IB 

Union Calendar No. 211 

116TH CONGRESS 

1ST SESSION H. R. 3398 

[Report No. 116–265] 

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 

OCTOBER 29, 2019 

Additional sponsors: Mr. SABLAN, Mr. BEYER, Mr. BLUMENAUER, Mr. 

BRENDAN F. BOYLE of Pennsylvania, Ms. JUDY CHU of California, Ms. 

DELBENE, Mr. EVANS, Mr. GOMEZ, Mr. HIGGINS of New York, Mr. 

HORSFORD, Mr. KILDEE, Mr. LEWIS, Ms. MOORE, Mrs. MURPHY of 

Florida, Mr. PANETTA, Mr. PASCRELL, Ms. SEWELL of Alabama, Mr. 

SUOZZI, Ms. SA ́NCHEZ, Mr. LARSON of Connecticut, Mr. SAN NICOLAS, 

Mr. SCHNEIDER, Mr. THOMPSON of California, Mr. TONKO, Ms. NORTON, Mr. CARSON of Indiana, Mr. CLAY, Mr. KHANNA, Mr. RUSH, Mrs. 

WATSON COLEMAN, Ms. BLUNT ROCHESTER, and Mr. CLEAVER

OCTOBER 29, 2019 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on June 21, 2019] 

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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. 

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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 Ca5 reers Act’’. 

6 SEC. 2. EXTENSION THROUGH FISCAL YEAR 2020 OF FUND7 ING FOR DEMONSTRATION PROJECTS TO AD8 DRESS HEALTH PROFESSIONS WORKFORCE 

9 NEEDS. 

10 (a) IN GENERAL.—Section 2008(c)(1) of the Social Se11 curity Act (42 U.S.C. 1397g(c)(1)) is amended by striking 

12 ‘‘2019.’’ and inserting ‘‘2020, and to provide technical as13 sistance and cover administrative costs associated with im14 plementing the successor to this section $15,000,000 for fis15 cal year 2020.’’. 

16 (b) AVAILABILITY OF OTHER FUNDS.—Upon the date 

17 of the enactment of this section— 

18 (1) amounts expended pursuant to section 1501 

19 of division B of Public Law 116–59, or any other 

20 prior law making amounts available for fiscal year 

21 2020 for activities authorized by section 2008 of the 

22 Social Security Act, shall be charged to the appro23 priation made by subsection (c)(1) of such section 

24 2008 for fiscal year 2020 (not including the amount 

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1 for technical assistance and administrative costs); 

2 and 

3 (2) if such enactment occurs on or before Novem4 ber 21, 2019, the availability of funds appropriated 

5 in, and the authority provided under, such section 

6 1501 shall terminate. 

7 SEC. 3. CAREER PATHWAYS THROUGH HEALTH PROFES8 SION OPPORTUNITY GRANTS. 

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

10 Security Act (42 U.S.C. 1397g) is amended to read as fol11 lows: 

12 ‘‘SEC. 2008. CAREER PATHWAYS THROUGH HEALTH PROFES13 SION OPPORTUNITY GRANTS. 

14 ‘‘(a) APPLICATION REQUIREMENTS.—An eligible enti15 ty desiring a grant under this section for a project shall 

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

17 includes the following: 

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

19 a career pathways approach to train eligible individ20 uals for health professions that pay well or will put 

21 eligible individuals on a career path to an occupation 

22 that pays well, under the project. 

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

24 and literacy activities, work readiness activities, 

25 training activities, and case management and career 

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1 coaching services that the applicant will use to assist 

2 eligible individuals to gain work experience, connec3 tion to employers, and job placement, and a descrip4 tion of the plan for recruiting, hiring, and training 

5 staff to provide the case management, mentoring, and 

6 career coaching services, under the project directly or 

7 through local governmental, apprenticeship, edu8 cational, or charitable institutions. 

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

10 under this section for a demonstration project de11 scribed in subsection (c)(2)(B)(i)(I)— 

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

13 which the demonstration project is to be con14 ducted has in effect policies or laws that permit 

15 certain allied health and behavioral health care 

16 credentials to be awarded to people with certain 

17 arrest or conviction records (which policies or 

18 laws shall include appeals processes, waivers, 

19 certificates, and other opportunities to dem20 onstrate rehabilitation to obtain credentials, li21 censure, and approval to work in the proposed 

22 health careers), and a plan described in the ap23 plication that will use a career pathway to assist 

24 participants with such a record in acquiring creVerDate Sep 11 2014 20:43 Oct 29, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6203 E:\BILLS\H3398.RH H3398
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1 dentials, licensing, and employment in the speci2 fied careers; 

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 con7 viction 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 on 

15 workforce shortage or in-demand jobs for which 

16 people with certain types of arrest or conviction 

17 records can be hired; 

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

19 eligible individuals into the project; and 

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

21 support and ongoing training as part of a career 

22 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, stra2 tegic staff hiring decisions, tailored program ac3 tivities, or other programmatic elements of the 

4 project, such as training plans for doulas and 

5 other community health workers and training 

6 plans for midwives and other allied health pro7 fessions, that are designed to support a career 

8 pathway in pregnancy, birth, or post-partum 

9 services; and 

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

11 which the demonstration project is to be con12 ducted recognizes doulas or midwives, as the case 

13 may be. 

14 ‘‘(5) A demonstration that the applicant has ex15 perience working with low-income populations, or a 

16 description of the plan of the applicant to work with 

17 a partner organization that has the experience. 

18 ‘‘(6) A plan for providing post-employment sup19 port and ongoing training as part of a career path20 way under the project. 

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

22 the applicant will provide under the project, includ23 ing a plan for how child care and transportation sup24 port services will be guaranteed and, if the applicant 

25 will provide a cash stipend or wage supplement, how 

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1 the stipend or supplement would be calculated and 

2 distributed. 

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

4 project development included— 

5 ‘‘(A) consultation with a local workforce de6 velopment board established under section 107 of 

7 the Workforce Innovation and Opportunity Act; 

8 ‘‘(B) consideration of apprenticeship and 

9 pre-apprenticeship models registered under the 

10 Act of August 16, 1937 (also known as the ‘Na11 tional Apprenticeship Act’); 

12 ‘‘(C) consideration of career pathway pro13 grams in the State in which the project is to be 

14 conducted; and 

15 ‘‘(D) a review of the State plan under sec16 tion 102 or 103 of the Workforce Innovation and 

17 Opportunity Act. 

18 ‘‘(9) A description of the availability and rel19 evance of recent labor market information and other 

20 pertinent evidence of in-demand jobs or worker short21 ages. 

22 ‘‘(10) A certification that the applicant will di23 rectly provide or contract for the training services de24 scribed in the application. 

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

2 grant is made to the applicant, the applicant will— 

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

4 project, provide the Secretary with any informa5 tion needed by the Secretary to establish ade6 quate data reporting and administrative struc7 ture for the project; 

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

9 later than the end of the planning period appli10 cable to the project; 

11 ‘‘(C) accept all technical assistance offered 

12 by the Secretary with respect to the grant; 

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

14 conferences as are regularly scheduled by the Sec15 retary; 

16 ‘‘(E) provide all data required by the Sec17 retary under subsection (g); and 

18 ‘‘(F) notify the local disabled veterans’ out19 reach program specialists under section 4103A of 

20 title 38, United States Code, and the local vet21 erans’ employment representatives under section 

22 4104 of such title, of the grantee’s outreach plan 

23 for advertising training opportunities to poten24 tial participants in the project. 

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1 ‘‘(b) PREFERENCES IN CONSIDERING APPLICATIONS.— 

2 In considering applications for a grant under this section, 

3 the Secretary shall give preference to— 

4 ‘‘(1) applications submitted by applicants to 

5 whom a grant was made under this section or any 

6 predecessor to this section; 

7 ‘‘(2) applications submitted by applicants who 

8 have business and community partners in each of the 

9 following categories: 

10 ‘‘(A) State and local government agencies 

11 and social service providers, including a State or 

12 local entity that administers a State program 

13 funded under part A of this title; 

14 ‘‘(B) institutions of higher education, ap15 prenticeship programs, and local workforce devel16 opment boards established under section 107 of 

17 the Workforce Innovation and Opportunity Act; 

18 and 

19 ‘‘(C) health care employers, health care in20 dustry or sector partnerships, labor unions, and 

21 labor-management partnerships; 

22 ‘‘(3) applications that include opportunities for 

23 mentoring or peer support, and make career coaching 

24 available, as part of the case management plan; 

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

2 will serve a rural area in which— 

3 ‘‘(A) the community in which the individ4 uals to be enrolled in the project reside is located; 

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

6 ‘‘(C) an employer partnership that has com7 mitted to hiring individuals who successfully 

8 complete all activities under the project is lo9 cated; 

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

11 providing project participants with a cash stipend or 

12 wage supplement; and 

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

14 fund to assist project participants financially in 

15 emergency situations. 

16 ‘‘(c) GRANTS.— 

17 ‘‘(1) COMPETITIVE GRANTS.— 

18 ‘‘(A) GRANT AUTHORITY.— 

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

20 consultation with the Secretary of Labor 

21 and the Secretary of Education, may make 

22 a grant in accordance with this paragraph 

23 to an eligible entity whose application for 

24 the grant is approved by the Secretary, to 

25 conduct a project designed to train low-inVerDate Sep 11 2014 20:43 Oct 29, 2019 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6203 E:\BILLS\H3398.RH H3398
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1 come individuals for allied health profes2 sions, health information technology, physi3 cians assistants, nursing assistants, reg4 istered nurse, advanced practice nurse, and 

5 other professions considered part of a health 

6 care career pathway model. 

7 ‘‘(ii) GUARANTEE OF GRANTEES IN

8 EACH STATE AND THE DISTRICT OF COLUM9 BIA.—For each grant cycle, the Secretary 

10 shall award a grant under this paragraph 

11 to at least 2 eligible entities in each State 

12 that is not a territory, to the extent there 

13 are a sufficient number of applications sub14 mitted by the entities that meet the require15 ments applicable with respect to such a 

16 grant. If, for a grant cycle, there are fewer 

17 than 2 such eligible entities in a State, the 

18 Secretary shall include that information in 

19 the report required by subsection (g)(2) that 

20 covers the fiscal year. 

21 ‘‘(B) GUARANTEE OF GRANTS FOR INDIAN

22 POPULATIONS.—From the amount reserved under 

23 subsection (i)(2)(B) for each fiscal year, the Sec24 retary shall award a grant under this paragraph 

25 to at least 10 eligible entities that are an Indian 

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1 tribe, a tribal organization, or a tribal college or 

2 university, to the extent there are a sufficient 

3 number of applications submitted by the entities 

4 that meet the requirements applicable with re5 spect to such a grant. 

6 ‘‘(C) GUARANTEE OF GRANTEES IN THE

7 TERRITORIES.—From the amount reserved under 

8 subsection (i)(2)(C) for each fiscal year, the Sec9 retary shall award a grant under this paragraph 

10 to at least 2 eligible entities that are located in 

11 a territory, to the extent there are a sufficient 

12 number of applications submitted by the entities 

13 that meet the requirements applicable with re14 spect to such a grant. 

15 ‘‘(2) GRANTS FOR DEMONSTRATION PROJECTS.— 

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

17 in consultation with the Secretary of Labor and 

18 the Secretary of Education (and, with respect to 

19 demonstration projects of the type described in 

20 subparagraph (B)(i)(I), the Attorney General) 

21 shall make a grant in accordance with this sub22 section to an eligible entity whose application for 

23 the grant is approved by the Secretary, to con24 duct a demonstration project that meets the re25 quirements of subparagraph (B). 

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1 ‘‘(B) REQUIREMENTS.—The requirements of 

2 this subparagraph are the following: 

3 ‘‘(i) TYPE OF PROJECT.—The dem4 onstration project shall be of 1 of the fol5 lowing types: 

6 ‘‘(I) INDIVIDUALS WITH ARREST

7 OR CONVICTION RECORDS DEMONSTRA8 TION.—The demonstration project shall 

9 be of a type designed to provide edu10 cation and training for eligible indi11 viduals with arrest or conviction 

12 records to enter and follow a career 

13 pathway in the health professions 

14 through occupations that pay well and 

15 are expected to experience a labor 

16 shortage or be in high demand. 

17 ‘‘(II) PREGNANCY AND CHILD18 BIRTH CAREER PATHWAY DEMONSTRA19 TION.—The demonstration project shall 

20 be of a type designed to provide edu21 cation and training for eligible indi22 viduals to enter and follow a career 

23 pathway in the field of pregnancy, 

24 childbirth, or post-partum, in a State 

25 that recognizes doulas or midwives and 

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1 that provides payment for services pro2 vided by doulas or midwives, as the 

3 case may be, under private or public 

4 health insurance plans. 

5 ‘‘(ii) DURATION.—The demonstration 

6 project shall be conducted for not less than 

7 5 years. 

8 ‘‘(C) MINIMUM ALLOCATION OF FUNDS FOR

9 EACH TYPE OF DEMONSTRATION PROJECT.— 

10 ‘‘(i) INDIVIDUALS WITH ARREST OR

11 CONVICTION RECORDS DEMONSTRATIONS.— 

12 Not less than 25 percent of the amounts 

13 made available for grants under this para14 graph shall be used to make grants for dem15 onstration projects of the type described in 

16 subparagraph (B)(i)(I). 

17 ‘‘(ii) PREGNANCY AND CHILDBIRTH CA18 REER PATHWAY DEMONSTRATIONS.—Not 

19 less than 25 percent of the amounts made 

20 available for grants under this paragraph 

21 shall be used to make grants for demonstra22 tion projects of the type described in sub23 paragraph (B)(i)(II). 

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

25 section shall be not less than 5 years, with a planning 

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

2 grant cycle. During the planning period, the amount 

3 of the grant shall be in such lesser amount as the Sec4 retary determines appropriate. 

5 ‘‘(d) USE OF GRANT.— 

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

7 is made under this section shall use the grant in ac8 cordance with the approved application for the grant. 

9 ‘‘(2) SUPPORT TO BE PROVIDED.— 

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

11 which a grant is made under this section shall 

12 include the following: 

13 ‘‘(i) An assessment for adult basic skill 

14 competency, and provision of adult basic 

15 skills education if necessary for lower-skilled 

16 eligible individuals to enroll in the project 

17 and go on to enter and complete post-sec18 ondary training, through means including 

19 the following: 

20 ‘‘(I) Establishing a network of 

21 partners that offer pre-training activi22 ties for project participants who need 

23 to improve basic academic skills or 

24 English language proficiency before enVerDate Sep 11 2014 20:43 Oct 29, 2019 Jkt 099200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6203 E:\BILLS\H3398.RH H3398
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1 tering a health occupational training 

2 career pathway program. 

3 ‘‘(II) Offering resources to enable 

4 project participants to continue ad5 vancing adult basic skill proficiency 

6 while enrolled in a career pathway 

7 program. 

8 ‘‘(III) Embedding adult basic skill 

9 maintenance as part of ongoing post10 graduation career coaching and men11 toring. 

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

13 available and affordable support service for 

14 project participants through means such as 

15 the following; 

16 ‘‘(I) Referral to, and assistance 

17 with, enrollment in a subsidized child 

18 care program. 

19 ‘‘(II) Direct payment to a child 

20 care provider if a slot in a subsidized 

21 child care program is not available or 

22 reasonably accessible. 

23 ‘‘(III) Payment of co-payments or 

24 associated fees for child care. 

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1 ‘‘(iii) Case management plans that in2 clude career coaching (with the option to 

3 offer appropriate peer support and men4 toring opportunities to help develop soft 

5 skills and social capital), which may be of6 fered on an ongoing basis before, during, 

7 and after initial training as part of a ca8 reer pathway model. 

9 ‘‘(iv) A plan to provide project partici10 pants with transportation through means 

11 such as the following: 

12 ‘‘(I) Referral to, and assistance 

13 with enrollment in, a subsidized trans14 portation program. 

15 ‘‘(II) If a subsidized transpor16 tation program is not reasonably 

17 available, direct payments to subsidize 

18 transportation costs. 

19 For purposes of this clause, the term ‘trans20 portation’ includes public transit, or gaso21 line for a personal vehicle if public transit 

22 is not reasonably accessible or available. 

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

24 project of the type described in subsection 

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

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1 project participants for the purpose of ad2 dressing arrest or conviction records and as3 sociated workforce barriers. 

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

5 services provided under a project for which a 

6 grant is made under this section may include the 

7 following: 

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

9 monthly. 

10 ‘‘(ii) A reserve fund for financial as11 sistance to project participants in emer12 gency situations. 

13 ‘‘(iii) Tuition, and training materials 

14 such as books, software, uniforms, shoes, and 

15 hair nets. 

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

17 as interview clothing and conference attend18 ance fees. 

19 ‘‘(v) Assistance with accessing and 

20 completing high school equivalency or adult 

21 basic education courses as necessary to 

22 achieve success in the project and make 

23 progress toward career goals. 

24 ‘‘(vi) Assistance with programs and ac25 tivities, including legal assistance, deemed 

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1 necessary to address arrest or conviction 

2 records as an employment barrier. 

3 ‘‘(vii) Other support services as deemed 

4 necessary for family well-being, success in 

5 the project, and progress toward career 

6 goals. 

7 ‘‘(C) TREATMENT OF SUPPORT FOR PUR8 POSES OF MEANS-TESTED PROGRAMS.—Any 

9 goods or services provided to an eligible indi10 vidual participating in a project for which a 

11 grant is made under this section shall not be 

12 considered income, and shall not be taken into 

13 account for purposes of determining the eligi14 bility of the individual for, or amount of benefits 

15 to be provided to the individual, under any 

16 means-tested program. 

17 ‘‘(3) TRAINING.—The number of hours of train18 ing provided to an eligible individual under a project 

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

20 recognized postsecondary credential, including an in21 dustry-recognized credential, which is awarded in rec22 ognition of attainment of measurable technical or oc23 cupational skills necessary to gain employment or ad24 vance within an occupation (including a certificate 

25 awarded by a local workforce development board esVerDate Sep 11 2014 20:43 Oct 29, 2019 Jkt 099200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6203 E:\BILLS\H3398.RH H3398
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1 tablished under section 107 of the Workforce Innova2 tion and Opportunity Act), shall be— 

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

4 training required for certification in that level of 

5 skill by the State in which the project is con6 ducted; or 

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

8 number of hours of training as the Secretary 

9 finds is necessary to achieve that skill level. 

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

11 grant is made under this section shall not use the 

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

13 eligible individual. 

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

15 case of a project for which a grant is made under this 

16 section that is conducted in a State that has a pro17 gram funded under part A of title IV, at least 10 per18 cent of the eligible individuals to whom support is 

19 provided under the project shall meet the income eligi20 bility requirements under that State program, with21 out regard to whether the individuals receive benefits 

22 or services directly under that State program. 

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

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

25 purposes of entertainment, except that case manageVerDate Sep 11 2014 20:43 Oct 29, 2019 Jkt 099200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6203 E:\BILLS\H3398.RH H3398
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1 ment and career coaching services may include cele2 brations of specific career-based milestones such as 

3 completing a semester, graduation, or job placement. 

4 ‘‘(e) TECHNICAL ASSISTANCE.— 

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

6 technical assistance— 

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

8 for grants under this section; 

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

10 grantees at each stage of the administration of 

11 projects for which grants are made under this 

12 section; 

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

14 needs of Indian tribes, tribal organizations, and 

15 tribal colleges and universities; 

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

17 needs of the territories; 

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

19 needs of eligible entities in carrying out dem20 onstration projects for which a grant is made 

21 under this section; and 

22 ‘‘(F) to facilitate the exchange of informa23 tion among eligible entities regarding best prac24 tices and promising practices used in the 

25 projects. 

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1 ‘‘(2) CONTINUATION OF PEER TECHNICAL ASSIST2 ANCE CONFERENCES.—The Secretary shall continue to 

3 hold peer technical assistance conferences for entities 

4 to which a grant is made under this section or was 

5 made under the immediate predecessor of this section. 

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

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

8 grant, contract, or interagency agreement, conduct 

9 rigorous and well-designed evaluations of the dem10 onstration projects for which a grant is made under 

11 this section. 

12 ‘‘(2) REQUIREMENT APPLICABLE TO INDIVIDUALS

13 WITH ARREST OR CONVICTION RECORDS DEMONSTRA14 TION.—In the case of a project of the type described 

15 in subsection (c)(2)(B)(i)(I), the evaluation shall in16 clude identification of successful activities for creating 

17 opportunities for developing and sustaining, particu18 larly with respect to low-income individuals with ar19 rest or conviction records, a health professions work20 force that has accessible entry points, that meets high 

21 standards for education, training, certification, and 

22 professional development, and that provides increased 

23 wages and affordable benefits, including health care 

24 coverage, that are responsive to the needs of the work25 force. 

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1 ‘‘(3) REQUIREMENT APPLICABLE TO PREGNANCY

2 AND CHILDBIRTH CAREER PATHWAY DEMONSTRA3 TION.—In the case of a project of the type described 

4 in subsection (c)(2)(B)(i)(II), the evaluation shall in5 clude identification of successful activities for creating 

6 opportunities for developing and sustaining, particu7 larly with respect to low-income individuals and 

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

9 accessible entry points, that meets high standards for 

10 education, training, certification, and professional de11 velopment, and that provides increased wages and af12 fordable benefits, including health care coverage, that 

13 are responsive to the needs of the birth, pregnancy, 

14 and post-partum workforce. 

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

16 conducted pursuant to this subsection may include a 

17 randomized controlled trial, but this subsection shall 

18 not be interpreted to require an evaluation to include 

19 such a trial. 

20 ‘‘(g) REPORTS.— 

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

22 awarded a grant to conduct a project under this sec23 tion shall submit interim reports to the Secretary on 

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

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1 tivities. Each such report shall include data on par2 ticipant outcomes related to earnings, employment in 

3 health professions, graduation rate, graduation time4 liness, credential attainment, participant demo5 graphics, and other data specified by the Secretary. 

6 ‘‘(2) TO THE CONGRESS.—During each Congress, 

7 the Secretary shall submit to the Committee on Ways 

8 and Means of the House of Representatives and the 

9 Committee on Finance of the Senate a report— 

10 ‘‘(A) on the demographics of the partici11 pants in the projects for which a grant is made 

12 under this section; 

13 ‘‘(B) on the rate of which project partici14 pants completed all activities under the projects; 

15 ‘‘(C) on the employment credentials ac16 quired by project participants; 

17 ‘‘(D) on the employment of project partici18 pants on completion of activities under the 

19 projects, and the earnings of project participants 

20 at entry into employment; 

21 ‘‘(E) on best practices and promising prac22 tices used in the projects; 

23 ‘‘(F) on the nature of any technical assist24 ance provided to grantees under this section; 

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

2 period covered in the most recent prior report 

3 submitted under this paragraph— 

4 ‘‘(i) the number of applications sub5 mitted under this section, with a separate 

6 statement of the number of applications re7 ferred to in subsection (b)(5); 

8 ‘‘(ii) the number of applications that 

9 were approved, with a separate statement of 

10 the number of such applications referred to 

11 in subsection (b)(5); and 

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

13 made in any case described in the last sen14 tence of subsection (c)(1)(A)(ii); and 

15 ‘‘(H) that includes an assessment of the ef16 fectiveness of the projects with respect to address17 ing health professions workforce shortages or in18 demand jobs. 

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

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

21 ‘allied health profession’ has the meaning given in 

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

23 ‘‘(2) CAREER PATHWAY.—The term ‘career path24 way’ has the meaning given that term in section 3(7) 

25 of the Workforce Innovation and Opportunity Act. 

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1 ‘‘(3) DOULA.—The term ‘doula’ means an indi2 vidual who— 

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

4 has been established for not less than 5 years and 

5 that requires the completion of continuing edu6 cation to maintain the certification, to provide 

7 non-medical advice, information, emotional sup8 port, and physical comfort to an individual dur9 ing the individual’s pregnancy, childbirth, and 

10 post-partum period; and 

11 ‘‘(B) maintains the certification by com12 pleting the required continuing education. 

13 ‘‘(4) ELIGIBLE ENTITY.—The term ‘eligible enti14 ty’ means any of the following entities that dem15 onstrates in an application submitted under this sec16 tion that the entity has the capacity to fully develop 

17 and administer the project described in the applica18 tion: 

19 ‘‘(A) A local workforce development board 

20 established under section 107 of the Workforce 

21 Innovation and Opportunity Act. 

22 ‘‘(B) A State or territory, a political sub23 division of a State or territory, or an agency of 

24 a State, territory, or such a political subdivision, 

25 including a State or local entity that adminVerDate Sep 11 2014 20:43 Oct 29, 2019 Jkt 099200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6203 E:\BILLS\H3398.RH H3398
28 

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1 isters a State program funded under part A of 

2 this title. 

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

4 or a tribal college or university. 

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

6 defined in the Higher Education Act of 1965). 

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

8 1861(e)). 

9 ‘‘(F) A high-quality skilled nursing facility 

10 (as defined in section 1819(a)). 

11 ‘‘(G) A Federally qualified health center (as 

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

13 ‘‘(H) A nonprofit organization described in 

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

15 1986, a labor organization, or an entity with 

16 shared labor-management oversight, that has a 

17 demonstrated history of providing health profes18 sion training to eligible individuals. 

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

20 of the type provided for in subsection 

21 (c)(2)(B)(i)(II) of this section, an entity recog22 nized by a State, Indian tribe, or tribal organi23 zation as qualified to train doulas or midwives, 

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

25 permitted to practice in the State involved. 

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1 ‘‘(J) An opioid treatment program (as de2 fined in section 1861(jjj)(2)), and other high 

3 quality comprehensive addiction care providers. 

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

5 individual’ means an individual whose family income 

6 does not exceed 200 percent of the Federal poverty 

7 level. 

8 ‘‘(6) FEDERAL POVERTY LEVEL.—The term ‘Fed9 eral poverty level’ means the poverty line (as defined 

10 in section 673(2) of the Omnibus Budget Reconcili11 ation Act of 1981, including any revision required by 

12 such section applicable to a family of the size in13 volved). 

14 ‘‘(7) HIGH-QUALITY SKILLED NURSING FACIL15 ITY.—The term ‘high-quality skilled nursing facility’ 

16 means a facility (as defined in section 1819(a)) that 

17 has at least a 5-star rating for staffing to participate 

18 based on the data from section 1819(i)(1)(A)(i) and 

19 not have an immediate jeopardy violation as de20 scribed in section 1819(h)(1)(A) within the preceding 

21 3 years. 

22 ‘‘(8) INDIAN TRIBE; TRIBAL ORGANIZATION.—The 

23 terms ‘Indian tribe’ and ‘tribal organization’ have the 

24 meaning given the terms in section 4 of the Indian 

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1 Self-Determination and Education Assistance Act (25 

2 U.S.C. 450b). 

3 ‘‘(9) INSTITUTION OF HIGHER EDUCATION.—The 

4 term ‘institution of higher education’ has the meaning 

5 given the term in section 101 or 102(a)(1)(B) of the 

6 Higher Education Act of 1965. 

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

8 the Commonwealth of Puerto Rico, the United States 

9 Virgin Islands, Guam, the Northern Mariana Islands, 

10 and American Samoa. 

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

12 term ‘tribal college or university’ has the meaning 

13 given the term in section 316(b) of the Higher Edu14 cation Act of 1965. 

15 ‘‘(i) FUNDING.— 

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

17 Treasury of the United States not otherwise appro18 priated, there are appropriated to the Secretary to 

19 carry out this section $425,000,000 for each of fiscal 

20 years 2021 through 2025. 

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

22 appropriated for a fiscal year under paragraph (1) of 

23 this subsection— 

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

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

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1 ‘‘(B) 4 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 (c)(2); 

7 ‘‘(E) 6 percent, plus all amounts referred to 

8 in subparagraphs (A) through (D) of this para9 graph that remain unused after all grant awards 

10 are made for the fiscal year, shall be available 

11 for the provision of technical assistance and as12 sociated staffing; and 

13 ‘‘(F) 4 percent shall be available for study14 ing the effects of the demonstration and non15 demonstration projects for which a grant is 

16 made under this section, and for associated staff17 ing, for the purpose of supporting the rigorous 

18 evaluation of the demonstration projects, and 

19 supporting the continued study of the short-, me20 dium-, and long-term effects of all such projects, 

21 including the effectiveness of new or added ele22 ments of the non-demonstration projects. 

23 ‘‘(j) NONAPPLICABILITY OF PRECEDING SECTIONS OF

24 THIS SUBTITLE.— 

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1 ‘‘(1) IN GENERAL.—Except as provided in para2 graph (2), the preceding sections of this subtitle shall 

3 not apply to a grant awarded under this section. 

4 ‘‘(2) EXCEPTION FOR CERTAIN LIMITATIONS ON

5 USE OF GRANTS.—Section 2005(a) (other than para6 graphs (2), (3), (5), (6), and (8)) shall apply to a 

7 grant awarded under this section to the same extent 

8 and in the same manner as such section applies to 

9 payments to States under this subtitle.’’. 

Union Calendar No. 211 

116TH CONGRESS 

1ST SESSION H. R. 3398 

[Report No. 116–265] 

A BILL 

To provide low-income individuals with opportunionstration projects, and for other purposes. health professions, to extend and expand dem- ties to enter and follow a career pathway in the 

OCTOBER 29, 2019 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union,