I 

116TH CONGRESS 

1ST SESSION H. R. 3398 

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

a career pathway in the health professions, to extend and expand demonstration projects, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 21, 2019 

Mr. DANNY K. DAVIS of Illinois introduced the following bill; which was 

referred to the Committee on Ways and Means 

A BILL 

To provide low-income individuals with opportunities to enter 

and follow a career pathway in the health professions, 

to extend and expand demonstration projects, 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 Act may be cited as the ‘‘Pathways to Health 

5 Careers Act’’. 


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1 SEC. 2. EXTENSION THROUGH FISCAL YEAR 2020 OF FUND2 ING FOR DEMONSTRATION PROJECTS TO AD3 DRESS HEALTH PROFESSIONS WORKFORCE 

4 NEEDS. 

5 Section 2008(c)(1) of the Social Security Act (42 

6 U.S.C. 1397g(c)(1)) is amended by striking ‘‘2019.’’ and 

7 inserting ‘‘2020, and to provide technical assistance and 

8 cover administrative costs associated with implementing 

9 the successor to this section $15,000,000 for fiscal year 

10 2020.’’. 

11 SEC. 3. CAREER PATHWAYS THROUGH HEALTH PROFES12 SION OPPORTUNITY GRANTS. 

13 Effective October 1, 2020, section 2008 of the Social 

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

15 follows: 

16 ‘‘SEC. 2008. CAREER PATHWAYS THROUGH HEALTH PRO17 FESSION OPPORTUNITY GRANTS. 

18 ‘‘(a) APPLICATION REQUIREMENTS.—An eligible en19 tity desiring a grant under this section for a project shall 

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

21 includes the following: 

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

23 a career pathways approach to train eligible individ24 uals for health professions that pay well or will put 

25 eligible individuals on a career path to an occupation 

26 that pays well, under the project. 


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1 ‘‘(2) A description of the basic skills education 

2 activities, work readiness activities, training activi3 ties, and case management and career coaching serv4 ices that the applicant will use to assist eligible indi5 viduals to gain work experience, connection to em6 ployers, and job placement, and a description of the 

7 plan for recruiting, hiring, and training staff to pro8 vide the case management, mentoring, and career 

9 coaching services, under the project directly or 

10 through local governmental, apprenticeship, edu11 cational, or charitable institutions. 

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

13 under this section for a demonstration project de14 scribed in subsection (c)(2)(B)(i)(I)— 

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

16 which the demonstration project is to be con17 ducted has in effect policies or laws that permit 

18 certain allied health and behavioral health care 

19 credentials to be awarded to people with certain 

20 arrest or conviction records (which policies or 

21 laws shall include appeals processes and other 

22 opportunities to demonstrate rehabilitation to 

23 obtain licensure and approval to work in the 

24 proposed health careers), and a plan described 

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1 way to train people with such a record to be 

2 trained and employed in such a career; 

3 ‘‘(B) a discussion of how the project or fu4 ture strategic hiring decisions will demonstrate 

5 the experience and expertise of the project in 

6 working with job seekers who have arrest or 

7 conviction records or employers with experience 

8 working with people with arrest or conviction 

9 records; 

10 ‘‘(C) an identification of promising innova11 tions or best practices that can be used to pro12 vide the training; 

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

14 that the applicant has done sufficient research 

15 on workforce shortage or in-demand jobs for 

16 which people with certain types of arrest or 

17 conviction records can be hired; 

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

19 are eligible individuals into the project; and 

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

21 support and ongoing training as part of a ca22 reer pathway under the project. 

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

24 under this section for a demonstration project de25 scribed in subsection (c)(2)(B)(i)(II)— 


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

2 strategic staff hiring decisions, tailored program 

3 activities, or other programmatic elements of 

4 the project that are designed to support a 

5 strong career pathway in pregnancy, birth, or 

6 post-partum services; and 

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

8 which the demonstration project is to be con9 ducted recognizes and permits doulas and mid10 wives to practice in the State. 

11 ‘‘(5) A demonstration that the applicant has ex12 perience working with low-income populations, or a 

13 description of the plan of the applicant to work with 

14 a partner organization that has the experience. 

15 ‘‘(6) A plan for providing post-employment sup16 port and ongoing training as part of a career path17 way under the project. 

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

19 the applicant will provide under the project, includ20 ing a plan for how child care and transportation 

21 support services will be guaranteed and, if the appli22 cant will provide a cash stipend, how the stipend 

23 would be calculated and distributed. 

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

25 project development included— 


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1 ‘‘(A) consultation with a local workforce 

2 development board established under section 

3 107 of the Workforce Innovation and Oppor4 tunity Act; 

5 ‘‘(B) consideration of apprenticeship mod6 els registered under the Act of August 16, 1937 

7 (also known as the ‘National Apprenticeship 

8 Act’); 

9 ‘‘(C) consideration of career pathway pro10 grams in the State in which the project is to be 

11 conducted; and 

12 ‘‘(D) a review of the State plan under sec13 tion 102 or 103 of the Workforce Innovation 

14 and Opportunity Act. 

15 ‘‘(9) A description of the availability and rel16 evance of recent labor market information and other 

17 pertinent evidence of in-demand jobs or worker 

18 shortages. 

19 ‘‘(10) A certification that the applicant will di20 rectly provide or contract for the training services 

21 described in the application. 

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

23 the grant is made to the applicant, the applicant 

24 will— 


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

2 project, provide the Secretary with any informa3 tion needed by the Secretary to establish ade4 quate data reporting and administrative struc5 ture for the project; 

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

7 later than the end of the planning period appli8 cable to the project; 

9 ‘‘(C) accept all technical assistance offered 

10 by the Secretary with respect to the grant; and 

11 ‘‘(D) participate in such in-person grantee 

12 conferences as are regularly scheduled by the 

13 Secretary. 

14 ‘‘(b) PREFERENCES IN CONSIDERING APPLICA15 TIONS.—In considering applications for a grant under this 

16 section, the Secretary shall give preference to— 

17 ‘‘(1) applications submitted by applicants to 

18 whom a grant was made for fiscal year 2020 under 

19 the immediate predecessor to this section, and who 

20 are in full compliance with the conditions of the 

21 grant; 

22 ‘‘(2) applications submitted by applicants who 

23 have completed a demonstration project funded 

24 under the immediate predecessor to this section or 

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1 tion of the project, which was funded by the Sec2 retary, found the project to have positive outcomes 

3 in the categories of— 

4 ‘‘(A) graduation and credential attainment; 

5 ‘‘(B) job placement and retention; and 

6 ‘‘(C) evidence of addressing the worker 

7 shortage or in-demand jobs described in the 

8 original application for funding for the com9 pleted demonstration project; 

10 ‘‘(3) applications submitted by applicants who 

11 have business and community partners in each of 

12 the following categories: 

13 ‘‘(A) State and local government agencies 

14 and social service providers, including a State 

15 or local entity that administers a State program 

16 funded under part A of this title; 

17 ‘‘(B) institutions of higher education, ap18 prenticeship programs, and local workforce de19 velopment boards established under section 107 

20 of the Workforce Innovation and Opportunity 

21 Act; and 

22 ‘‘(C) health care employers, labor unions, 

23 and labor-management partnerships; 


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1 ‘‘(4) applications that include opportunities for 

2 mentoring or peer support, and make career coach3 ing available, as part of the case management plan; 

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

5 will serve a rural area in which— 

6 ‘‘(A) the community in which the individ7 uals to be enrolled in the project reside is lo8 cated; 

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

10 ‘‘(C) an employer partnership that has 

11 committed to hiring individuals who successfully 

12 complete all activities under the project is lo13 cated; 

14 ‘‘(6) applications that include a commitment to 

15 providing project participants with a cash stipend of 

16 at least 50 percent of the Federal poverty level ap17 plicable to a family of the same size as the family 

18 of the participant; and 

19 ‘‘(7) applications which have an emergency cash 

20 fund to assist project participants financially in 

21 emergency situations. 

22 ‘‘(c) GRANTS.— 

23 ‘‘(1) COMPETITIVE GRANTS.— 

24 ‘‘(A) GRANT AUTHORITY.— 


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

2 consultation with the Secretary of Labor 

3 and the Secretary of Education, may make 

4 a grant in accordance with this paragraph 

5 to an eligible entity whose application for 

6 the grant is approved by the Secretary, to 

7 conduct a project designed to train low-in8 come individuals for allied health profes9 sions using a career pathways model. 

10 ‘‘(ii) GUARANTEE OF GRANTEES IN

11 EACH STATE AND THE DISTRICT OF CO12 LUMBIA.—For each grant cycle, the Sec13 retary shall award a grant under this para14 graph to at least 2 eligible entities in each 

15 State that is not a territory, to the extent 

16 there are a sufficient number of applica17 tions submitted by the entities that meet 

18 the requirements applicable with respect to 

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

20 are fewer than 2 such eligible entities in a 

21 State, the Secretary shall include that in22 formation in the report required by sub23 section (g)(2) that covers the fiscal year. 

24 ‘‘(B) GUARANTEE OF GRANTS FOR INDIAN

25 POPULATIONS.—From the amount reserved 


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

2 the Secretary shall award a grant under this 

3 paragraph to at least 10 eligible entities that 

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

5 tribal college or university, to the extent there 

6 are a sufficient number of applications sub7 mitted by the entities that meet the require8 ments applicable with respect to such a grant. 

9 ‘‘(C) GUARANTEE OF GRANTEES IN THE

10 TERRITORIES.—From the amount reserved 

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

12 the Secretary shall award a grant under this 

13 paragraph to at least 2 eligible entities that are 

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

15 sufficient number of applications submitted by 

16 the entities that meet the requirements applica17 ble with respect to such a grant. 

18 ‘‘(2) GRANTS FOR DEMONSTRATION

19 PROJECTS.— 

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

21 in consultation with the Secretary of Labor and 

22 the Secretary of Education (and, with respect 

23 to demonstration projects of the type described 

24 in subparagraph (B)(i)(I), the Attorney Gen25 eral) shall make a grant in accordance with this 


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1 subsection to an eligible entity whose applica2 tion for the grant is approved by the Secretary, 

3 to conduct a demonstration project that meets 

4 the requirements of subparagraph (B). 

5 ‘‘(B) REQUIREMENTS.—The requirements 

6 of this subparagraph are the following: 

7 ‘‘(i) TYPE OF PROJECT.—The dem8 onstration project shall be of 1 of the fol9 lowing types: 

10 ‘‘(I) INDIVIDUALS WITH ARREST

11 OR CONVICTION RECORDS DEM12 ONSTRATION.—The demonstration 

13 project shall be of a type designed to 

14 provide education and training for eli15 gible individuals with arrest or convic16 tion records to enter and follow a ca17 reer pathway in the health professions 

18 through occupations that pay well and 

19 are expected to experience a labor 

20 shortage or be in high demand. 

21 ‘‘(II) PREGNANCY AND CHILD22 BIRTH CAREER PATHWAY DEM23 ONSTRATION.—The demonstration 

24 project shall be of a type designed to 

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1 gible individuals to enter and follow a 

2 career pathway in the field of preg3 nancy, childbirth, or post-partum, in a 

4 State that recognizes doulas or mid5 wives as health care providers and 

6 that provides payment for services 

7 provided by doulas or midwives, as the 

8 case may be, under the State plan ap9 proved under title XIX. 

10 ‘‘(ii) DURATION.—The demonstration 

11 project shall be conducted for not less than 

12 3 years. 

13 ‘‘(C) MINIMUM ALLOCATION OF FUNDS

14 FOR EACH TYPE OF DEMONSTRATION

15 PROJECT.— 

16 ‘‘(i) INDIVIDUALS WITH ARREST OR

17 CONVICTION RECORDS DEMONSTRA18 TIONS.—Not less than 25 percent of the 

19 amounts made available for grants under 

20 this paragraph shall be used to make 

21 grants for demonstration projects of the 

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

23 ‘‘(ii) PREGNANCY AND CHILDBIRTH

24 CAREER PATHWAY DEMONSTRATIONS.— 

25 Not less than 25 percent of the amounts 


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1 made available for grants under this para2 graph shall be used to make grants for 

3 demonstration projects of the type de4 scribed in subparagraph (B)(i)(II). 

5 ‘‘(3) GRANT PERIODS.—A grant award under 

6 this section for a project shall be in the form of— 

7 ‘‘(A) in the case of any such grant, equal 

8 annual grants for 3 years, not more than the 

9 first 120 days of which shall be the planning 

10 period for the project; or 

11 ‘‘(B) in the case of a grant under para12 graph (2), equal annual grants for 4 years, ex13 cept that the amount of the grant for the 1st 

14 year shall be in such lesser amount as the Sec15 retary determines appropriate, and the 1st year 

16 shall be the planning period for the project. 

17 ‘‘(d) USE OF GRANT.— 

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

19 is made under this section shall use the grant in ac20 cordance with the approved application for the 

21 grant. 

22 ‘‘(2) SUPPORT TO BE PROVIDED.— 

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

24 which a grant is made under this section shall 

25 include the following: 


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1 ‘‘(i) An assessment for adult basic 

2 skill competency, and provision of adult 

3 basic skills education if necessary for 

4 lower-skilled eligible individuals to enroll in 

5 the project and go on to enter and com6 plete post-secondary training, through 

7 means including the following: 

8 ‘‘(I) Establishing a network of 

9 partners that offer pre-training activi10 ties for project participants who need 

11 to improve basic academic skills or 

12 English language proficiency before 

13 entering a health occupational train14 ing career pathway program. 

15 ‘‘(II) Offering resources to enable 

16 project participants to continue ad17 vancing adult basic skill proficiency 

18 while enrolled in a career pathway 

19 program. 

20 ‘‘(III) Embedding adult basic 

21 skill maintenance as part of ongoing 

22 post-graduation career coaching and 

23 mentoring. 

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

25 available and affordable support service for 


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1 project participants through means such as 

2 the following: 

3 ‘‘(I) Referral to, and assistance 

4 with, enrollment in a subsidized child 

5 care program. 

6 ‘‘(II) Direct payment to a child 

7 care provider if a slot in a subsidized 

8 child care program is not available or 

9 reasonably accessible. 

10 ‘‘(III) Payment of co-payments 

11 or associated fees for child care. 

12 ‘‘(iii) Case management plans that in13 clude career coaching (with the option to 

14 offer appropriate peer support and men15 toring opportunities to help develop soft 

16 skills and social capital), which may be of17 fered on an ongoing basis before, during, 

18 and after initial training as part of a ca19 reer pathway model. 

20 ‘‘(iv) A plan to provide project partici21 pants with transportation through means 

22 such as the following: 

23 ‘‘(I) Referral to, and assistance 

24 with enrollment in, a subsidized trans25 portation program. 


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1 ‘‘(II) If a subsidized transpor2 tation program is not reasonably 

3 available, direct payments to subsidize 

4 transportation costs. 

5 For purposes of this clause, the term 

6 ‘transportation’ includes public transit, or 

7 gasoline for a personal vehicle if public 

8 transit is not reasonably accessible or 

9 available. 

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

11 project of the type described in subsection 

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

13 for project participants for the purpose of 

14 addressing arrest or conviction records and 

15 associated workforce barriers. 

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

17 services provided under a project for which a 

18 grant is made under this section may include 

19 the following: 

20 ‘‘(i) A cash stipend that is at least 

21 monthly. 

22 ‘‘(ii) A reserve fund for financial as23 sistance to project participants in emer24 gency situations. 


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1 ‘‘(iii) Tuition, and training materials 

2 such as books, software, uniforms, shoes, 

3 and hair nets. 

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

5 as interview clothing and conference at6 tendance fees. 

7 ‘‘(v) Assistance with accessing and 

8 completing high school equivalency or adult 

9 basic education courses as necessary to 

10 achieve success in the project and make 

11 progress toward career goals. 

12 ‘‘(vi) Assistance with programs and 

13 activities, including legal assistance, 

14 deemed necessary to address arrest or con15 viction records as an employment barrier. 

16 ‘‘(vii) Other support services as 

17 deemed necessary for family well-being, 

18 success in the project, and progress toward 

19 career goals. 

20 ‘‘(C) TREATMENT OF SUPPORT FOR PUR21 POSES OF MEANS-TESTED PROGRAMS.—Any 

22 goods or services provided to an eligible indi23 vidual participating in a project for which a 

24 grant is made under this section shall not be 

25 considered income, and shall not be taken into 


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1 account for purposes of determining the eligi2 bility of the individual for, or amount of bene3 fits to be provided to the individual, under any 

4 means-tested program. 

5 ‘‘(3) TRAINING.—The number of hours of train6 ing provided to an eligible individual under a project 

7 for which a grant is made under this section, for a 

8 credential recognized by an employer or industry, 

9 which is awarded in recognition of attainment of 

10 measurable technical or occupational skills necessary 

11 to gain employment or advance within an occupation 

12 (including a certificate awarded by a local workforce 

13 development board established under section 107 of 

14 the Workforce Innovation and Opportunity Act), 

15 shall be— 

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

17 training required for certification in that level 

18 of skill by the State in which the project is con19 ducted; or 

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

21 number of hours of training as the Secretary 

22 finds is necessary to achieve that skill level. 

23 ‘‘(4) INCOME LIMITATION.—An entity to which 

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


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

2 eligible individual. 

3 ‘‘(5) INCLUSION OF TANF RECIPIENTS.—In the 

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

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

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

7 percent of the eligible individuals to whom support 

8 is provided under the project shall be a recipient of 

9 assistance under that program. 

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

11 is made under this section shall not use the grant 

12 for purposes of entertainment, except that case man13 agement and career coaching services may include 

14 celebrations of specific career-based milestones such 

15 as completing a semester, graduation, or job place16 ment. 

17 ‘‘(e) TECHNICAL ASSISTANCE.— 

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

19 technical assistance— 

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

21 for grants under this section; 

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

23 grantees at each stage of the administration of 

24 projects for which grants are made under this 

25 section; 


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

2 needs of Indian tribes, tribal organizations, and 

3 tribal colleges and universities; 

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

5 needs of the territories; 

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

7 needs of eligible entities in carrying out dem8 onstration projects for which a grant is made 

9 under this section; and 

10 ‘‘(F) to facilitate the exchange of informa11 tion among eligible entities regarding best prac12 tices and promising practices used in the 

13 projects. 

14 ‘‘(2) CONTINUATION OF PEER TECHNICAL AS15 SISTANCE CONFERENCES.—The Secretary shall con16 tinue to hold peer technical assistance conferences 

17 for entities to which a grant is made under this sec18 tion or was made under the immediate predecessor 

19 of this section. 

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

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

22 grant, contract, or interagency agreement, conduct 

23 rigorous and well-designed evaluations of the dem24 onstration projects for which a grant is made under 

25 this section. 


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1 ‘‘(2) REQUIREMENT APPLICABLE TO INDIVID2 UALS WITH ARREST OR CONVICTION RECORDS DEM3 ONSTRATION.—In the case of a project of the type 

4 described in subsection (c)(2)(B)(i)(I), the evalua5 tion shall include identification of successful activi6 ties for creating opportunities for developing and 

7 sustaining, particularly with respect to low-income 

8 individuals with arrest or conviction records, a 

9 health professions workforce that has accessible 

10 entry points, that meets high standards for edu11 cation, training, certification, and professional devel12 opment, and that provides increased wages and af13 fordable benefits, including health care coverage, 

14 that are responsive to the needs of the workforce. 

15 ‘‘(3) REQUIREMENT APPLICABLE TO PREG16 NANCY AND CHILDBIRTH CAREER PATHWAY DEM17 ONSTRATION.—In the case of a project of the type 

18 described in subsection (c)(2)(B)(i)(II), the evalua19 tion shall include identification of successful activi20 ties for creating opportunities for developing and 

21 sustaining, particularly with respect to low-income 

22 individuals and other entry-level workers, a career 

23 pathway that has accessible entry points, that meets 

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1 creased wages and affordable benefits, including 

2 health care coverage, that are responsive to the 

3 needs of the birth, pregnancy, and post-partum 

4 workforce. 

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

6 conducted pursuant to this subsection may include a 

7 randomized controlled trial, but this subsection shall 

8 not be interpreted to require an evaluation to include 

9 such a trial. 

10 ‘‘(g) REPORTS.— 

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

12 awarded a grant to conduct a project under this sec13 tion shall submit interim reports to the Secretary on 

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

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

16 activities. Each such report shall include data on 

17 participant outcomes related to earnings, employ18 ment in health professions, graduation rate, gradua19 tion timeliness, credential attainment, participant 

20 demographics, and other data specified by the Sec21 retary. 

22 ‘‘(2) TO THE CONGRESS.—During each Con23 gress, the Secretary shall submit to the Committee 

24 on Ways and Means of the House of Representatives 


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1 and the Committee on Finance of the Senate a re2 port— 

3 ‘‘(A) on the demographics of the partici4 pants in the projects for which a grant is made 

5 under this section; 

6 ‘‘(B) on the rate of which project partici7 pants completed all activities under the 

8 projects; 

9 ‘‘(C) on the employment credentials ac10 quired by project participants; 

11 ‘‘(D) on the employment of project partici12 pants on completion of activities under the 

13 projects, and the earnings of project partici14 pants at entry into employment; 

15 ‘‘(E) on best practices and promising prac16 tices used in the projects; 

17 ‘‘(F) on the nature of any technical assist18 ance provided to grantees under this section; 

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

20 the period covered in the most recent prior re21 port submitted under this paragraph— 

22 ‘‘(i) the number of applications sub23 mitted under this section, with a separate 

24 statement of the number of applications re25 ferred to in subsection (b)(5); 


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1 ‘‘(ii) the number of applications that 

2 were approved, with a separate statement 

3 of the number of such applications referred 

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

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

6 made in any case described in the last sen7 tence of subsection (c)(1)(A)(ii); and 

8 ‘‘(H) that includes an assessment of the ef9 fectiveness of the projects with respect to ad10 dressing health professions workforce shortages 

11 or in-demand jobs. 

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

13 ‘‘(1) CAREER PATHWAY.—The term ‘career 

14 pathway’ has the meaning given that term in section 

15 3(7) of the Workforce Innovation and Opportunity 

16 Act. 

17 ‘‘(2) DOULA.—The term ‘doula’ means an indi18 vidual who— 

19 ‘‘(A) is certified by an organization that 

20 has been established for not less than 5 years 

21 and that requires the completion of continuing 

22 education to maintain the certification, to pro23 vide non-medical advice, information, emotional 

24 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 ‘‘(B) maintains the certification by com4 pleting the required continuing education. 

5 ‘‘(3) 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)). 


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1 ‘‘(F) A skilled nursing facility (as defined 

2 in section 1819(h)(1)(A)). 

3 ‘‘(G) A Federally qualified health center 

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

5 ‘‘(H) A nonprofit organization described in 

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

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

8 shared labor-management oversight, that has a 

9 demonstrated history of providing health profes10 sion training to eligible individuals. 

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

12 of the type provided for in subsection 

13 (c)(2)(B)(i)(II) of this section, an entity recog14 nized by a State, Indian tribe, or tribal organi15 zation as qualified to train doulas or midwives, 

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

17 permitted to practice in the State involved. 

18 ‘‘(J) An opioid treatment program (as de19 fined in section 1861(iii)(2)). 

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

21 individual’ means an individual whose household in22 come does not exceed 138 percent of the Federal 

23 poverty level. 

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

25 ‘Federal poverty level’ means the poverty line (as deVerDate Sep 11 2014 22:41 Jun 26, 2019 Jkt 089200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\H3398.IH H3398

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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 ‘‘(6) 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 ‘‘(7) INSTITUTION OF HIGHER EDUCATION.— 

11 The term ‘institution of higher education’ has the 

12 meaning given the term in section 101 of the Higher 

13 Education Act of 1965. 

14 ‘‘(8) MIDWIFE.— 

15 ‘‘(A) IN GENERAL.—The term ‘midwife’ 

16 means a certified midwife, certified professional 

17 midwife, licensed midwife, and tribally-recog18 nized midwife. 

19 ‘‘(B) CERTIFIED MIDWIFE.—The term 

20 ‘certified midwife’ means an individual who is 

21 certified by the American Midwifery Certifi22 cation Board to practice midwifery. 

23 ‘‘(C) CERTIFIED PROFESSIONAL MID24 WIFE.—The term ‘certified professional mid25 wife’ means an individual who— 


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1 ‘‘(i) is certified by the North Amer2 ican Registry of Midwives to practice mid3 wifery for normal, low-risk pregnancies and 

4 childbirths; and 

5 ‘‘(ii) has completed— 

6 ‘‘(I) a midwifery education pro7 gram accredited by the Midwifery 

8 Education and Accreditation Council 

9 or any other entity recognized by the 

10 Department of Education; or 

11 ‘‘(II) the requirements to obtain 

12 a Midwifery Bridge Certificate from 

13 the North American Registry of Mid14 wives, and maintains the certification 

15 by completing any required continuing 

16 education for the certification. 

17 ‘‘(D) LICENSED MIDWIFE.—The term ‘li18 censed midwife’ means, with respect to a State, 

19 an individual who is licensed under State law to 

20 practice midwifery. 

21 ‘‘(E) TRIBALLY-RECOGNIZED MIDWIFE.— 

22 The term ‘tribally-recognized midwife’ means 

23 an individual who is recognized by an Indian 

24 tribe (as defined in section 4 of the Indian 


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1 Health Care Improvement Act) to practice mid2 wifery for the tribe. 

3 ‘‘(9) TERRITORY.—The term ‘territory’ means 

4 the Commonwealth of Puerto Rico, the United 

5 States Virgin Islands, Guam, the Northern Mariana 

6 Islands, and American Samoa. 

7 ‘‘(10) TRIBAL COLLEGE OR UNIVERSITY.—The 

8 term ‘tribal college or university’ has the meaning 

9 given the term in section 316(b) of the Higher Edu10 cation Act of 1965. 

11 ‘‘(i) FUNDING.— 

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

13 Treasury of the United States not otherwise appro14 priated, there are appropriated to the Secretary to 

15 carry out this section— 

16 ‘‘(A) $350,000,000 for fiscal year 2021; 

17 ‘‘(B) $400,000,000 for fiscal year 2022; 

18 ‘‘(C) $450,000,000 for fiscal year 2023; 

19 and 

20 ‘‘(D) $500,000,000 for fiscal year 2024. 

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

22 appropriated for a fiscal year under paragraph (1) 

23 of this subsection— 

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

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


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1 ‘‘(B) 2 percent shall be reserved for grants 

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

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

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

5 ‘‘(D) 6 percent shall be available for dem6 onstration project grants under subsection 

7 (c)(2); 

8 ‘‘(E) 9 percent, plus all amounts referred 

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

10 paragraph that remain unused after all grant 

11 awards are made for the fiscal year, shall be 

12 available for the provision of technical assist13 ance and associated staffing; and 

14 ‘‘(F) 3 percent shall be available for eval15 uations and associated staffing. 

16 ‘‘(j) NONAPPLICABILITY OF PRECEDING SECTIONS

17 OF THIS SUBTITLE.— 

18 ‘‘(1) IN GENERAL.—Except as provided in para19 graph (2), the preceding sections of this subtitle 

20 shall not apply to a grant awarded under this sec21 tion. 

22 ‘‘(2) EXCEPTION FOR CERTAIN LIMITATIONS ON

23 USE OF GRANTS.—Section 2005(a) (other than para24 graphs (2), (5), (6), and (8)) shall apply to a grant 

25 awarded under this section to the same extent and 


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1 in the same manner as such section applies to pay2 ments to States under this subtitle.’’. 

Æ 


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