Supporting Our Direct Care Workforce and Family Caregivers Act



<html><body><pre>[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1298 Introduced in Senate (IS)]

&lt;DOC&gt;






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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Supporting Our Direct Care Workforce 
and Family Caregivers Act''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Apprenticeship program.--The term ``apprenticeship 
        program'' means an apprenticeship program registered under the 
        Act of August 16, 1937 (commonly known as the ``National 
        Apprenticeship Act''; 50 Stat. 664, chapter 663; 29 U.S.C. 50 
        et seq.), including any requirement, standard, or rule 
        promulgated under such Act.
            (2) Community college.--The term ``community college'' 
        means a public institution of higher education at which the 
        highest degree that is predominantly awarded to students is an 
        associate's degree, including Tribal Colleges or Universities 
        receiving grants under section 316 of the Higher Education Act 
        of 1965 (20 U.S.C. 1059c) that offer a 2-year program for 
        completion of such degree and State public institutions of 
        higher education that offer such a 2-year program.
            (3) Direct care professional.--The term ``direct care 
        professional''--
                    (A) means an individual who, in exchange for 
                compensation, provides services to a person with a 
                disability or an older individual that promotes the 
                independence of such person or individual, including--
                            (i) services that enhance the independence 
                        and community inclusion for such person or 
                        individual, including traveling with such 
                        person or individual or attending and assisting 
                        such person or individual while visiting 
                        friends and family, shopping, or socializing;
                            (ii) services such as coaching and 
                        supporting such person or individual in 
                        communicating needs, achieving self-expression, 
                        pursuing personal goals, living independently, 
                        and participating actively in employment or 
                        voluntary roles in the community;
                            (iii) services such as providing assistance 
                        with activities of daily living (such as 
                        feeding, bathing, toileting, and ambulation) 
                        and with tasks such as meal preparation, 
                        shopping, light housekeeping, and laundry;
                            (iv) services that support such person or 
                        individual at home, work, school, or in any 
                        other community setting; or
                            (v) services that promote health and 
                        wellness, including scheduling and taking such 
                        person or individual to health care 
                        appointments, communicating with health and 
                        allied health professionals administering 
                        medications, implementing health and behavioral 
                        health interventions and treatment plans, 
                        monitoring and recording health status and 
                        progress; and
                    (B) may include--
                            (i) a direct support professional 
                        supporting people with intellectual and 
                        developmental disabilities;
                            (ii) a home and community-based services 
                        manager or direct support professional manager;
                            (iii) a self-directed care worker;
                            (iv) a personal care service worker;
                            (v) a direct care worker, as defined in 
                        section 799B of the Public Health Service Act 
                        (42 U.S.C. 295p); or
                            (vi) any other position or job related to 
                        the home care or direct care workforce, such as 
                        positions or jobs in respite care or palliative 
                        care, as determined by the Secretary, in 
                        consultation with the Center for Medicare & 
                        Medicaid Services and the Secretary of Labor.
            (4) Direct care workforce.--The term ``direct care 
        workforce'' means the broad workforce of direct care 
        professionals.
            (5) Family caregiver.--The term ``family caregiver'' has 
        the meaning given such term in section 2 of the RAISE Family 
        Caregivers Act (42 U.S.C. 3030s note; Public Law 115-119) and 
        includes paid and unpaid family caregivers.
            (6) Eligible entity.--The term ``eligible entity'' means an 
        entity--
                    (A) that is--
                            (i) a State;
                            (ii) a labor organization, joint labor-
                        management organization, or employer of direct 
                        care professionals;
                            (iii) a nonprofit entity with experience in 
                        aging, disability, or supporting the rights and 
                        interests of, training of, or educating direct 
                        care professionals or family caregivers;
                            (iv) an Indian Tribe, Tribal organization, 
                        or Urban Indian organization;
                            (v) a community college or other 
                        institution of higher education; or
                            (vi) a consortium of entities listed in any 
                        of clauses (i) through (v);
                    (B) that agrees to include, as applicable with 
                respect to the type of grant the entity is seeking 
                under this Act and the activities supported through 
                such grant, older individuals, people with 
                disabilities, direct care professionals, and family 
                caregivers, as advisors and trainers in such 
                activities; and
                    (C) that agrees to consult with the State Medicaid 
                agency of the State (or each State) served by the grant 
                on the grant activities, to the extent that such agency 
                (or each such agency) is not the eligible entity.
            (7) Employer.--The terms ``employ'' and ``employer'' have 
        the meanings given the terms in section 3 of the Fair Labor 
        Standards Act of 1938 (29 U.S.C. 203 et seq.).
            (8) Indian tribe; tribal organization.--The terms ``Indian 
        Tribe'' and ``Tribal organization'' have the meanings given 
        such terms in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 5304).
            (9) Institution of higher education.--The term 
        ``institution of higher education'' means--
                    (A) an institution of higher education defined in 
                section 101 of the Higher Education Act of 1965 (20 
                U.S.C. 1001); or
                    (B) an institution of higher education defined in 
                section 102(a)(1)(B) of such Act (20 U.S.C. 
                1002(a)(1)(B)).
            (10) Older individual.--The term ``older individual'' means 
        an individual who is 60 years of age or older.
            (11) Person with a disability.--The term ``person with 
        disability'' means an individual with a disability, as defined 
        in section 3 of the Americans with Disabilities Act of 1990 (42 
        U.S.C. 12102).
            (12) Project participant.--The term ``project participant'' 
        means an individual participating in a project or activity 
        assisted with a grant under this Act, including (as applicable 
        for the category of the grant) a direct care professional, or 
        an individual training to be such a professional, or a family 
        caregiver.
            (13) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services, acting through the Administrator 
        for Community Living.
            (14) Self-directed care professional.--The term ``self-
        directed care professional'' means a direct care professional 
        who is employed by an individual who is an older individual, a 
        person with a disability, or a representative of such older 
        individual or person with a disability, and such older 
        individual or person with a disability has the decision-making 
        authority over certain supports and services provided by the 
        direct care professional and takes direct responsibility to 
        manage those supports and services.
            (15) Supportive services.--The term ``supportive services'' 
        means services that are necessary to enable an individual to 
        participate in activities assisted with a grant under this Act, 
        such as transportation, child care, dependent care, housing, 
        workplace accommodations, employee benefits such as paid sick 
        leave and child care, workplace health and safety protections, 
        wages and overtime pay, and needs-related payments.
            (16) Urban indian organization.--The term ``urban Indian 
        organization'' has the meaning given the term in section 4 of 
        the Indian Health Care Improvement Act (25 U.S.C. 1603).
            (17) Workforce innovation and opportunity act terms.--The 
        terms ``career pathway'', ``career planning'', ``in-demand 
        industry sector or occupation'', ``individual with a barrier to 
        employment'', ``local board'', ``on-the-job training'', 
        ``recognized postsecondary credential'', ``region'', and 
        ``State board'' have the meanings given such terms in section 3 
        of the Workforce Innovation and Opportunity Act (29 U.S.C. 
        3102).
            (18) Work-based learning.--The term ``work-based learning'' 
        has the meaning given the term in section 3 of the Carl D. 
        Perkins Career and Technical Education Act of 2006 (20 U.S.C. 
        2302).

SEC. 3. AUTHORITY TO ESTABLISH A TECHNICAL ASSISTANCE CENTER FOR 
              BUILDING THE DIRECT CARE WORKFORCE.

    (a) Program Authorized.--The Secretary shall establish a national 
technical assistance center (referred to in this section as the 
``Center'') for, in consultation with the Secretary of Labor, the 
Secretary of Education, the Administrator of the Centers for Medicare & 
Medicaid Services, and the heads of other entities as necessary--
            (1) supporting direct care workforce creation, training and 
        education, recruitment, retention, and advancement; and
            (2) supporting family caregivers and activities of family 
        caregivers as a critical part of the support team for older 
        individuals or people with disabilities.
    (b) Advisory Council.--The Secretary shall convene an advisory 
council to provide recommendations to the Center with respect to the 
duties of the Center under this section and may engage individuals and 
entities described in paragraphs (3)(B), and (12), of section 5(b) 
(without regard to a specific project described in such paragraphs) for 
service on the advisory council.
    (c) Activities.--The Center may--
            (1) develop recommendations for training and education 
        curricula for direct care professionals, which such 
        recommendations may include recommendations for curricula for 
        higher education, postsecondary credentials, and programs with 
        community colleges;
            (2) develop learning and dissemination strategies to--
                    (A) engage States and other entities in activities 
                supported under this Act and best practices; and
                    (B) distribute findings from activities supported 
                by grants under this Act;
            (3) develop recommendations for training and education 
        curricula and other strategies for supporting family 
        caregivers;
            (4) explore the national data gaps, workforce shortage 
        areas, and data collection strategies for direct care 
        professionals and make recommendations to the Director of the 
        Office of Management and Budget for an occupation category in 
        the Standard Occupational Classification system for direct 
        support professionals as a healthcare support occupation;
            (5) recommend career development and advancement 
        opportunities for direct care professionals, which may include 
        occupational frameworks, national standards, recruitment 
        campaigns, pre-apprenticeship and on-the-job training 
        opportunities, apprenticeship programs, career ladders or 
        pathways, specializations or certifications, or other 
        activities; and
            (6) develop strategies for assisting with reporting and 
        evaluation of grant activities under section 7.

SEC. 4. AUTHORITY TO AWARD GRANTS.

    (a) Grants.--
            (1) In general.--Not later than 12 months after the date of 
        enactment of this Act, the Secretary, in consultation with the 
        Center for Medicare & Medicaid Services, the Secretary of 
        Labor, and the Secretary of Education, shall award grants 
        described in paragraph (2) to eligible entities. A grant 
        awarded under this section may be in more than 1 category 
        described in such paragraph.
            (2) Categories of grants.--The categories of grants 
        described in this paragraph are each of the following:
                    (A) Direct care professional grants.--Grants to 
                eligible entities to create and carry out projects for 
                the purposes of recruiting, retaining, or providing 
                advancement opportunities for direct care professionals 
                who are not described in subparagraph (B) or (C), 
                including through education or training programs for 
                such professionals or individuals seeking to become 
                such professionals.
                    (B) Direct care professional managers grants.--
                Grants to eligible entities to create and carry out 
                projects for the purposes of recruiting, retaining, or 
                providing advancement opportunities for direct care 
                professionals who are managers or supervisory staff 
                that have coaching, training, managerial, supervisory, 
                or other oversight responsibilities, including through 
                education or training programs for such professionals 
                or individuals seeking to become such professionals.
                    (C) Self-directed care professionals grants.--
                Grants to eligible entities to create and carry out 
                projects for the purposes of recruiting, retaining, or 
                providing advancement opportunities for self-directed 
                care professionals, including through education or 
                training programs for such professionals or individuals 
                seeking to become such professionals.
                    (D) Family caregiver grants.--Grants to eligible 
                entities to create and carry out projects for providing 
                support to paid or unpaid family caregivers through 
                educational, training, or other resources, including 
                resources for caregiver self-care or educational or 
                training resources for individuals newly in a 
                caregiving role or seeking additional support in the 
                role of a family caregiver.
            (3) Projects for advancement opportunities.--Not less than 
        30 percent of projects assisted with grants under this Act 
        shall be projects to provide career pathways that offer 
        opportunities for professional development and advancement 
        opportunities to direct care professionals.
    (b) Treatment of Continuation Activities.--An eligible entity that 
carries out activities described in subsection (a)(2) prior to receipt 
of a grant under this Act may use such grant to continue carrying out 
such activities, and, in using such grant to continue such activities, 
shall be treated as an eligible entity carrying out a project through a 
grant under this Act.

SEC. 5. PROJECT PLANS.

    (a) In General.--An eligible entity seeking a grant under this Act 
shall submit to the Secretary a project plan for each project to be 
developed and carried out (including for activities to be continued as 
described in section 4(b)) with the grant at such time, in such manner, 
and containing such information as the Secretary may require.
    (b) Contents.--A project plan submitted by an eligible entity under 
subsection (a) shall include a description of information determined 
relevant by the Secretary for purposes of the category of the grant and 
the activities to be carried out through the grant. Such information 
may include (as applicable) the following:
            (1) Demographic information regarding the population in the 
        State or relevant geographic area, including a description of 
        the populations likely to need long-term care services, such as 
        people with disabilities and older individuals.
            (2) Projections of unmet need for services provided by 
        direct care professionals based on enrollment waiting lists 
        under home and community-based waivers under section 1115 of 
        the Social Security Act (42 U.S.C. 1315) or section 1915(c) of 
        such Act (42 U.S.C. 1396n(c)) and other relevant data to the 
        extent practicable and feasible, such as direct care workforce 
        vacancy rates, crude separation rates, and the number of direct 
        care professionals, including such professionals who are 
        managers or supervisors, in the region.
            (3) An advisory committee to advise the eligible entity on 
        activities to be carried out through the grant. Such advisory 
        committee--
                    (A) may be comprised of entities listed in 
                paragraph (12); and
                    (B) shall include--
                            (i) older individuals or persons with a 
                        disability;
                            (ii) organizations representing the rights 
                        and interests of people receiving services by 
                        the direct care professionals or family 
                        caregivers targeted by the project;
                            (iii) individuals who are direct care 
                        professionals or family caregivers targeted by 
                        the project and organizations representing the 
                        rights and interests of direct care 
                        professionals or family caregivers;
                            (iv) as applicable, employers of 
                        individuals described in clause (iii) and labor 
                        organizations representing such individuals;
                            (v) representatives of the State Medicaid 
                        agency, the State agency defined in section 102 
                        of the Older Americans Act of 1965 (42 U.S.C. 
                        3002), the State developmental disabilities 
                        office, and the State mental health agency, in 
                        the State (or each State) to be served by the 
                        project; and
                            (vi) representatives reflecting diverse 
                        racial, cultural, ethnic, geographic, 
                        socioeconomic, and gender identity and sexual 
                        orientation perspectives.
            (4) Current or projected job openings for, or relevant 
        labor market information related to, the direct care 
        professionals targeted by the project in the State or region to 
        be served by the project, and the geographic scope of the 
        workforce to be served by the project.
            (5) Specific efforts and strategies that the project will 
        undertake to reduce barriers to recruitment, retention, or 
        advancement of the direct care professionals targeted by the 
        project, including an assurance that such efforts will 
        include--
                    (A) an assessment of the wages or other 
                compensation or benefits necessary to recruit and 
                retain the direct care professionals targeted by the 
                project;
                    (B) a description of the project's projected 
                compensation or benefits for the direct care 
                professionals targeted by the project at the State or 
                local level, including a comparison of such projected 
                compensation or benefits to regional and national 
                compensation or benefits and a description of how wages 
                and benefits received by project participants will be 
                impacted by the participation in and completion of the 
                project; and
                    (C) a description of the projected impact of 
                workplace safety issues on the recruitment and 
                retention of direct care professionals targeted by the 
                project, including the availability of personal 
                protective equipment.
            (6) In the case of a project offering an education or 
        training program for direct care professionals, a description 
        of such program (including how the core competencies identified 
        by the Centers for Medicare & Medicaid Services will be 
        incorporated, curricula, models, and standards used under the 
        program, and any associated recognized postsecondary 
        credentials for which the program provides preparation, as 
        applicable), which shall include an assurance that such program 
        will provide to each project participant in such program--
                    (A) relevant training regarding the rights of 
                recipients of home and community based services, 
                including their rights to--
                            (i) receive services in integrated settings 
                        that provide access to the broader community;
                            (ii) exercise self-determination;
                            (iii) be free from all forms of abuse, 
                        neglect, or exploitation; and
                            (iv) person-centered planning and 
                        practices, including participation in planning 
                        activities;
                    (B) relevant training to ensure that each project 
                participant has the necessary skills to recognize abuse 
                and understand their obligations with regard to 
                reporting and responding to abuse appropriately in 
                accordance with relevant Federal and State law;
                    (C) relevant training regarding the provision of 
                culturally competent and disability competent supports 
                to recipients of services provided by the direct care 
                professionals targeted by the project;
                    (D) an apprenticeship program, work-based learning, 
                or on-the-job training opportunities;
                    (E) supervision or mentoring; and
                    (F) for any on-the-job training portion of the 
                program, a progressively increasing, clearly defined 
                schedule of wages to be paid to each such participant 
                that--
                            (i) is consistent with skill gains or 
                        attainment of a recognized postsecondary 
                        credential received as a result of 
                        participation in or completion of such program; 
                        and
                            (ii) ensures the entry wage is not less 
                        than the greater of--
                                    (I) the minimum wage required under 
                                section 6(a) of the Fair Labor 
                                Standards Act of 1938 (29 U.S.C. 
                                206(a)); or
                                    (II) the applicable wage required 
                                by other applicable Federal or State 
                                law, or a collective bargaining 
                                agreement.
            (7) Any other innovative models or processes the eligible 
        entity will implement to support the retention and career 
        advancement of the direct care professionals targeted by the 
        project.
            (8) The supportive services and benefits to be provided to 
        the project participants in order to support the employment, 
        retention, or career advancement of the direct care 
        professionals targeted by the project.
            (9) How the eligible entity will make use of career 
        planning to support the identification of advancement 
        opportunities and career pathways for the direct care 
        professionals in the State or region to be served by the 
        project.
            (10) How the eligible entity will collect and submit to the 
        Secretary workforce data and outcomes of the project.
            (11) How the project--
                    (A) will--
                            (i) provide adequate and safe equipment and 
                        facilities for training and supervision, 
                        including a safe work environment free from 
                        discrimination, which may include the provision 
                        of personal protective equipment and other 
                        necessary equipment to prevent the spread of 
                        infectious disease among the direct care 
                        professionals targeted by the project and 
                        recipients of services provided by such 
                        professionals;
                            (ii) incorporate remote training and 
                        education opportunities or technology-supported 
                        opportunities;
                            (iii) for training and education curricula, 
                        incorporate evidenced-supported practices for 
                        adult learners and universal design for 
                        learning and ensure recipients of services 
                        provided by the direct care professionals or 
                        family caregivers targeted by the project 
                        participate in the development and 
                        implementation of such training and education 
                        curricula;
                            (iv) use outreach, recruitment, and 
                        retention strategies designed to reach and 
                        retain a diverse workforce;
                            (v) incorporate methods to monitor 
                        satisfaction with project activities for 
                        project participants and individuals receiving 
                        services from such participants;
                            (vi) incorporate evidence-supported 
                        practices for family caregiver engagement; and
                            (vii) incorporate core competencies 
                        identified by the Centers for Medicare & 
                        Medicaid Services; and
                    (B) may incorporate continuing education programs 
                and specialty training, with a specific focus on--
                            (i) trauma-informed care;
                            (ii) behavioral health, including co-
                        occurring behavioral health conditions and 
                        intellectual or developmental disabilities;
                            (iii) Alzheimer's and dementia care;
                            (iv) chronic disease management; and
                            (v) the use of supportive or assistive 
                        technology.
            (12) How the eligible entity will consult on the 
        implementation of the project, or coordinate the project with, 
        each of the following entities, to the extent that each such 
        entity is not the eligible entity:
                    (A) The State Medicaid agency, State agency defined 
                in section 102 of the Older Americans Act of 1965 (42 
                U.S.C. 3002), and the State developmental disabilities 
                office for the State (or each State) to be served by 
                the project.
                    (B) The local board and State board for each 
                region, or State, to be served by the project.
                    (C) In the case of a project that carries out an 
                education or training program, a nonprofit organization 
                with demonstrated experience in the development or 
                delivery of curricula or coursework.
                    (D) A nonprofit organization, including a labor 
                organization, that fosters the professional development 
                and collective engagement of the direct care 
                professionals targeted by the project.
                    (E) Area agencies on aging, as defined in section 
                102 of the Older Americans Act of 1965 (42 U.S.C. 
                3002).
                    (F) Centers for independent living, as described in 
                part C of title VII of the Rehabilitation Act of 1973 
                (29 U.S.C. 796f et seq.).
                    (G) The State Council on Developmental Disabilities 
                (as such term is used in subtitle B of title I of the 
                Developmental Disabilities Assistance and Bill of 
                Rights Act of 2000 (42 U.S.C. 15021 et seq.)) for the 
                State (or each State) to be served by the project.
                    (H) Aging and Disability Resource Centers (as 
                defined in section 102 of the Older Americans Act of 
                1965 (42 U.S.C. 3002)).
                    (I) A nonprofit State provider association that 
                represents providers who employ the direct care 
                professionals targeted by the project, where such 
                associations exist.
                    (J) An entity that employs the direct care 
                professionals targeted by the project.
                    (K) University Centers for Excellence in 
                Developmental Disabilities Education, Research, and 
                Service supported under subtitle D of title I of the 
                Developmental Disabilities Assistance and Bill of 
                Rights Act of 2000 (42 U.S.C. 15061 et seq.).
                    (L) The State protection and advocacy system 
                described in section 143 of such Act (42 U.S.C. 15043) 
                of the State (or each State) to be served by the 
                project.
                    (M) Direct care professionals or direct care 
                workforce organizations representing underserved 
                communities, including communities of color.
            (13) How the eligible entity will consult throughout the 
        project with--
                    (A) individuals employed or working as the direct 
                care professionals or family caregivers targeted by the 
                project;
                    (B) representatives of such professionals or 
                caregivers;
                    (C) individuals assisted by such professionals or 
                caregivers;
                    (D) the families of such professionals or 
                caregivers; and
                    (E) individuals receiving education or training to 
                become such professionals or caregivers.
            (14) Outreach efforts to individuals for participation in 
        such project, including targeted outreach efforts to--
                    (A) individuals who are recipients of assistance 
                under a State program funded under part A of title IV 
                of the Social Security Act (42 U.S.C. 601 et seq.) or 
                individuals who are eligible for such assistance; and
                    (B) individuals with barriers to employment.
    (c) Considerations.--In selecting eligible entities to receive a 
grant under this Act, the Secretary shall ensure--
            (1) equitable geographic and demographic diversity, 
        including by selecting recipients serving rural areas and 
        selecting recipients serving urban areas; and
            (2) that selected eligible entities will serve areas where 
        the occupation of direct care professional, or a related 
        occupation, is an in-demand industry sector or occupation.

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

    (a) Uses of Funds.--
            (1) In general.--Each eligible entity receiving a grant 
        under this Act shall use the funds of such grant to carry out 
        at least 1 project described in section 4(a)(2).
            (2) Administrative costs.--Each eligible entity receiving a 
        grant under this Act shall not use more than 5 percent of the 
        funds of such grant for costs associated with the 
        administration of activities under this Act.
            (3) Direct support.--Each eligible entity receiving a grant 
        under this Act (except for a grant described in section 
        4(a)(2)(D)) shall use not less than 5 percent of the funds of 
        such grant to provide direct financial benefits or supportive 
        services to direct care professionals to support the financial 
        needs of such participants during the duration of the project 
        activities.
    (b) Supplement, Not Supplant.--An eligible entity receiving a grant 
under this Act shall use such grant only to supplement, and not 
supplant, the amount of funds that, in the absence of such grant, would 
be available to address the recruitment, training and education, 
retention, and advancement of direct care professionals or provide 
support for family caregivers, in the State or region served by the 
eligible entity.
    (c) Prohibition.--No amounts made available under this Act may be 
used for any activity that is subject to the reporting requirements set 
forth in section 203(a) of the Labor-Management Reporting and 
Disclosure Act of 1959 (29 U.S.C. 433(a)).

SEC. 7. EVALUATIONS AND REPORTS; TECHNICAL ASSISTANCE.

    (a) Reporting Requirements by Grant Recipients.--
            (1) In general.--An eligible entity receiving a grant under 
        this Act shall cooperate with the Secretary and annually 
        provide a report to the Secretary that includes any relevant 
        data requested by the Secretary in a manner specified by the 
        Secretary.
            (2) Contents.--The data requested by the Secretary for an 
        annual report may include any of the following (as determined 
        relevant by the Secretary with respect to the category of the 
        grant and each project supported through the grant):
                    (A) The number of individuals and the demographics 
                of these individuals served by each project supported 
                by the grant, including--
                            (i) the number of individuals recruited 
                        through each such project to be employed as a 
                        direct care professional;
                            (ii) the number of individuals who through 
                        each such project attained employment as a 
                        direct care professional; and
                            (iii) the number of individuals who 
                        enrolled in each such project and withdrew or 
                        were terminated from each such project without 
                        completing training or attaining employment as 
                        a direct care professional.
                    (B) The number of family caregivers participating 
                in an education or training program through each 
                project supported by the grant.
                    (C) The number of project participants who through 
                each such project participated in and completed--
                            (i) work-based learning;
                            (ii) on-the-job training;
                            (iii) an apprenticeship program; or
                            (iv) a professional development or 
                        mentoring program.
                    (D)(i) Other services, benefits, or supports (other 
                than the services, benefits, or supports described in 
                subparagraph (C)) provided through each such project to 
                assist in the recruitment, retention, or advancement of 
                direct care professionals (including through education 
                or training for such professionals or individuals 
                seeking to become such professionals);
                    (ii) the number of individuals who accessed such 
                services, benefits, or supports; and
                    (iii) the impact of such services, benefits, or 
                supports.
                    (E) The crude separation and vacancy rates of 
                direct care professionals, and such rates for those 
                professionals who are managers or supervisors, in the 
                geographic region for a number of years before the 
                grant was awarded, as determined by the Secretary, and 
                annually thereafter for the duration of the grant 
                period.
                    (F) How each project supported by the grant 
                assessed satisfaction with respect to--
                            (i) project participants assisted by the 
                        project;
                            (ii) individuals receiving services 
                        delivered by project participants, including--
                                    (I) any impact on the health or 
                                health outcomes of such individuals; 
                                and
                                    (II) any impact on the ability of 
                                individuals to transition to or remain 
                                in the community in an environment that 
                                meets the criteria established in the 
                                section 441.301(c)(4) of title 42, Code 
                                of Federal Regulations (or successor 
                                regulations); and
                            (iii) employers of such project 
                        participants.
                    (G) The performance of the eligible entity with 
                respect to the indicators of performance on 
                unsubsidized employment, median earnings, credential 
                attainment, measurable skill gains, and employer 
                satisfaction.
                    (H) Any other information with respect to outcomes 
                of the project as determined by the Secretary.
    (b) Annual Report to Congress by Secretary.--Not later than 2 years 
after the date of enactment of this Act, and each year thereafter until 
all projects supported through a grant under this Act are completed, 
the Secretary shall prepare and submit to Congress an annual report on 
the progress of each project supported through a grant under this Act 
and the activities of the technical assistance center established under 
section 3.
    (c) GAO Report.--Not later than 1 year after the date on which all 
projects supported through a grant under this Act are completed, the 
Comptroller General of the United States shall conduct a study and 
submit to Congress a report including--
            (1) an assessment of how the technical assistance center 
        established under section 3 and the projects supported through 
        a grant under this Act assisted in the creation, recruitment, 
        training and education, retention, and advancement of the 
        direct care workforce or in providing support for family 
        caregivers; and
            (2) recommendations for such legislative or administrative 
        actions needed for improving the assistance described in 
        paragraph (1), as the Comptroller General determines 
        appropriate.
    (d) Independent Evaluations.--Not later than 6 months after the 
date of enactment of this Act, the Secretary shall enter into a 
contract with an independent entity to provide independent evaluations 
of activities supported by grants under this Act and activities of the 
technical assistance center established under section 3.

SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There are authorized to be appropriated--
            (1) for the establishment and activities of the technical 
        assistance center under section 3, $2,000,000 for each of 
        fiscal years 2024 through 2028; and
            (2) for grants under section 4, $1,000,000,000 for fiscal 
        year 2024.
    (b) Availability.--Amounts made available under this Act shall 
remain available until September 30, 2033.
                                 &lt;all&gt;
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