent shall be available for dem24 onstration project grants under subsection 

25 (c)(2); 

29 

•S 3449 IS

1 ‘‘(E) 6 percent, plus all amounts referred 

2 to in subparagraphs (A) through (D) of this 

3 paragraph that remain unused after all grant 

4 awards are made for the fiscal year, shall be 

5 available for the provision of technical assist6 ance and associated staffing; and 

7 ‘‘(F) 4 percent shall be available for study8 ing the effects of the demonstration and non9 demonstration projects for which a grant is 

10 made under this section, and for associated 

11 staffing, for the purpose of supporting the rig12 orous evaluation of the demonstration projects, 

13 and supporting the continued study of the 

14 short-, medium-, and long-term effects of all 

15 such projects, including the effectiveness of spe16 cific elements of the non-demonstration 

17 projects. 

18 ‘‘(j) NONAPPLICABILITY OF PRECEDING SECTIONS

19 OF THIS SUBTITLE.— 

20 ‘‘(1) IN GENERAL.—Except as provided in para21 graph (2), the preceding sections of this subtitle 

22 shall not apply to a grant awarded under this sec23 tion. 

24 ‘‘(2) EXCEPTION FOR CERTAIN LIMITATIONS ON

25 USE OF GRANTS.—Section 2005(a) (other than paraVerDate Sep 11 2014 20:06 Dec 18, 2023 Jkt 049200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\S3449.IS S3449
30 

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1 graphs (2), (3), (5), (6), and (8)) shall apply to a 

2 grant awarded under this section to the same extent 

3 and in the same manner as such section applies to 

4 payments to States under this subtitle. 

5 ‘‘(k) INCOME DISREGARD.—Amounts paid to an eligi6 ble individual as a cash stipend or as emergency assistance 

7 under a project for which a grant is made under this sec8 tion shall not be considered income for any purpose under 

9 the Internal Revenue Code of 1986, and an entity making 

10 such a payment shall not be required to submit an infor11 mation return under subtitle F of such Code with respect 

12 to the payment.’’. 

Æ