II 

118TH CONGRESS 

1ST SESSION S. 1298 

To award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants 

to support family caregivers. 

IN THE SENATE OF THE UNITED STATES 

APRIL 26, 2023 

Mr. KAINE (for himself, Mr. CASEY, Mr. REED, Ms. SMITH, Ms. HASSAN, Mr. 

WHITEHOUSE, Mrs. GILLIBRAND, and Mr. WYDEN) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To award grants for the creation, recruitment, training and 

education, retention, and advancement of the direct care 

workforce and to award grants to support family caregivers. 

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 ‘‘Supporting Our Direct 

5 Care Workforce and Family Caregivers Act’’. 

6 SEC. 2. DEFINITIONS. 

7 In this Act: 


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1 (1) APPRENTICESHIP PROGRAM.—The term 

2 ‘‘apprenticeship program’’ means an apprenticeship 

3 program registered under the Act of August 16, 

4 1937 (commonly known as the ‘‘National Appren5 ticeship Act’’; 50 Stat. 664, chapter 663; 29 U.S.C. 

6 50 et seq.), including any requirement, standard, or 

7 rule promulgated under such Act. 

8 (2) COMMUNITY COLLEGE.—The term ‘‘commu9 nity college’’ means a public institution of higher 

10 education at which the highest degree that is pre11 dominantly awarded to students is an associate’s de12 gree, including Tribal Colleges or Universities receiv13 ing grants under section 316 of the Higher Edu14 cation Act of 1965 (20 U.S.C. 1059c) that offer a 

15 2-year program for completion of such degree and 

16 State public institutions of higher education that 

17 offer such a 2-year program. 

18 (3) DIRECT CARE PROFESSIONAL.—The term 

19 ‘‘direct care professional’’— 

20 (A) means an individual who, in exchange 

21 for compensation, provides services to a person 

22 with a disability or an older individual that pro23 motes the independence of such person or indi24 vidual, including— 


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1 (i) services that enhance the inde2 pendence and community inclusion for 

3 such person or individual, including trav4 eling with such person or individual or at5 tending and assisting such person or indi6 vidual while visiting friends and family, 

7 shopping, or socializing; 

8 (ii) services such as coaching and sup9 porting such person or individual in com10 municating needs, achieving self-expres11 sion, pursuing personal goals, living inde12 pendently, and participating actively in em13 ployment or voluntary roles in the commu14 nity; 

15 (iii) services such as providing assist16 ance with activities of daily living (such as 

17 feeding, bathing, toileting, and ambulation) 

18 and with tasks such as meal preparation, 

19 shopping, light housekeeping, and laundry; 

20 (iv) services that support such person 

21 or individual at home, work, school, or in 

22 any other community setting; or 

23 (v) services that promote health and 

24 wellness, including scheduling and taking 

25 such person or individual to health care 


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1 appointments, communicating with health 

2 and allied health professionals admin3 istering medications, implementing health 

4 and behavioral health interventions and 

5 treatment plans, monitoring and recording 

6 health status and progress; and 

7 (B) may include— 

8 (i) a direct support professional sup9 porting people with intellectual and devel10 opmental disabilities; 

11 (ii) a home and community-based 

12 services manager or direct support profes13 sional manager; 

14 (iii) a self-directed care worker; 

15 (iv) a personal care service worker; 

16 (v) a direct care worker, as defined in 

17 section 799B of the Public Health Service 

18 Act (42 U.S.C. 295p); or 

19 (vi) any other position or job related 

20 to the home care or direct care workforce, 

21 such as positions or jobs in respite care or 

22 palliative care, as determined by the Sec23 retary, in consultation with the Center for 

24 Medicare & Medicaid Services and the Sec25 retary of Labor. 


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1 (4) DIRECT CARE WORKFORCE.—The term ‘‘di2 rect care workforce’’ means the broad workforce of 

3 direct care professionals. 

4 (5) FAMILY CAREGIVER.—The term ‘‘family 

5 caregiver’’ has the meaning given such term in sec6 tion 2 of the RAISE Family Caregivers Act (42 

7 U.S.C. 3030s note; Public Law 115–119) and in8 cludes paid and unpaid family caregivers. 

9 (6) ELIGIBLE ENTITY.—The term ‘‘eligible enti10 ty’’ means an entity— 

11 (A) that is— 

12 (i) a State; 

13 (ii) a labor organization, joint labor14 management organization, or employer of 

15 direct care professionals; 

16 (iii) a nonprofit entity with experience 

17 in aging, disability, or supporting the 

18 rights and interests of, training of, or edu19 cating direct care professionals or family 

20 caregivers; 

21 (iv) an Indian Tribe, Tribal organiza22 tion, or Urban Indian organization; 

23 (v) a community college or other insti24 tution of higher education; or 


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1 (vi) a consortium of entities listed in 

2 any of clauses (i) through (v); 

3 (B) that agrees to include, as applicable 

4 with respect to the type of grant the entity is 

5 seeking under this Act and the activities sup6 ported through such grant, older individuals, 

7 people with disabilities, direct care profes8 sionals, and family caregivers, as advisors and 

9 trainers in such activities; and 

10 (C) that agrees to consult with the State 

11 Medicaid agency of the State (or each State) 

12 served by the grant on the grant activities, to 

13 the extent that such agency (or each such agen14 cy) is not the eligible entity. 

15 (7) EMPLOYER.—The terms ‘‘employ’’ and 

16 ‘‘employer’’ have the meanings given the terms in 

17 section 3 of the Fair Labor Standards Act of 1938 

18 (29 U.S.C. 203 et seq.). 

19 (8) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

20 The terms ‘‘Indian Tribe’’ and ‘‘Tribal organiza21 tion’’ have the meanings given such terms in section 

22 4 of the Indian Self-Determination and Education 

23 Assistance Act (25 U.S.C. 5304). 

24 (9) INSTITUTION OF HIGHER EDUCATION.—The 

25 term ‘‘institution of higher education’’ means— 


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1 (A) an institution of higher education de2 fined in section 101 of the Higher Education 

3 Act of 1965 (20 U.S.C. 1001); or 

4 (B) an institution of higher education de5 fined in section 102(a)(1)(B) of such Act (20 

6 U.S.C. 1002(a)(1)(B)). 

7 (10) OLDER INDIVIDUAL.—The term ‘‘older in8 dividual’’ means an individual who is 60 years of age 

9 or older. 

10 (11) PERSON WITH A DISABILITY.—The term 

11 ‘‘person with disability’’ means an individual with a 

12 disability, as defined in section 3 of the Americans 

13 with Disabilities Act of 1990 (42 U.S.C. 12102). 

14 (12) PROJECT PARTICIPANT.—The term 

15 ‘‘project participant’’ means an individual partici16 pating in a project or activity assisted with a grant 

17 under this Act, including (as applicable for the cat18 egory of the grant) a direct care professional, or an 

19 individual training to be such a professional, or a 

20 family caregiver. 

21 (13) SECRETARY.—The term ‘‘Secretary’’ 

22 means the Secretary of Health and Human Services, 

23 acting through the Administrator for Community 

24 Living. 


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1 (14) SELF-DIRECTED CARE PROFESSIONAL.— 

2 The term ‘‘self-directed care professional’’ means a 

3 direct care professional who is employed by an indi4 vidual who is an older individual, a person with a 

5 disability, or a representative of such older indi6 vidual or person with a disability, and such older in7 dividual or person with a disability has the decision8 making authority over certain supports and services 

9 provided by the direct care professional and takes di10 rect responsibility to manage those supports and 

11 services. 

12 (15) SUPPORTIVE SERVICES.—The term ‘‘sup13 portive services’’ means services that are necessary 

14 to enable an individual to participate in activities as15 sisted with a grant under this Act, such as transpor16 tation, child care, dependent care, housing, work17 place accommodations, employee benefits such as 

18 paid sick leave and child care, workplace health and 

19 safety protections, wages and overtime pay, and 

20 needs-related payments. 

21 (16) URBAN INDIAN ORGANIZATION.—The term 

22 ‘‘urban Indian organization’’ has the meaning given 

23 the term in section 4 of the Indian Health Care Im24 provement Act (25 U.S.C. 1603). 


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1 (17) WORKFORCE INNOVATION AND OPPOR2 TUNITY ACT TERMS.—The terms ‘‘career pathway’’, 

3 ‘‘career planning’’, ‘‘in-demand industry sector or 

4 occupation’’, ‘‘individual with a barrier to employ5 ment’’, ‘‘local board’’, ‘‘on-the-job training’’, ‘‘recog6 nized postsecondary credential’’, ‘‘region’’, and 

7 ‘‘State board’’ have the meanings given such terms 

8 in section 3 of the Workforce Innovation and Oppor9 tunity Act (29 U.S.C. 3102). 

10 (18) WORK-BASED LEARNING.—The term 

11 ‘‘work-based learning’’ has the meaning given the 

12 term in section 3 of the Carl D. Perkins Career and 

13 Technical Education Act of 2006 (20 U.S.C. 2302). 

14 SEC. 3. AUTHORITY TO ESTABLISH A TECHNICAL ASSIST15 ANCE CENTER FOR BUILDING THE DIRECT 

16 CARE WORKFORCE. 

17 (a) PROGRAM AUTHORIZED.—The Secretary shall es18 tablish a national technical assistance center (referred to 

19 in this section as the ‘‘Center’’) for, in consultation with 

20 the Secretary of Labor, the Secretary of Education, the 

21 Administrator of the Centers for Medicare & Medicaid 

22 Services, and the heads of other entities as necessary— 

23 (1) supporting direct care workforce creation, 

24 training and education, recruitment, retention, and 

25 advancement; and 


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1 (2) supporting family caregivers and activities 

2 of family caregivers as a critical part of the support 

3 team for older individuals or people with disabilities. 

4 (b) ADVISORY COUNCIL.—The Secretary shall con5 vene an advisory council to provide recommendations to 

6 the Center with respect to the duties of the Center under 

7 this section and may engage individuals and entities de8 scribed in paragraphs (3)(B), and (12), of section 5(b) 

9 (without regard to a specific project described in such 

10 paragraphs) for service on the advisory council. 

11 (c) ACTIVITIES.—The Center may— 

12 (1) develop recommendations for training and 

13 education curricula for direct care professionals, 

14 which such recommendations may include rec15 ommendations for curricula for higher education, 

16 postsecondary credentials, and programs with com17 munity colleges; 

18 (2) develop learning and dissemination strate19 gies to— 

20 (A) engage States and other entities in ac21 tivities supported under this Act and best prac22 tices; and 

23 (B) distribute findings from activities sup24 ported by grants under this Act; 


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1 (3) develop recommendations for training and 

2 education curricula and other strategies for sup3 porting family caregivers; 

4 (4) explore the national data gaps, workforce 

5 shortage areas, and data collection strategies for di6 rect care professionals and make recommendations 

7 to the Director of the Office of Management and 

8 Budget for an occupation category in the Standard 

9 Occupational Classification system for direct support 

10 professionals as a healthcare support occupation; 

11 (5) recommend career development and ad12 vancement opportunities for direct care profes13 sionals, which may include occupational frameworks, 

14 national standards, recruitment campaigns, pre-ap15 prenticeship and on-the-job training opportunities, 

16 apprenticeship programs, career ladders or path17 ways, specializations or certifications, or other activi18 ties; and 

19 (6) develop strategies for assisting with report20 ing and evaluation of grant activities under section 

21 7. 

22 SEC. 4. AUTHORITY TO AWARD GRANTS. 

23 (a) GRANTS.— 

24 (1) IN GENERAL.—Not later than 12 months 

25 after the date of enactment of this Act, the SecVerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298

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1 retary, in consultation with the Center for Medicare 

2 & Medicaid Services, the Secretary of Labor, and the 

3 Secretary of Education, shall award grants described 

4 in paragraph (2) to eligible entities. A grant award5 ed under this section may be in more than 1 cat6 egory described in such paragraph. 

7 (2) CATEGORIES OF GRANTS.—The categories 

8 of grants described in this paragraph are each of the 

9 following: 

10 (A) DIRECT CARE PROFESSIONAL

11 GRANTS.—Grants to eligible entities to create 

12 and carry out projects for the purposes of re13 cruiting, retaining, or providing advancement 

14 opportunities for direct care professionals who 

15 are not described in subparagraph (B) or (C), 

16 including through education or training pro17 grams for such professionals or individuals 

18 seeking to become such professionals. 

19 (B) DIRECT CARE PROFESSIONAL MAN20 AGERS GRANTS.—Grants to eligible entities to 

21 create and carry out projects for the purposes 

22 of recruiting, retaining, or providing advance23 ment opportunities for direct care professionals 

24 who are managers or supervisory staff that 

25 have coaching, training, managerial, superVerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298

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1 visory, or other oversight responsibilities, in2 cluding through education or training programs 

3 for such professionals or individuals seeking to 

4 become such professionals. 

5 (C) SELF-DIRECTED CARE PROFESSIONALS

6 GRANTS.—Grants to eligible entities to create 

7 and carry out projects for the purposes of re8 cruiting, retaining, or providing advancement 

9 opportunities for self-directed care profes10 sionals, including through education or training 

11 programs for such professionals or individuals 

12 seeking to become such professionals. 

13 (D) FAMILY CAREGIVER GRANTS.—Grants 

14 to eligible entities to create and carry out 

15 projects for providing support to paid or unpaid 

16 family caregivers through educational, training, 

17 or other resources, including resources for care18 giver self-care or educational or training re19 sources for individuals newly in a caregiving 

20 role or seeking additional support in the role of 

21 a family caregiver. 

22 (3) PROJECTS FOR ADVANCEMENT OPPORTUNI23 TIES.—Not less than 30 percent of projects assisted 

24 with grants under this Act shall be projects to pro25 vide career pathways that offer opportunities for 


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1 professional development and advancement opportu2 nities to direct care professionals. 

3 (b) TREATMENT OF CONTINUATION ACTIVITIES.— 

4 An eligible entity that carries out activities described in 

5 subsection (a)(2) prior to receipt of a grant under this 

6 Act may use such grant to continue carrying out such ac7 tivities, and, in using such grant to continue such activi8 ties, shall be treated as an eligible entity carrying out a 

9 project through a grant under this Act. 

10 SEC. 5. PROJECT PLANS. 

11 (a) IN GENERAL.—An eligible entity seeking a grant 

12 under this Act shall submit to the Secretary a project plan 

13 for each project to be developed and carried out (including 

14 for activities to be continued as described in section 4(b)) 

15 with the grant at such time, in such manner, and con16 taining such information as the Secretary may require. 

17 (b) CONTENTS.—A project plan submitted by an eli18 gible entity under subsection (a) shall include a descrip19 tion of information determined relevant by the Secretary 

20 for purposes of the category of the grant and the activities 

21 to be carried out through the grant. Such information may 

22 include (as applicable) the following: 

23 (1) Demographic information regarding the 

24 population in the State or relevant geographic area, 

25 including a description of the populations likely to 


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1 need long-term care services, such as people with 

2 disabilities and older individuals. 

3 (2) Projections of unmet need for services pro4 vided by direct care professionals based on enroll5 ment waiting lists under home and community-based 

6 waivers under section 1115 of the Social Security 

7 Act (42 U.S.C. 1315) or section 1915(c) of such Act 

8 (42 U.S.C. 1396n(c)) and other relevant data to the 

9 extent practicable and feasible, such as direct care 

10 workforce vacancy rates, crude separation rates, and 

11 the number of direct care professionals, including 

12 such professionals who are managers or supervisors, 

13 in the region. 

14 (3) An advisory committee to advise the eligible 

15 entity on activities to be carried out through the 

16 grant. Such advisory committee— 

17 (A) may be comprised of entities listed in 

18 paragraph (12); and 

19 (B) shall include— 

20 (i) older individuals or persons with a 

21 disability; 

22 (ii) organizations representing the 

23 rights and interests of people receiving 

24 services by the direct care professionals or 

25 family caregivers targeted by the project; 


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1 (iii) individuals who are direct care 

2 professionals or family caregivers targeted 

3 by the project and organizations rep4 resenting the rights and interests of direct 

5 care professionals or family caregivers; 

6 (iv) as applicable, employers of indi7 viduals described in clause (iii) and labor 

8 organizations representing such individ9 uals; 

10 (v) representatives of the State Med11 icaid agency, the State agency defined in 

12 section 102 of the Older Americans Act of 

13 1965 (42 U.S.C. 3002), the State develop14 mental disabilities office, and the State 

15 mental health agency, in the State (or each 

16 State) to be served by the project; and 

17 (vi) representatives reflecting diverse 

18 racial, cultural, ethnic, geographic, socio19 economic, and gender identity and sexual 

20 orientation perspectives. 

21 (4) Current or projected job openings for, or 

22 relevant labor market information related to, the di23 rect care professionals targeted by the project in the 

24 State or region to be served by the project, and the 


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1 geographic scope of the workforce to be served by 

2 the project. 

3 (5) Specific efforts and strategies that the 

4 project will undertake to reduce barriers to recruit5 ment, retention, or advancement of the direct care 

6 professionals targeted by the project, including an 

7 assurance that such efforts will include— 

8 (A) an assessment of the wages or other 

9 compensation or benefits necessary to recruit 

10 and retain the direct care professionals targeted 

11 by the project; 

12 (B) a description of the project’s projected 

13 compensation or benefits for the direct care 

14 professionals targeted by the project at the 

15 State or local level, including a comparison of 

16 such projected compensation or benefits to re17 gional and national compensation or benefits 

18 and a description of how wages and benefits re19 ceived by project participants will be impacted 

20 by the participation in and completion of the 

21 project; and 

22 (C) a description of the projected impact of 

23 workplace safety issues on the recruitment and 

24 retention of direct care professionals targeted 


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1 by the project, including the availability of per2 sonal protective equipment. 

3 (6) In the case of a project offering an edu4 cation or training program for direct care profes5 sionals, a description of such program (including 

6 how the core competencies identified by the Centers 

7 for Medicare & Medicaid Services will be incor8 porated, curricula, models, and standards used 

9 under the program, and any associated recognized 

10 postsecondary credentials for which the program 

11 provides preparation, as applicable), which shall in12 clude an assurance that such program will provide to 

13 each project participant in such program— 

14 (A) relevant training regarding the rights 

15 of recipients of home and community based 

16 services, including their rights to— 

17 (i) receive services in integrated set18 tings that provide access to the broader 

19 community; 

20 (ii) exercise self-determination; 

21 (iii) be free from all forms of abuse, 

22 neglect, or exploitation; and 

23 (iv) person-centered planning and 

24 practices, including participation in plan25 ning activities; 


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1 (B) relevant training to ensure that each 

2 project participant has the necessary skills to 

3 recognize abuse and understand their obliga4 tions with regard to reporting and responding 

5 to abuse appropriately in accordance with rel6 evant Federal and State law; 

7 (C) relevant training regarding the provi8 sion of culturally competent and disability com9 petent supports to recipients of services pro10 vided by the direct care professionals targeted 

11 by the project; 

12 (D) an apprenticeship program, work13 based learning, or on-the-job training opportu14 nities; 

15 (E) supervision or mentoring; and 

16 (F) for any on-the-job training portion of 

17 the program, a progressively increasing, clearly 

18 defined schedule of wages to be paid to each 

19 such participant that— 

20 (i) is consistent with skill gains or at21 tainment of a recognized postsecondary 

22 credential received as a result of participa23 tion in or completion of such program; and 

24 (ii) ensures the entry wage is not less 

25 than the greater of— 


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1 (I) the minimum wage required 

2 under section 6(a) of the Fair Labor 

3 Standards Act of 1938 (29 U.S.C. 

4 206(a)); or 

5 (II) the applicable wage required 

6 by other applicable Federal or State 

7 law, or a collective bargaining agree8 ment. 

9 (7) Any other innovative models or processes 

10 the eligible entity will implement to support the re11 tention and career advancement of the direct care 

12 professionals targeted by the project. 

13 (8) The supportive services and benefits to be 

14 provided to the project participants in order to sup15 port the employment, retention, or career advance16 ment of the direct care professionals targeted by the 

17 project. 

18 (9) How the eligible entity will make use of ca19 reer planning to support the identification of ad20 vancement opportunities and career pathways for 

21 the direct care professionals in the State or region 

22 to be served by the project. 

23 (10) How the eligible entity will collect and sub24 mit to the Secretary workforce data and outcomes of 

25 the project. 


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1 (11) How the project— 

2 (A) will— 

3 (i) provide adequate and safe equip4 ment and facilities for training and super5 vision, including a safe work environment 

6 free from discrimination, which may in7 clude the provision of personal protective 

8 equipment and other necessary equipment 

9 to prevent the spread of infectious disease 

10 among the direct care professionals tar11 geted by the project and recipients of serv12 ices provided by such professionals; 

13 (ii) incorporate remote training and 

14 education opportunities or technology-sup15 ported opportunities; 

16 (iii) for training and education cur17 ricula, incorporate evidenced-supported 

18 practices for adult learners and universal 

19 design for learning and ensure recipients 

20 of services provided by the direct care pro21 fessionals or family caregivers targeted by 

22 the project participate in the development 

23 and implementation of such training and 

24 education curricula; 


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1 (iv) use outreach, recruitment, and re2 tention strategies designed to reach and re3 tain a diverse workforce; 

4 (v) incorporate methods to monitor 

5 satisfaction with project activities for 

6 project participants and individuals receiv7 ing services from such participants; 

8 (vi) incorporate evidence-supported 

9 practices for family caregiver engagement; 

10 and 

11 (vii) incorporate core competencies 

12 identified by the Centers for Medicare & 

13 Medicaid Services; and 

14 (B) may incorporate continuing education 

15 programs and specialty training, with a specific 

16 focus on— 

17 (i) trauma-informed care; 

18 (ii) behavioral health, including co-oc19 curring behavioral health conditions and 

20 intellectual or developmental disabilities; 

21 (iii) Alzheimer’s and dementia care; 

22 (iv) chronic disease management; and 

23 (v) the use of supportive or assistive 

24 technology. 


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1 (12) How the eligible entity will consult on the 

2 implementation of the project, or coordinate the 

3 project with, each of the following entities, to the ex4 tent that each such entity is not the eligible entity: 

5 (A) The State Medicaid agency, State 

6 agency defined in section 102 of the Older 

7 Americans Act of 1965 (42 U.S.C. 3002), and 

8 the State developmental disabilities office for 

9 the State (or each State) to be served by the 

10 project. 

11 (B) The local board and State board for 

12 each region, or State, to be served by the 

13 project. 

14 (C) In the case of a project that carries 

15 out an education or training program, a non16 profit organization with demonstrated experi17 ence in the development or delivery of curricula 

18 or coursework. 

19 (D) A nonprofit organization, including a 

20 labor organization, that fosters the professional 

21 development and collective engagement of the 

22 direct care professionals targeted by the project. 

23 (E) Area agencies on aging, as defined in 

24 section 102 of the Older Americans Act of 1965 

25 (42 U.S.C. 3002). 


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1 (F) Centers for independent living, as de2 scribed in part C of title VII of the Rehabilita3 tion Act of 1973 (29 U.S.C. 796f et seq.). 

4 (G) The State Council on Developmental 

5 Disabilities (as such term is used in subtitle B 

6 of title I of the Developmental Disabilities As7 sistance and Bill of Rights Act of 2000 (42 

8 U.S.C. 15021 et seq.)) for the State (or each 

9 State) to be served by the project. 

10 (H) Aging and Disability Resource Centers 

11 (as defined in section 102 of the Older Ameri12 cans Act of 1965 (42 U.S.C. 3002)). 

13 (I) A nonprofit State provider association 

14 that represents providers who employ the direct 

15 care professionals targeted by the project, 

16 where such associations exist. 

17 (J) An entity that employs the direct care 

18 professionals targeted by the project. 

19 (K) University Centers for Excellence in 

20 Developmental Disabilities Education, Re21 search, and Service supported under subtitle D 

22 of title I of the Developmental Disabilities As23 sistance and Bill of Rights Act of 2000 (42 

24 U.S.C. 15061 et seq.). 


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1 (L) The State protection and advocacy sys2 tem described in section 143 of such Act (42 

3 U.S.C. 15043) of the State (or each State) to 

4 be served by the project. 

5 (M) Direct care professionals or direct care 

6 workforce organizations representing under7 served communities, including communities of 

8 color. 

9 (13) How the eligible entity will consult 

10 throughout the project with— 

11 (A) individuals employed or working as the 

12 direct care professionals or family caregivers 

13 targeted by the project; 

14 (B) representatives of such professionals or 

15 caregivers; 

16 (C) individuals assisted by such profes17 sionals or caregivers; 

18 (D) the families of such professionals or 

19 caregivers; and 

20 (E) individuals receiving education or 

21 training to become such professionals or care22 givers. 

23 (14) Outreach efforts to individuals for partici24 pation in such project, including targeted outreach 

25 efforts to— 


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1 (A) individuals who are recipients of assist2 ance under a State program funded under part 

3 A of title IV of the Social Security Act (42 

4 U.S.C. 601 et seq.) or individuals who are eligi5 ble for such assistance; and 

6 (B) individuals with barriers to employ7 ment. 

8 (c) CONSIDERATIONS.—In selecting eligible entities 

9 to receive a grant under this Act, the Secretary shall en10 sure— 

11 (1) equitable geographic and demographic di12 versity, including by selecting recipients serving 

13 rural areas and selecting recipients serving urban 

14 areas; and 

15 (2) that selected eligible entities will serve areas 

16 where the occupation of direct care professional, or 

17 a related occupation, is an in-demand industry sec18 tor or occupation. 

19 SEC. 6. USES OF FUNDS; SUPPLEMENT, NOT SUPPLANT. 

20 (a) USES OF FUNDS.— 

21 (1) IN GENERAL.—Each eligible entity receiving 

22 a grant under this Act shall use the funds of such 

23 grant to carry out at least 1 project described in sec24 tion 4(a)(2). 


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1 (2) ADMINISTRATIVE COSTS.—Each eligible en2 tity receiving a grant under this Act shall not use 

3 more than 5 percent of the funds of such grant for 

4 costs associated with the administration of activities 

5 under this Act. 

6 (3) DIRECT SUPPORT.—Each eligible entity re7 ceiving a grant under this Act (except for a grant 

8 described in section 4(a)(2)(D)) shall use not less 

9 than 5 percent of the funds of such grant to provide 

10 direct financial benefits or supportive services to di11 rect care professionals to support the financial needs 

12 of such participants during the duration of the 

13 project activities. 

14 (b) SUPPLEMENT, NOT SUPPLANT.—An eligible enti15 ty receiving a grant under this Act shall use such grant 

16 only to supplement, and not supplant, the amount of funds 

17 that, in the absence of such grant, would be available to 

18 address the recruitment, training and education, reten19 tion, and advancement of direct care professionals or pro20 vide support for family caregivers, in the State or region 

21 served by the eligible entity. 

22 (c) PROHIBITION.—No amounts made available 

23 under this Act may be used for any activity that is subject 

24 to the reporting requirements set forth in section 203(a) 


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1 of the Labor-Management Reporting and Disclosure Act 

2 of 1959 (29 U.S.C. 433(a)). 

3 SEC. 7. EVALUATIONS AND REPORTS; TECHNICAL ASSIST4 ANCE. 

5 (a) REPORTING REQUIREMENTS BY GRANT RECIPI6 ENTS.— 

7 (1) IN GENERAL.—An eligible entity receiving a 

8 grant under this Act shall cooperate with the Sec9 retary and annually provide a report to the Sec10 retary that includes any relevant data requested by 

11 the Secretary in a manner specified by the Sec12 retary. 

13 (2) CONTENTS.—The data requested by the 

14 Secretary for an annual report may include any of 

15 the following (as determined relevant by the Sec16 retary with respect to the category of the grant and 

17 each project supported through the grant): 

18 (A) The number of individuals and the de19 mographics of these individuals served by each 

20 project supported by the grant, including— 

21 (i) the number of individuals recruited 

22 through each such project to be employed 

23 as a direct care professional; 


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1 (ii) the number of individuals who 

2 through each such project attained employ3 ment as a direct care professional; and 

4 (iii) the number of individuals who en5 rolled in each such project and withdrew or 

6 were terminated from each such project 

7 without completing training or attaining 

8 employment as a direct care professional. 

9 (B) The number of family caregivers par10 ticipating in an education or training program 

11 through each project supported by the grant. 

12 (C) The number of project participants 

13 who through each such project participated in 

14 and completed— 

15 (i) work-based learning; 

16 (ii) on-the-job training; 

17 (iii) an apprenticeship program; or 

18 (iv) a professional development or 

19 mentoring program. 

20 (D)(i) Other services, benefits, or supports 

21 (other than the services, benefits, or supports 

22 described in subparagraph (C)) provided 

23 through each such project to assist in the re24 cruitment, retention, or advancement of direct 

25 care professionals (including through education 


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1 or training for such professionals or individuals 

2 seeking to become such professionals); 

3 (ii) the number of individuals who accessed 

4 such services, benefits, or supports; and 

5 (iii) the impact of such services, benefits, 

6 or supports. 

7 (E) The crude separation and vacancy 

8 rates of direct care professionals, and such 

9 rates for those professionals who are managers 

10 or supervisors, in the geographic region for a 

11 number of years before the grant was awarded, 

12 as determined by the Secretary, and annually 

13 thereafter for the duration of the grant period. 

14 (F) How each project supported by the 

15 grant assessed satisfaction with respect to— 

16 (i) project participants assisted by the 

17 project; 

18 (ii) individuals receiving services deliv19 ered by project participants, including— 

20 (I) any impact on the health or 

21 health outcomes of such individuals; 

22 and 

23 (II) any impact on the ability of 

24 individuals to transition to or remain 

25 in the community in an environment 


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1 that meets the criteria established in 

2 the section 441.301(c)(4) of title 42, 

3 Code of Federal Regulations (or suc4 cessor regulations); and 

5 (iii) employers of such project partici6 pants. 

7 (G) The performance of the eligible entity 

8 with respect to the indicators of performance on 

9 unsubsidized employment, median earnings, cre10 dential attainment, measurable skill gains, and 

11 employer satisfaction. 

12 (H) Any other information with respect to 

13 outcomes of the project as determined by the 

14 Secretary. 

15 (b) ANNUAL REPORT TO CONGRESS BY SEC16 RETARY.—Not later than 2 years after the date of enact17 ment of this Act, and each year thereafter until all 

18 projects supported through a grant under this Act are 

19 completed, the Secretary shall prepare and submit to Con20 gress an annual report on the progress of each project 

21 supported through a grant under this Act and the activi22 ties of the technical assistance center established under 

23 section 3. 

24 (c) GAO REPORT.—Not later than 1 year after the 

25 date on which all projects supported through a grant 


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1 under this Act are completed, the Comptroller General of 

2 the United States shall conduct a study and submit to 

3 Congress a report including— 

4 (1) an assessment of how the technical assist5 ance center established under section 3 and the 

6 projects supported through a grant under this Act 

7 assisted in the creation, recruitment, training and 

8 education, retention, and advancement of the direct 

9 care workforce or in providing support for family 

10 caregivers; and 

11 (2) recommendations for such legislative or ad12 ministrative actions needed for improving the assist13 ance described in paragraph (1), as the Comptroller 

14 General determines appropriate. 

15 (d) INDEPENDENT EVALUATIONS.—Not later than 6 

16 months after the date of enactment of this Act, the Sec17 retary shall enter into a contract with an independent enti18 ty to provide independent evaluations of activities sup19 ported by grants under this Act and activities of the tech20 nical assistance center established under section 3. 

21 SEC. 8. AUTHORIZATION OF APPROPRIATIONS. 

22 (a) IN GENERAL.—There are authorized to be appro23 priated— 

24 (1) for the establishment and activities of the 

25 technical assistance center under section 3, 


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1 $2,000,000 for each of fiscal years 2024 through 

2 2028; and 

3 (2) for grants under section 4, $1,000,000,000 

4 for fiscal year 2024. 

5 (b) AVAILABILITY.—Amounts made available under 

6 this Act shall remain available until September 30, 2033. 

Æ 


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