1415 
‘‘(e) APPROPRIATION.—Out of any money in the 
Treasury not otherwise appropriated, there is appro-
priated to the Secretary for each of fiscal years 2023 
through 2026 such sums as may be necessary for reim-
bursements or estimated payments referred to in sub-
section (a). 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) APPLICABLE MINIMUM RATE.—The term 
‘applicable minimum rate’ means the rate at which 
basic pay is payable for a position at level 3, step 
1, of the General Schedule under subchapter III of 
chapter 53 of title 5, United States Code, including 
any applicable locality-based comparability payment 
under section 5304 of such title or similar authority, 
at the time such wages are paid and determined 
with respect to the locality in which services are pro-
vided. 
‘‘(2) CHILD
CARE
WAGES.—The term ‘child 
care wages’ means— 
‘‘(A) wages paid to an employee for serv-
ices in providing child care; and 
‘‘(B) an owner’s draw in lieu of wages, in 
the case of a sole proprietor who provides child 
care services or an owner who directly provides 
child care services alongside employees. 
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‘‘(3) CHILD CARE EMPLOYEE.—The term ‘child 
care employee’ means an employee— 
‘‘(A) who is employed by a qualified child 
care provider; 
‘‘(B) who provides child care services as a 
primary function of employment; and 
‘‘(C) whose wages do not qualify under 
section 3135(a) of the Internal Revenue Code 
of 1986. 
‘‘(4) ELIGIBLE
CHILD
CARE
WAGE
SUPPLE-
MENT.— 
‘‘(A) IN
GENERAL.—The term ‘eligible 
child care wage supplement’ means, with re-
spect to a year, a supplement to child care 
wages of an employee (or owner), but only to 
the extent that the total amount of the child 
care wage supplements provided to the em-
ployee (or owner) during the year— 
‘‘(i) in the case of a full-time em-
ployee (or an owner who works on a full- 
time basis), is not more than $16,000; or 
‘‘(ii) in the case of a part-time em-
ployee (or an owner who works on a part- 
time basis), is not more than $10,000. 
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In the case of any employee who is not em-
ployed as a child care employee for the full 
year, the maximum dollar amounts set forth in 
the preceding sentence shall be proportionately 
reduced. 
‘‘(B) INFLATION ADJUSTMENT.—Each dol-
lar amount in effect under subparagraph (A) 
with respect to a year shall be increased by a 
percentage equal to the percentage (if any) by 
which the Consumer Price Index for all urban 
consumers (U.S. city average) increased during 
the 12-month period ending with the last month 
for which Consumer Price Index data is avail-
able. 
‘‘(5) FIELD
ENGAGEMENT
ORGANIZATION.— 
The term ‘field engagement organization’ means any 
nonprofit, 
community-based 
organization, 
labor 
union, trade association, staffed family child care 
network, child care resource and referral organiza-
tion, or local government entity with experience pro-
viding representation, technical assistance, or com-
munity supports to child care providers or individ-
uals seeking to enter or re-enter the child care mar-
ket. 
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‘‘(6) QUALIFIED CHILD CARE PROVIDER.—The 
term ‘qualified child care provider’ means an entity 
who— 
‘‘(A) provides child care services as the pri-
mary function of the entity; 
‘‘(B) is registered with, or regulated or li-
censed by, the State as a child care provider; 
‘‘(C) at the time of application for a child 
care wage grant under this section, does not 
have an unresolved violation of a State law or 
regulation pertaining to health or safety in the 
provision of child care services; 
‘‘(D) has at least 1 employee whose wages 
may not be taken into account under section 
3135(a) of the Internal Revenue Code of 1986 
because the employee is a sole proprietor or re-
ports self-employment income; 
‘‘(E) as of the time of the application, pays 
child care wages at a rate that is at least the 
applicable minimum rate, and certifies that the 
entity will not reduce the hourly wage rate of 
any employee during the 1-year period for 
which the entity has applied for a child care 
wage grant under this section; and 
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‘‘(F) has submitted to the lead agency all 
data requested by the Secretary under this sec-
tion; 
‘‘(G) has submitted the application to the 
lead agency, which has approved the applica-
tion; and 
‘‘(H) has not failed to include all informa-
tion required to be included in any quarterly re-
port required by subsection (b)(2) to be sub-
mitted by the entity with respect to the year 
preceding the year for which the application is 
submitted.’’. 
SEC. 132006. COMMON PROVISIONS. 
(a) DEFINITIONS.—Section 419 of the Social Secu-
rity Act (42 U.S.C. 619) is amended by adding at the end 
the following: 
‘‘(6) LEAD AGENCY.—The term ‘lead agency’ 
means, with respect to a jurisdiction, the lead agen-
cy responsible for administering the child care as-
sistance program of the jurisdiction. 
‘‘(7) TERRITORY.—The term ‘territory’ means 
the Commonwealth of Puerto Rico, the United 
States Virgin Islands, Guam, American Samoa, and 
the Commonwealth of the Northern Mariana Is-
lands.’’. 
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(b) REPORTS TO THE CONGRESS.—Section 411 of 
such Act (42 U.S.C. 611) is amended by adding at the 
end the following: 
‘‘(e) REPORTS ON CERTAIN STATE CHILD CARE EX-
PENDITURES.—The Secretary shall submit to the Com-
mittee on Ways and Means of the House of Representa-
tives and the Committee on Finance of the Senate biennial 
reports on— 
‘‘(1) eligible expenditures (as defined in section 
418A(b)(2)(B)) by the States, and on expenditures 
by the Secretary under section 418A during the pe-
riod covered by the report; 
‘‘(2) the extent to which payments under sec-
tion 418A have been made with respect to the ex-
penditures; 
‘‘(3) to the extent that any funds made avail-
able to carry out such section have not been ex-
pended, the reasons therefor; and 
‘‘(4) expenditures under section 418C.’’. 
(c) INAPPLICABILITY OF PAYMENT LIMITATION.— 
Section 1108(a) of such Act (42 U.S.C. 1308(a)) is 
amended by inserting ‘‘418A, 418B, 418C, 418D, 418E,’’ 
before ‘‘or’’. 
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Subtitle D—Trade Adjustment 
Assistance 
SEC. 133001. SHORT TITLE. 
This subtitle may be cited as the ‘‘Trade Adjustment 
Assistance Modernization Act of 2021’’. 
SEC. 133002. APPLICATION OF PROVISIONS RELATING TO 
TRADE ADJUSTMENT ASSISTANCE. 
(a) EFFECTIVE DATE; APPLICABILITY.—Except as 
otherwise provided in this subtitle, the provisions of chap-
ters 2 through 6 of title II of the Trade Act of 1974, as 
in effect on June 30, 2021, and as amended by this sub-
title, shall— 
(1) take effect on the date of the enactment of 
this Act; and 
(2) apply with respect to petitions for certifi-
cation filed under chapter 2, 3, 4, or 6 of title II of 
the Trade Act of 1974 on or after such date of en-
actment. 
(b) REFERENCE.—Except as otherwise provided in 
this subtitle, whenever in this subtitle an amendment or 
repeal is expressed in terms of an amendment to, or repeal 
of, a provision of chapters 2 through 6 of title II of the 
Trade Act of 1974, the reference shall be considered to 
be made to a provision of any such chapter, as in effect 
on June 30, 2021. 
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(c) REPEAL
OF SNAPBACK.—Section 406 of the 
Trade Adjustment Assistance Reauthorization Act of 
2015 (Public Law 114–27; 129 Stat. 379) is repealed. 
PART 1—TRADE ADJUSTMENT ASSISTANCE FOR 
WORKERS 
SEC. 133101. FILING PETITIONS. 
Section 221(a)(1) of the Trade Act of 1974 (19 
U.S.C. 2271(a)(1)) is amended— 
(1) by amending subparagraph (A) to read as 
follows: 
‘‘(A) One or more workers in the group of 
workers.’’; and 
(2) in subparagraph (C), by striking ‘‘or a 
State dislocated worker unit’’ and inserting ‘‘a State 
dislocated worker unit, or workforce intermediaries, 
including labor-management organizations that carry 
out re-employment and training services’’. 
SEC. 133102. GROUP ELIGIBILITY REQUIREMENTS. 
(a) IN GENERAL.—Section 222(a)(2) of the Trade 
Act of 1974 (19 U.S.C. 2272(a)(2)) is amended— 
(1) in subparagraph (A)— 
(A) in clause (i), by inserting ‘‘, failed to 
increase, or will decrease absolutely due to a 
scheduled or imminently anticipated, long-term 
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decrease in or reallocation of the production ca-
pacity of the firm’’ after ‘‘absolutely’’; and 
(B) in clause (iii)— 
(i) by striking ‘‘to the decline’’ and in-
serting ‘‘to any decline or absence of in-
crease’’; and 
(ii) by striking ‘‘or’’ at the end; 
(2) in subparagraph (B)(ii), by striking the pe-
riod at the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following: 
‘‘(C)(i) the sales or production, or both, of such 
firm have decreased; 
‘‘(ii)(I) exports of articles produced or services 
supplied by such workers’ firm have decreased; or 
‘‘(II) imports of articles or services necessary 
for the production of articles or services supplied by 
such firm have decreased; and 
‘‘(iii) the decrease in exports or imports de-
scribed in clause (ii) contributed to such workers’ 
separation or threat of separation and to the decline 
in the sales or production of such firm.’’. 
(b) REPEAL.—Section 222 of the Trade Act of 1974 
(19 U.S.C. 2272) is amended— 
(1) in subsections (a) and (b), by striking ‘‘im-
portantly’’ each place it appears; and 
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(2) in subsection (c)— 
(A) by striking paragraph (1); and 
(B) 
by 
redesignating 
paragraphs 
(2) 
through (4) as paragraphs (1) through (3), re-
spectively. 
(c) ELIGIBILITY OF STAFFED WORKERS AND TELE-
WORKERS.—Section 222 of the Trade Act of 1974 (19 
U.S.C. 2272), as amended by subsection (b), is further 
amended by adding at the end the following: 
‘‘(f) TREATMENT OF STAFFED WORKERS AND TELE-
WORKERS.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(a), workers in a firm include staffed workers and 
teleworkers. 
‘‘(2) DEFINITIONS.—In this subsection: 
‘‘(A) 
STAFFED
WORKER.—The 
term 
‘staffed worker’ means a worker who performs 
work under the operational control of a firm 
that is the subject of a petition filed under sec-
tion 221, even if the worker is directly em-
ployed by another firm. 
‘‘(B) 
TELEWORKER.—The 
term 
‘tele-
worker’ means a worker who works remotely 
but who reports to the location listed for a firm 
in a petition filed under section 221.’’. 
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SEC. 133103. APPLICATION OF DETERMINATIONS OF ELIGI-
BILITY TO WORKERS EMPLOYED BY SUCCES-
SORS-IN-INTEREST. 
Section 223 of the Trade Act of 1974 (19 U.S.C. 
2273) is amended by adding at the end the following: 
‘‘(f) TREATMENT OF WORKERS OF SUCCESSORS-IN- 
INTEREST.—If the Secretary certifies a group of workers 
of a firm as eligible to apply for adjustment assistance 
under this chapter, a worker of a successor-in-interest to 
that firm shall be covered by the certification to the same 
extent as a worker of that firm.’’. 
SEC. 133104. PROVISION OF BENEFIT INFORMATION TO 
WORKERS. 
Section 225 of the Trade Act of 1974 (19 U.S.C. 
2275) is amended— 
(1) in subsection (a), by inserting after the sec-
ond sentence the following new sentence: ‘‘The Sec-
retary shall make every effort to provide such infor-
mation and assistance to workers in their native lan-
guage.’’; and 
(2) in subsection (b)— 
(A) by redesignating paragraph (2) as 
paragraph (3); 
(B) by inserting after paragraph (1) the 
following: 
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‘‘(2) The Secretary shall provide a second notice to 
a worker described in paragraph (1) before the worker has 
exhausted all rights to any unemployment insurance to 
which the worker is entitled (other than additional com-
pensation described in section 231(a)(3)(B) funded by a 
State and not reimbursed from Federal funds).’’; 
(C) in paragraph (3), as redesignated by 
paragraph (1), by striking ‘‘newspapers of gen-
eral circulation’’ and inserting ‘‘appropriate 
print or digital outlets’’; and 
(D) by adding at the end the following: 
‘‘(4) For purposes of providing sustained outreach re-
garding the benefits available under this chapter to work-
ers covered by a certification made under this subchapter, 
the Secretary may take any necessary actions, including 
the following: 
‘‘(A) Collecting the email addresses and tele-
phone numbers of such workers from the employers 
of such workers to provide sustained outreach to 
such workers. 
‘‘(B) Partnering with the certified or recognized 
union, a community-based worker organization, or 
other duly authorized representatives of such work-
ers. 
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‘‘(C) Hiring peer support workers to perform 
sustained outreach to other workers covered by that 
certification. 
‘‘(D) Using advertising methods and public in-
formation campaigns, including social media, in ad-
dition to notice published in print or digital outlets 
under paragraph (3).’’. 
SEC. 133105. QUALIFYING REQUIREMENTS FOR WORKERS. 
(a) MODIFICATION OF CONDITIONS.— 
(1) IN GENERAL.—Section 231(a) of the Trade 
Act of 1974 (19 U.S.C. 2291(a)) is amended— 
(A) by striking paragraph (2); 
(B) by redesignating paragraphs (3), (4), 
and (5) as paragraphs (2), (3), and (4), respec-
tively; and 
(C) in paragraph (4) (as redesignated), by 
striking ‘‘paragraphs (1) and (2)’’ each place it 
appears and inserting ‘‘paragraph (1)’’. 
(2) CONFORMING AMENDMENTS.—(A) Section 
232 of the Trade Act of 1974 (19 U.S.C. 2292) is 
amended by striking ‘‘section 231(a)(3)(B)’’ each 
place 
it 
appears 
and 
inserting 
‘‘section 
231(a)(2)(B)’’. 
(B) Section 233(a) of the Trade Act of 1974 
(19 U.S.C. 2293(a)) is amended— 
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(i) in paragraph (1), by striking ‘‘section 
231(a)(3)(A)’’ 
and 
inserting 
‘‘section 
231(a)(2)(A)’’; and 
(ii) in paragraph (2)— 
(I) by striking ‘‘adversely affected em-
ployment’’ and all that follows through 
‘‘(A) within’’ and inserting ‘‘adversely af-
fected employment within’’; 
(II) by striking ‘‘, and’’ and inserting 
a period; and 
(III) by striking subparagraph (B). 
(b) WAIVERS OF TRAINING REQUIREMENTS.—Sec-
tion 231(c)(1) of the Trade Act of 1974 (19 U.S.C. 
2291(c)(1)) is amended— 
(1) by redesignating subparagraphs (A), (B), 
and (C) as subparagraphs (C), (D), and (E), respec-
tively; and 
(2) by inserting before subparagraph (C) (as re-
designated) the following: 
‘‘(A) RECALL.—The worker has been noti-
fied that the worker will be recalled by the firm 
from which the separation occurred. 
‘‘(B) RETIREMENT.—The worker is within 
2 years of meeting all requirements for entitle-
ment to either— 
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‘‘(i) old-age insurance benefits under 
title II of the Social Security Act (42 
U.S.C. 401 et seq.) (except for application 
therefor); or 
‘‘(ii) a private pension sponsored by 
an employer or labor organization.’’. 
SEC. 133106. MODIFICATION TO TRADE READJUSTMENT AL-
LOWANCES. 
Section 233 of the Trade Act of 1974 (19 U.S.C. 
2293) is amended— 
(1) in subsection (a)— 
(A) in paragraph (2), by inserting after 
‘‘104-week period’’ the following: ‘‘(or, in the 
case of an adversely affected worker who re-
quires a program of prerequisite education or 
remedial education (as described in section 
236(a)(5)(D)) in order to complete training ap-
proved for the worker under section 236, the 
130-week period)’’; 
(B) in paragraph (3), by striking ‘‘65 addi-
tional weeks in the 78-week period’’ and insert-
ing ‘‘78 additional weeks in the 91-week pe-
riod’’; and 
(C) in the flush text, by striking ‘‘78-week 
period’’ and inserting ‘‘91-week period’’; 
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(2) by striking subsection (d); and 
(3) by amending subsection (f) to read as fol-
lows: 
‘‘(f) PAYMENT OF TRADE READJUSTMENT ALLOW-
ANCES TO COMPLETE TRAINING.—Notwithstanding any 
other provision of this section, in order to assist an ad-
versely affected worker to complete training approved for 
the worker under section 236 that includes a program of 
prerequisite education or remedial education (as described 
in section 236(a)(5)(D)), and in accordance with regula-
tions prescribed by the Secretary, payments may be made 
as trade readjustment allowances for up to 26 additional 
weeks in the 26-week period that follows the last week of 
entitlement to trade readjustment allowances otherwise 
payable under this chapter.’’. 
SEC. 133107. AUTOMATIC EXTENSION OF TRADE READJUST-
MENT ALLOWANCES. 
(a) IN GENERAL.—Part I of subchapter B of chapter 
2 of title II of the Trade Act of 1974 (19 U.S.C. 2291 
et seq.) is amended by inserting after section 233 the fol-
lowing new section: 
‘‘SEC. 233A. AUTOMATIC EXTENSION OF TRADE READJUST-
MENT ALLOWANCES. 
‘‘(a) IN GENERAL.—Notwithstanding the limitations 
under section 233(a), the Secretary shall extend the period 
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during which trade readjustment allowances are payable 
to an adversely affected worker who completes training ap-
proved under section 236 by the Secretary during a period 
of heightened unemployment with respect to the State in 
which such worker seeks benefits, for the shorter of— 
‘‘(1) the 26-week period beginning on the date 
of completion of such training; or 
‘‘(2) the period ending on the date on which the 
adversely affected worker secures employment. 
‘‘(b) JOB SEARCH REQUIRED.—A worker shall only 
be eligible for an extension under subsection (a) if the 
worker is complying with the job search requirements as-
sociated with unemployment insurance in the applicable 
State. 
‘‘(c) PERIOD OF HEIGHTENED UNEMPLOYMENT DE-
FINED.—In this section, the term ‘period of heightened 
unemployment’ with respect to a State means a 90-day 
period during which, in the determination of the Sec-
retary, either of the following average rates equals or ex-
ceeds 5.5 percent: 
‘‘(1) The average rate of total unemployment in 
such State (seasonally adjusted) for the period con-
sisting of the most recent 3-month period for which 
data for all States are published before the close of 
such period. 
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‘‘(2) The average rate of total unemployment in 
all States (seasonally adjusted) for the period con-
sisting of the most recent 3-month period for which 
data for all States are published before the close of 
such period.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
for the Trade Act of 1974 is amended by inserting after 
the item relating to section 233 the following: 
‘‘Sec. 233A. Automatic extension of trade readjustment allowances.’’. 
SEC. 133108. EMPLOYMENT AND CASE MANAGEMENT SERV-
ICES. 
Section 235 of the Trade Act of 1974 (19 U.S.C. 
2295) is amended— 
(1) in paragraph (3)— 
(A) by inserting after ‘‘regional areas’’ the 
following: ‘‘(including information about reg-
istered apprenticeship programs, on-the-job 
training opportunities, and other work-based 
learning opportunities)’’; and 
(B) by inserting after ‘‘suitable training’’ 
the following: ‘‘, information regarding the 
track record of a training provider’s ability to 
successfully place participants into suitable em-
ployment’’; 
(2) by redesignating paragraph (8) as para-
graph (10); and 
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(3) by inserting after paragraph (7) the fol-
lowing: 
‘‘(8) Information related to direct job place-
ment, including facilitating the extent to which em-
ployers within the community commit to employing 
workers who would benefit from the employment and 
case management services under this section. 
‘‘(9) Sustained outreach to groups of workers 
likely to be certified as eligible for adjustment assist-
ance under this chapter and members of certified 
worker groups who have not yet applied for or been 
enrolled in benefits or services under this chapter, 
especially such groups and members from under-
served communities.’’. 
SEC. 133109. TRAINING. 
Section 236 of the Trade Act of 1974 (19 U.S.C. 
2296(a)) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1)(D), by inserting ‘‘, 
with a demonstrated ability to place partici-
pants into employment’’ before the comma at 
the end; 
(B) in paragraph (3), by adding at the end 
before the period the following: ‘‘, except that 
every effort shall be made to ensure that em-
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ployment opportunities are available upon the 
completion of training’’; and 
(C) in paragraph (5)— 
(i) in subparagraph (G), by striking ‘‘, 
and’’ and inserting a comma; 
(ii) in subparagraph (H)(ii), by strik-
ing the period at the end and inserting ‘‘, 
and’’; and 
(iii) by adding at the end before the 
flush text the following: 
‘‘(I) pre-apprenticeship training.’’; and 
(2) by adding at the end the following: 
‘‘(h) REIMBURSEMENT FOR OUT-OF-POCKET TRAIN-
ING EXPENSES.—If the Secretary approves training for 
a worker under paragraph (1) of subsection (a), the Sec-
retary may reimburse the worker for out-of-pocket ex-
penses relating to training program described in para-
graph (5) of that subsection that were incurred by the 
worker on and after the date of the worker’s total or par-
tial separation and before the date on which the certifi-
cation of eligibility under section 222 that covers the work-
er is issued.’’. 
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SEC. 133110. JOB SEARCH, RELOCATION, AND CHILD CARE 
ALLOWANCES. 
(a) JOB SEARCH ALLOWANCES.—Section 237 of the 
Trade Act of 1974 (19 U.S.C. 2297) is amended— 
(1) in subsection (a)(1), by striking ‘‘may use 
funds made available to the State to carry out sec-
tions 235 through 238’’ and inserting ‘‘shall use, 
from funds made available to the State to carry out 
sections 235 through 238A, such amounts as may be 
necessary’’; 
(2) in subsection (a)(2), in the matter pre-
ceding subparagraph (A), by striking ‘‘may grant’’ 
and inserting ‘‘shall grant’’; and 
(3) in subsection (b)— 
(A) in paragraph (1), by striking ‘‘not 
more than 90 percent’’ and inserting ‘‘100 per-
cent’’; 
(B) in paragraph (2), by striking ‘‘$1,250’’ 
and inserting ‘‘$2,000 (subject to adjustment 
under paragraph (4))’’; and 
(C) by adding at the end the following; 
‘‘(4) ADJUSTMENT
OF
MAXIMUM
ALLOWANCE 
LIMITATION FOR INFLATION.— 
‘‘(A) IN
GENERAL.—The Secretary of 
Labor shall adjust the maximum allowance limi-
tation under paragraph (2) on the date that is 
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30 days after the date of the enactment of this 
paragraph, and at the beginning of each fiscal 
year thereafter, to reflect the percentage (if 
any) of the increase in the average of the Con-
sumer Price Index for the preceding 12-month 
period compared to the Consumer Price Index 
for fiscal year 2020. 
‘‘(B) SPECIAL
RULES
FOR
CALCULATION 
OF
ADJUSTMENT.—In making an adjustment 
under subparagraph (A), the Secretary— 
‘‘(i) shall round the amount of any in-
crease in the Consumer Price Index to the 
nearest dollar; and 
‘‘(ii) may ignore any such increase of 
less than 1 percent. 
‘‘(C) CONSUMER PRICE INDEX DEFINED.— 
For purposes of this paragraph, the term ‘Con-
sumer Price Index’ means the Consumer Price 
Index for All Urban Consumers published by 
the Bureau of Labor Statistics of the Depart-
ment of Labor.’’. 
(b) RELOCATION ALLOWANCES.—Section 238 of the 
Trade Act of 1974 (19 U.S.C. 2298) is amended— 
(1) in subsection (a)(1), by striking ‘‘may use 
funds made available to the State to carry out sec-
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tions 235 through 238’’ and inserting ‘‘shall use, 
from funds made available to the State to carry out 
sections 235 through 238A, such amounts as may be 
necessary’’; 
(2) in subsection (a)(2), in the matter pre-
ceding subparagraph (A), by striking ‘‘may be grant-
ed’’ and inserting ‘‘shall be granted’’; 
(3) in subsection (b)— 
(A) in paragraph (1), by striking ‘‘not 
more than 90 percent’’ and inserting ‘‘100 per-
cent’’; and 
(B) in paragraph (2), by striking ‘‘$1,250’’ 
and inserting ‘‘$2,000 (subject to adjustment 
under subsection (d))’’; and 
(4) by adding at the end the following: 
‘‘(d) ADJUSTMENT OF MAXIMUM PAYMENT LIMITA-
TION FOR INFLATION.— 
‘‘(1) IN
GENERAL.—The Secretary of Labor 
shall adjust the maximum payment limitation under 
subsection (b)(2) on the date that is 30 days after 
the date of the enactment of this subsection, and at 
the beginning of each fiscal year thereafter, to re-
flect the percentage (if any) of the increase in the 
average of the Consumer Price Index for the pre-
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ceding 12-month period compared to the Consumer 
Price Index for fiscal year 2020. 
‘‘(2) SPECIAL RULES FOR CALCULATION OF AD-
JUSTMENT.—In making an adjustment under para-
graph (1), the Secretary— 
‘‘(A) shall round the amount of any in-
crease in the Consumer Price Index to the near-
est dollar; and 
‘‘(B) may ignore any such increase of less 
than 1 percent. 
‘‘(3) CONSUMER PRICE INDEX DEFINED.—For 
purposes of this subsection, the term ‘Consumer 
Price Index’ means the Consumer Price Index for 
All Urban Consumers published by the Bureau of 
Labor Statistics of the Department of Labor.’’. 
(c) CHILD CARE ALLOWANCES.— 
(1) IN GENERAL.—Part II of subchapter B of 
chapter 2 of title II of the Trade Act of 1974 (19 
U.S.C. 2295 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 238A. CHILD CARE ALLOWANCES. 
‘‘(a) CHILD CARE ALLOWANCES AUTHORIZED.— 
‘‘(1) IN GENERAL.—Each State shall use, from 
funds made available to the State to carry out sec-
tions 235 through 238A, such amounts as may be 
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necessary to allow an adversely affected worker cov-
ered by a certification issued under subchapter A of 
this chapter to file an application for a child care al-
lowance with the Secretary, and the Secretary may 
grant the child care allowance, subject to the terms 
and conditions of this section. 
‘‘(2) CONDITIONS
FOR
GRANTING
ALLOW-
ANCE.—A child care allowance shall be granted if 
the allowance will assist an adversely affected worker 
to attend training or seek suitable employment, by 
providing for the care of one or more of the minor 
dependents of the worker. 
‘‘(b) AMOUNT OF ALLOWANCE.—Any child care al-
lowance granted to a worker under subsection (a) shall 
not exceed $2,000 per minor dependent per year. 
‘‘(c) ADJUSTMENT OF MAXIMUM ALLOWANCE LIMI-
TATION FOR INFLATION.— 
‘‘(1) IN
GENERAL.—The Secretary of Labor 
shall adjust the maximum allowance limitation under 
subsection (b) on the date that is 30 days after the 
date of the enactment of this subsection, and at the 
beginning of each fiscal year thereafter, to reflect 
the percentage (if any) of the increase in the average 
of the Consumer Price Index for the preceding 12- 
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month period compared to the Consumer Price 
Index for fiscal year 2020. 
‘‘(2) SPECIAL RULES FOR CALCULATION OF AD-
JUSTMENT.—In making an adjustment under para-
graph (1), the Secretary— 
‘‘(A) shall round the amount of any in-
crease in the Consumer Price Index to the near-
est dollar; and 
‘‘(B) may ignore any such increase of less 
than 1 percent. 
‘‘(3) CONSUMER PRICE INDEX DEFINED.—For 
purposes of this subsection, the term ‘Consumer 
Price Index’ means the Consumer Price Index for 
All Urban Consumers published by the Bureau of 
Labor Statistics of the Department of Labor.’’. 
(2) CONFORMING AMENDMENTS.— 
(A) LIMITATIONS ON ADMINISTRATIVE EX-
PENSES AND EMPLOYMENT AND CASE MANAGE-
MENT SERVICES.—Section 235A of the Trade 
Act of 1974 (19 U.S.C. 2295a) is amended in 
the matter preceding paragraph (1) by striking 
‘‘through 238’’ and inserting ‘‘through 238A’’. 
(B) TRAINING.—Section 236(a)(2) of the 
Trade Act of 1974 (19 U.S.C. 2296(a)(2)) is 
amended— 
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(i) in subparagraph (A), by striking 
‘‘and 238’’ and inserting ‘‘238, and 
238A’’; 
(ii) in subparagraph (B), by striking 
‘‘and 238’’ each place it appears and in-
serting ‘‘238, and 238A’’; 
(iii) in subparagraph (C)(i), by strik-
ing ‘‘and 238’’ and inserting ‘‘238, and 
238A’’; 
(iv) in subparagraph (C)(v), by strik-
ing ‘‘and 238’’ and inserting ‘‘238, and 
238A’’; and 
(v) in subparagraph (E), by striking 
‘‘and 238’’ each place it appears and in-
serting ‘‘238, and 238A’’. 
(3) CLERICAL AMENDMENT.—The table of con-
tents for the Trade Act of 1974 is amended by add-
ing after the item relating to section 238 the fol-
lowing new item: 
‘‘Sec. 238A. Child care allowances.’’. 
SEC. 133111. AGREEMENTS WITH STATES. 
(a) COORDINATION.—Section 239(f) of the Trade Act 
of 1974 (19 U.S.C. 2311(f)) is amended— 
(1) by striking ‘‘(f) Any agreement’’ and insert-
ing the following: 
‘‘(f)(1) Any agreement’’; and 
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(2) by adding at the end the following: 
‘‘(2) In arranging for training programs to be 
carried out under this chapter, each cooperating 
State agency shall, among other factors, take into 
account and measure the progress of the extent to 
which such programs— 
‘‘(A) achieve a satisfactory rate of comple-
tion and placement in jobs that provide a living 
wage and that increase economic security; 
‘‘(B) assist workers in developing the 
skills, networks, and experiences necessary to 
advance along a career path; 
‘‘(C) assist workers from underserved com-
munities to establish a work history, dem-
onstrate success in the workplace, and develop 
the skills that lead to entry into and retention 
in unsubsidized employment; and 
‘‘(D) adequately serve individuals who face 
the greatest barriers to employment, including 
people with low incomes, people of color, immi-
grants, persons with disabilities, and formerly 
incarcerated individuals. 
‘‘(3) Each cooperating State agency shall facili-
tate joint cooperation between training programs, 
representatives of workers, employers, and commu-
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nities, especially in underserved rural and urban re-
gions, to ensure a fair and engaging workplace that 
balances the priorities and well-being of workers 
with the needs of businesses. 
‘‘(4) Each cooperating State agency shall seek, 
including through agreements and training programs 
described in this subsection, to ensure the reemploy-
ment of adversely affected workers upon completion 
of training as described in section 236.’’. 
(b) ADMINISTRATION.—Section 239(g) of the Trade 
Act of 1974 (19 U.S.C. 2311(g)) is amended— 
(1) by redesignating— 
(A) paragraphs (1) through (4) as para-
graphs (3) through (6), respectively; and 
(B) paragraph (5) as paragraph (8); 
(2) by inserting before paragraph (3) (as redes-
ignated) the following: 
‘‘(1) review each layoff of more than 5 workers 
in a firm to determine whether trade played a role 
in the layoff and whether workers in such firm are 
potentially eligible to receive benefits under this 
chapter, 
‘‘(2) perform sustained outreach to firms to fa-
cilitate and assist with filing petitions under section 
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221 and collecting necessary supporting informa-
tion,’’; 
(3) in paragraph (3) (as redesignated), by strik-
ing ‘‘who applies for unemployment insurance of’’ 
and inserting ‘‘identified under paragraph (1) of un-
employment insurance benefits and’’; 
(4) in paragraph (4) (as redesignated), by in-
serting ‘‘and assist with’’ after ‘‘facilitate’’; 
(5) in paragraph (6) (as redesignated), by strik-
ing ‘‘and’’ at the end; 
(6) by inserting after paragraph (6) (as redesig-
nated) the following: 
‘‘(7) perform sustained outreach to workers 
from underserved communities and to firms that em-
ploy a majority or a substantial percentage of work-
ers from underserved communities and develop a 
plan, in consultation with the Secretary, for address-
ing common barriers to receiving services that such 
workers have faced,’’; 
(7) in paragraph (8) (as redesignated), by strik-
ing ‘‘funds provided to carry out this chapter are in-
sufficient to make such services available, make ar-
rangements to make such services available through 
other Federal programs’’ and inserting ‘‘support 
services are needed beyond what this chapter can 
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provide, make arrangements to coordinate such serv-
ices available through other Federal programs’’ ; 
and 
(8) by adding at the end the following: 
‘‘(9) develop a strategy to engage with local 
workforce development institutions, including local 
community colleges and other educational institu-
tions, and 
‘‘(10) develop a comprehensive strategy to pro-
vide agency staffing to support the requirements of 
paragraphs (1) through (9).’’. 
(c) STAFFING.—Section 239 of the Trade Act of 
1974 (19 U.S.C. 2311) is amended by striking subsection 
(k) and inserting the following: 
‘‘(k) STAFFING.—An agreement entered into under 
this section shall provide that the cooperating State or co-
operating State agency shall require that any individual 
engaged in functions (other than functions that are not 
inherently governmental) to carry out the trade adjust-
ment assistance program under this chapter shall be a 
State employee covered by a merit system of personnel ad-
ministration.’’. 
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SEC. 133112. REEMPLOYMENT TRADE ADJUSTMENT ASSIST-
ANCE PROGRAM. 
Section 246(a) of the Trade Act of 1974 (19 U.S.C. 
2318(a)) is amended— 
(1) 
in 
paragraph 
(3)(B)(ii), 
by 
striking 
‘‘$50,000’’ and inserting ‘‘$70,000 (subject to ad-
justment under paragraph (8))’’; 
(2) 
in 
paragraph 
(5)(B)(i), 
by 
striking 
‘‘$10,000’’ and inserting ‘‘$20,000 (subject to ad-
justment under paragraph (8))’’; and 
(3) by adding at the end the following: 
‘‘(8) ADJUSTMENT OF SALARY LIMITATION AND 
TOTAL AMOUNT OF PAYMENTS FOR INFLATION.— 
‘‘(A) IN
GENERAL.—The Secretary of 
Labor shall adjust the salary limitation under 
paragraph (3)(B)(ii) and the amount under 
paragraph (5)(B)(i) on the date that is 30 days 
after the date of the enactment of this para-
graph, and at the beginning of each fiscal year 
thereafter, to reflect the percentage (if any) of 
the increase in the average of the Consumer 
Price Index for the preceding 12-month period 
compared to the Consumer Price Index for fis-
cal year 2020. 
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‘‘(B) SPECIAL
RULES
FOR
CALCULATION 
OF
ADJUSTMENT.—In making an adjustment 
under subparagraph (A), the Secretary— 
‘‘(i) shall round the amount of any in-
crease in the Consumer Price Index to the 
nearest dollar; and 
‘‘(ii) may ignore any such increase of 
less than 1 percent. 
‘‘(C) CONSUMER PRICE INDEX DEFINED.— 
For purposes of this paragraph, the term ‘Con-
sumer Price Index’ means the Consumer Price 
Index for All Urban Consumers published by 
the Bureau of Labor Statistics of the Depart-
ment of Labor.’’. 
SEC. 133113. EXTENSION OF TRADE ADJUSTMENT ASSIST-
ANCE TO PUBLIC AGENCY WORKERS. 
(a) DEFINITIONS.—Section 247 of the Trade Act of 
1974 (19 U.S.C. 2319) is amended— 
(1) in paragraph (3)— 
(A) in the matter preceding subparagraph 
(A), by striking ‘‘The’’ and inserting ‘‘Subject 
to section 222(d)(5), the’’; and 
(B) in subparagraph (A), by striking ‘‘or 
service sector firm’’ and inserting ‘‘, service sec-
tor firm, or public agency’’; and 
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(2) by adding at the end the following: 
‘‘(20) The term ‘public agency’ means a depart-
ment or agency of a State or local government or of 
the Federal Government.’’. 
(b) GROUP ELIGIBILITY REQUIREMENTS.—Section 
222 of the Trade Act of 1974 (19 U.S.C. 2272), as 
amended by subsections (b) and (c) of section 133102, is 
further amended— 
(1) by redesignating subsections (c), (d), (e), 
and (f) as subsections (d), (e), (f), and (g), respec-
tively; 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) ADVERSELY AFFECTED WORKERS IN PUBLIC 
AGENCIES.—A group of workers in a public agency shall 
be certified by the Secretary as eligible to apply for adjust-
ment assistance under this chapter pursuant to a petition 
filed under section 221 if the Secretary determines that— 
‘‘(1) a significant number or proportion of the 
workers in the public agency have become totally or 
partially separated, or are threatened to become to-
tally or partially separated; 
‘‘(2) the public agency has acquired from a for-
eign country services like or directly competitive with 
services which are supplied by such agency; and 
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‘‘(3) the acquisition of services described in 
paragraph (2) contributed to such workers’ separa-
tion or threat of separation.’’; 
(3) in subsection (d) (as redesignated), by add-
ing at the end the following: 
‘‘(5) REFERENCE TO FIRM.—For purposes of 
subsections (a) and (b), the term ‘firm’ does not in-
clude a public agency.’’; and 
(4) in paragraph (2) of subsection (e) (as redes-
ignated), by striking ‘‘subsection (a) or (b)’’ and in-
serting ‘‘subsection (a), (b), or (c)’’. 
SEC. 133114. DEFINITIONS. 
(a) EXTENSION OF ADJUSTMENT ASSISTANCE FOR 
WORKERS
TO
TERRITORIES.—Section 247(7) of the 
Trade Act of 1974 (19 U.S.C. 2319(7)) is amended— 
(1) by inserting ‘‘, Guam, the Virgin Islands of 
the United States, American Samoa, the Common-
wealth of the Northern Mariana Islands,’’ after 
‘‘District of Columbia’’; and 
(2) by striking ‘‘such Commonwealth.’’ and in-
serting ‘‘such territories.’’. 
(b) UNDERSERVED COMMUNITY.—Section 247 of the 
Trade Act of 1974 (19 U.S.C. 2319), as amended by sec-
tion 133113(a), is further amended by adding at the end 
the following: 
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‘‘(21) The term ‘underserved community’ 
means a community with populations sharing a par-
ticular characteristic that have been systematically 
denied a full opportunity to participate in aspects of 
economic, social, or civic life, such as Black, Latino, 
and Indigenous and Native American persons, Asian 
Americans and Pacific Islanders, other persons of 
color, members of other minority communities, per-
sons with disabilities, persons who live in rural 
areas, and other populations otherwise adversely af-
fected by persistent poverty or inequality.’’. 
SEC. 133115. SUBPOENA POWER. 
Section 249 of the Trade Act of 1974 (19 U.S.C. 
2321) is amended— 
(1) in subsection (a), by adding at the end the 
following: ‘‘The authority under the preceding sen-
tence includes the authority of States to require, by 
subpoena, a firm to provide information on workers 
employed by, or totally or partially separated from, 
the firm that is necessary to make a determination 
under this chapter or to provide outreach to work-
ers, including the names and address of workers.’’; 
and 
(2) by adding at the end the following: 
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‘‘(c) ENFORCEMENT OF SUBPOENAS BY STATES.— 
A State may enforce compliance with a subpoena issued 
under subsection (a)— 
‘‘(1) as provided for under State law; and 
‘‘(2) by petitioning an appropriate United 
States district court for an order requiring compli-
ance with the subpoena.’’. 
PART 2—TRADE ADJUSTMENT ASSISTANCE FOR 
FIRMS 
SEC. 133201. PETITIONS AND DETERMINATIONS. 
Section 251 of the Trade Act of 1974 (19 U.S.C. 
2341) is amended— 
(1) in the second sentence of subsection (a), by 
striking ‘‘Upon’’ and inserting ‘‘Not later than 15 
days after’’; 
(2) by amending subsection (c) to read as fol-
lows: 
‘‘(c)(1) The Secretary shall certify a firm (including 
any agricultural firm or service sector firm) as eligible to 
apply for adjustment assistance under this chapter if the 
Secretary determines— 
‘‘(A)(i) that a significant number or proportion 
of the workers in such firm have become totally or 
partially separated, or are threatened to become to-
tally or partially separated, or 
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‘‘(ii) that— 
‘‘(I) sales or production, or both, of the 
firm have decreased absolutely or failed to in-
crease, 
‘‘(II) sales or production, or both, of an ar-
ticle or service that accounted for not less than 
25 percent of the total sales or production of 
the firm during the 12-month period preceding 
the most recent 12-month period for which data 
are available have decreased absolutely or failed 
to increase, 
‘‘(III) sales or production, or both, of the 
firm during the most recent 12-month period 
for which data are available have decreased or 
failed to increase compared to— 
‘‘(aa) the average annual sales or pro-
duction for the firm during the 24-month 
period preceding that 12-month period, or 
‘‘(bb) the average annual sales or pro-
duction for the firm during the 36-month 
period preceding that 12-month period, 
and 
‘‘(IV) sales or production, or both, of an 
article or service that accounted for not less 
than 25 percent of the total sales or production 
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of the firm during the most recent 12-month 
period for which data are available have de-
creased or failed to increase compared to— 
‘‘(aa) the average annual sales or pro-
duction for the article or service during the 
24-month period preceding that 12-month 
period, or 
‘‘(bb) the average annual sales or pro-
duction for the article or service during the 
36-month period preceding that 12-month 
period, and 
‘‘(B)(i) increases of imports of articles or serv-
ices like or directly competitive with articles which 
are produced or services which are supplied by such 
firm contributed to such total or partial separation, 
or threat thereof, or to such decline or failure to in-
crease in sales or production, or 
‘‘(ii) decreases in exports of articles produced or 
services supplied by such firm, or imports of articles 
or services necessary for the production of articles or 
services supplied by such firm, contributed to such 
total or partial separation, or threat thereof, or to 
such decline in sales or production. 
‘‘(2) For purposes of paragraph (1)(B): 
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‘‘(A) Any firm which engages in exploration or 
drilling for oil or natural gas shall be considered to 
be a firm producing oil or natural gas. 
‘‘(B) Any firm that engages in exploration or 
drilling for oil or natural gas, or otherwise produces 
oil or natural gas, shall be considered to be pro-
ducing articles directly competitive with imports of 
oil and with imports of natural gas.’’; and 
(3) in subsection (d)— 
(A) by striking ‘‘this section,’’ and insert-
ing ‘‘this section.’’; and 
(B) by striking ‘‘but in any event’’ and all 
that follows and inserting the following: ‘‘If the 
Secretary does not make a determination with 
respect to a petition within 55 days after the 
date on which an investigation is initiated 
under subsection (a) with respect to the peti-
tion, the Secretary shall be deemed to have cer-
tified the firm as eligible to apply for adjust-
ment assistance under this chapter.’’. 
SEC. 133202. APPROVAL OF ADJUSTMENT PROPOSALS. 
Section 252 of the Trade Act of 1974 (19 U.S.C. 
2342) is amended— 
(1) in the second sentence of subsection (a), by 
adding at the end before the period the following: 
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‘‘and an assessment of the potential employment 
outcomes of such proposal’’; 
(2) in subsection (b)(1)(B), by striking ‘‘gives 
adequate consideration to’’ and inserting ‘‘is in’’; 
(3) by redesignating subsection (c) as sub-
section (d); and 
(4) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) AMOUNT OF ASSISTANCE.— 
‘‘(1) IN GENERAL.—A firm may receive adjust-
ment assistance under this chapter with respect to 
the firm’s economic adjustment proposal in an 
amount not to exceed $300,000, subject to adjust-
ment under paragraph (2) and the matching re-
quirement under paragraph (3). 
‘‘(2) ADJUSTMENT OF ASSISTANCE LIMITATION 
FOR INFLATION.— 
‘‘(A) IN
GENERAL.—The Secretary of 
Commerce shall adjust the technical assistance 
limitation under paragraph (1) on the date that 
is 30 days after the date of the enactment of 
this paragraph, and at the beginning of each 
fiscal year thereafter, to reflect the percentage 
(if any) of the increase in the average of the 
Consumer Price Index for the preceding 12- 
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month period compared to the Consumer Price 
Index for fiscal year 2020. 
‘‘(B) SPECIAL
RULES
FOR
CALCULATION 
OF
ADJUSTMENT.—In making an adjustment 
under subparagraph (A), the Secretary— 
‘‘(i) shall round the amount of any in-
crease in the Consumer Price Index to the 
nearest dollar; and 
‘‘(ii) may ignore any such increase of 
less than 1 percent. 
‘‘(C) CONSUMER PRICE INDEX DEFINED.— 
For purposes of this paragraph, the term ‘Con-
sumer Price Index’ means the Consumer Price 
Index for All Urban Consumers published by 
the Bureau of Labor Statistics of the Depart-
ment of Labor. 
‘‘(3) MATCHING REQUIREMENT.—A firm may 
receive adjustment assistance under this chapter 
only if the firm provides matching funds in an 
amount equal to the amount of adjustment assist-
ance received under paragraph (1).’’. 
SEC. 133203. TECHNICAL ASSISTANCE. 
Section 253(a)(3) of the Trade Act of 1974 (19 
U.S.C. 2343(a)(3)) is amended by adding at the end be-
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fore the period the following: ‘‘, including assistance to 
provide skills training programs to employees of the firm’’. 
SEC. 133204. DEFINITIONS. 
Section 259 of the Trade Act of 1974 (19 U.S.C. 
2351) is amended by adding at the end the following: 
‘‘(3) UNDERSERVED
COMMUNITY.—The term 
‘underserved community’ has the meaning given that 
term in section 247.’’. 
SEC. 133205. PLAN FOR SUSTAINED OUTREACH TO POTEN-
TIALLY-ELIGIBLE FIRMS. 
(a) IN GENERAL.—Chapter 3 of title II of the Trade 
Act of 1974 (19 U.S.C. 2341 et seq.) is amended by add-
ing at the end the following: 
‘‘SEC. 263. PLAN FOR SUSTAINED OUTREACH TO POTEN-
TIALLY-ELIGIBLE FIRMS. 
‘‘(a) IN GENERAL.—The Secretary shall develop a 
plan to provide sustained outreach to firms that may be 
eligible for adjustment assistance under this chapter. 
‘‘(b) MATTERS
TO BE INCLUDED.—The plan re-
quired by paragraph (1) shall include the following: 
‘‘(1) Outreach to the United States Inter-
national Trade Commission and to such firms in in-
dustries with increased imports identified in the 
Commission’s annual report regarding the operation 
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of the trade agreements program under section 
163(c). 
‘‘(2) Outreach to such firms in the service sec-
tor. 
‘‘(3) Outreach to such firms that are small 
businesses. 
‘‘(4) Outreach to such firms that are minority- 
or women-owned firms. 
‘‘(5) Outreach to such firms that employ a ma-
jority or a substantial percentage of workers from 
underserved communities. 
‘‘(c) UPDATES.—The Secretary shall update the plan 
required under this section on an annual basis. 
‘‘(d) SUBMISSION
TO CONGRESS.—The Secretary 
shall submit the plan and each update to the plan required 
under this section to Congress.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
for the Trade Act of 1974 is amended by inserting after 
the item relating to section 262 the following new item: 
‘‘Sec. 263. Plan for sustained outreach to potentially-eligible firms.’’. 
PART 3—TRADE ADJUSTMENT ASSISTANCE FOR 
COMMUNITIES AND COMMUNITY COLLEGES 
SEC. 133301. TRADE ADJUSTMENT ASSISTANCE FOR COM-
MUNITIES. 
(a) IN GENERAL.—Chapter 4 of title II of the Trade 
Act of 1974 (19 U.S.C. 2371 et seq.) is amended— 
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(1) by inserting after the chapter heading the 
following: 
‘‘Subchapter B—Trade Adjustment Assistance 
for 
Community 
Colleges 
and 
Career 
Training’’; and 
(2) by redesignating sections 271 and 272 as 
sections 279 and 279A, respectively; and 
(3) by inserting before subchapter B (as des-
ignated by paragraph (1)) the following: 
‘‘Subchapter A—Trade Adjustment Assistance 
for Communities 
‘‘SEC. 271. DEFINITIONS. 
‘‘In this subchapter: 
‘‘(1) AGRICULTURAL COMMODITY PRODUCER.— 
The term ‘agricultural commodity producer’ has the 
meaning given that term in section 291. 
‘‘(2) 
COMMUNITY.—The 
term 
‘community’ 
means— 
‘‘(A) a city or other political subdivision of 
a State, including a special purpose unit of a 
State or local government engaged in economic 
or infrastructure development activities, or a 
consortium of political subdivisions; 
‘‘(B) an Economic Development District 
designated by the Economic Development Ad-
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ministration of the Department of Commerce; 
or 
‘‘(C) an Indian Tribe. 
‘‘(3) ELIGIBLE COMMUNITY.—The term ‘eligible 
community’ means a community that is impacted by 
trade under section 273(a)(2) and is determined to 
be eligible for assistance under this subchapter. 
‘‘(4) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means— 
‘‘(A) an eligible community; 
‘‘(B) an institution of higher education or 
a consortium of institutions of higher education; 
or 
‘‘(C) a public or private nonprofit organi-
zation or association acting in cooperation with 
officials of a political subdivision of a State. 
‘‘(4) SECRETARY.—The term ‘Secretary’ means 
the Secretary of Commerce. 
‘‘(5) UNDERSERVED
COMMUNITY.—The term 
‘underserved community’ has the meaning given that 
term in section 247. 
‘‘SEC. 272. ESTABLISHMENT OF TRADE ADJUSTMENT AS-
SISTANCE FOR COMMUNITIES PROGRAM. 
‘‘The Secretary, acting through the Assistant Sec-
retary for Economic Development, shall, not later than 
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180 days after the date of enactment of this subchapter, 
establish a program to provide communities impacted by 
trade with assistance in accordance with the requirements 
of this subchapter. 
‘‘SEC. 273. ELIGIBILITY; NOTIFICATION OF ELIGIBILITY. 
‘‘(a) ELIGIBILITY.— 
‘‘(1) IN GENERAL.—A community shall be eligi-
ble for assistance under this subchapter if the com-
munity is a community impacted by trade under 
paragraph (2). 
‘‘(2) COMMUNITY
IMPACTED
BY
TRADE.—A 
community is impacted by trade if it meets each of 
the following requirements: 
‘‘(A) One or more of the following certifi-
cations are made with respect to the commu-
nity: 
‘‘(i) By the Secretary of Labor, that a 
group of workers located in the community 
is eligible to apply for assistance under 
section 223. 
‘‘(ii) By the Secretary of Commerce, 
that a firm located in the community is eli-
gible to apply for adjustment assistance 
under section 251. 
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‘‘(iii) By the Secretary of Agriculture, 
that a group of agricultural commodity 
producers located in the community is eli-
gible to apply for adjustment assistance 
under section 293. 
‘‘(B) The community— 
‘‘(i) applies for assistance not later 
than 180 days after the date on which the 
most recent certification described in sub-
paragraph (A) is made; or 
‘‘(ii) in the case of a community with 
respect to which one or more such certifi-
cations were made on or after January 1, 
1994, and before the date of the enactment 
of this subchapter, applies for assistance 
not later than September 30, 2024. 
‘‘(C) The community— 
‘‘(i) has a per capita income of 80 
percent or less of the national average; 
‘‘(ii) has an unemployment rate that 
is, for the most recent 24-month period for 
which data are available, at least 1 percent 
greater than the national average unem-
ployment rate; or 
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‘‘(iii) is significantly affected by a loss 
of, or threat to, the jobs associated with 
any certification described in subparagraph 
(A), or the community is undergoing tran-
sition of its economic base as a result of 
changing trade patterns, as determined by 
the Secretary. 
‘‘(b) NOTIFICATION OF ELIGIBILITY.—If one or more 
certifications described in subsection (a)(2)(A) are made 
with respect to a community, the applicable Secretary with 
respect to such certification shall concurrently, notify the 
Governor of the State in which the community is located 
of the ability of the community to apply for assistance 
under this section. 
‘‘SEC. 274. GRANTS TO ELIGIBLE COMMUNITIES. 
‘‘(a) IN GENERAL.—The Secretary may— 
‘‘(1) upon the application of an eligible commu-
nity, award a grant under this section to the com-
munity to assist in developing or updating a stra-
tegic plan that meets the requirements of section 
275; or 
‘‘(2) upon the application of an eligible entity, 
award an implementation grant under this section to 
the entity to assist in implementing projects included 
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in a strategic plan that meets the requirements of 
section 275. 
‘‘(b) SPECIAL PROVISIONS.— 
‘‘(1) REVOLVING LOAN FUND GRANTS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
maintain the proper operation and financial in-
tegrity of revolving loan funds established by el-
igible entities with assistance under this section. 
‘‘(B) EFFICIENT
ADMINISTRATION.—The 
Secretary may— 
‘‘(i) at the request of an eligible enti-
ty, amend and consolidate grant agree-
ments governing revolving loan funds to 
provide flexibility with respect to lending 
areas and borrower criteria; and 
‘‘(ii) assign or transfer assets of a re-
volving loan fund to third party for the 
purpose of liquidation, and the third party 
may retain assets of the fund to defray 
costs related to liquidation. 
‘‘(C) TREATMENT OF ACTIONS.—An action 
taken by the Secretary under this subsection 
with respect to a revolving loan fund shall not 
constitute a new obligation if all grant funds 
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associated with the original grant award have 
been disbursed to the recipient. 
‘‘(2) USE
OF
FUNDS
IN
PROJECTS
CON-
STRUCTED UNDER PROJECT COST.— 
‘‘(A) IN GENERAL.—In the case of a grant 
for a construction project under this section, if 
the Secretary determines, before closeout of the 
project, that the cost of the project, based on 
the designs and specifications that were the 
basis of the grant, has decreased because of de-
creases in costs, the Secretary may approve the 
use of the excess funds (or a portion of the ex-
cess funds) to improve the project. 
‘‘(B) OTHER USES OF EXCESS FUNDS.— 
Any amount of excess funds remaining after ap-
plication of subparagraph (A) may be used by 
the Secretary for providing assistance under 
this section. 
‘‘(c) COORDINATION.—If an eligible institution (as 
such term is defined in section 279) located in an eligible 
community is seeking a grant under section 279 at the 
same time the community is seeking an implementation 
grant under subsection (a)— 
‘‘(1) the Secretary, upon receipt of such infor-
mation from the Secretary of Labor as required 
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under section 279(e), shall notify the community 
that the institution is seeking a grant under section 
279; and 
‘‘(2) the community shall provide to the Sec-
retary, in coordination with the institution, a de-
scription of how the community will integrate 
projects included in the strategic plan with the spe-
cific project for which the institution submits the 
grant proposal under section 279. 
‘‘(d) LIMITATION.—The total amount of grants 
awarded with respect to an eligible community under this 
section for fiscal years 2022 through 2026 may not exceed 
$25,000,000. 
‘‘(e) PRIORITY.—The Secretary shall, in awarding 
grants under this section, provide higher levels of funding 
with respect to eligible communities that have a history 
of economic distress and long-term unemployment, as de-
termined by the Secretary. 
‘‘(f) GEOGRAPHIC DIVERSITY.— 
‘‘(1) IN
GENERAL.—The Secretary shall, in 
awarding grants under this section, ensure that 
grants are awarded with respect to eligible commu-
nities from geographically diverse areas. 
‘‘(2) GEOGRAPHIC
REGION
REQUIREMENT.— 
The Secretary shall, in meeting the requirement 
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under paragraph (1), award a grant under this sec-
tion for each of the fiscal years 2022 through 2026 
to at least one eligible community located in each ge-
ographic region for which regional offices of the 
Economic Development Administration of the De-
partment of Commerce are responsible, to the extent 
that the Secretary receives an application from at 
least one eligible community in each such geographic 
region. 
‘‘SEC. 275. STRATEGIC PLANS. 
‘‘(a) IN GENERAL.—A strategic plan meets the re-
quirements of this section if— 
‘‘(1) the consultation requirements of sub-
section (b) are met with respect to the development 
of the plan; 
‘‘(2) the plan meets the requirements of sub-
section (c); and 
‘‘(3) the plan is approved in accordance with 
the requirements of subsection (d). 
‘‘(b) CONSULTATION.— 
‘‘(1) IN GENERAL.—To the extent practicable, 
an eligible community shall consult with the entities 
described in paragraph (2) in developing the stra-
tegic plan. 
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‘‘(2) ENTITIES DESCRIBED.—The entities de-
scribed in this paragraph are public and private en-
tities located in or serving the eligible community, 
including— 
‘‘(A) local, county, or State government 
agencies; 
‘‘(B) firms, including small- and medium- 
sized firms; 
‘‘(C) local workforce investment boards; 
‘‘(D) labor organizations, including State 
labor federations and labor-management initia-
tives, representing workers in the community; 
‘‘(E) educational institutions, local edu-
cational agencies, and other training providers; 
and 
‘‘(F) local civil rights organizations and 
community-based organizations, including orga-
nizations representing underserved commu-
nities. 
‘‘(c) CONTENTS.—The strategic plan may contain, as 
applicable to the community, the following: 
‘‘(1) A description and analysis of the capacity 
of the eligible community to achieve economic ad-
justment to the impact of trade. 
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‘‘(2) An analysis of the economic development 
challenges and opportunities facing the community, 
including the strengths and weaknesses of the econ-
omy of the community. 
‘‘(3) An assessment of— 
‘‘(A) the commitment of the community to 
carry out the strategic plan on a long-term 
basis; 
‘‘(B) the participation and input of mem-
bers of the community who are dislocated from 
employment due to the impact of trade; and 
‘‘(C) the extent to which underserved com-
munities have been impacted by trade. 
‘‘(4) A description of how underserved commu-
nities will benefit from the strategic plan. 
‘‘(5) A description of the role of the entities de-
scribed in subsection (b)(2) in developing the stra-
tegic plan. 
‘‘(6) A description of projects under the stra-
tegic plan to facilitate the community’s economic ad-
justment to the impact of trade, including projects 
to— 
‘‘(A) develop public facilities, public serv-
ices, jobs, and businesses (including establishing 
a revolving loan fund); 
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‘‘(B) provide for planning and technical as-
sistance; 
‘‘(C) provide for training; 
‘‘(D) provide for the demolition of vacant 
or abandoned commercial, industrial, or resi-
dential property; 
‘‘(E) redevelop brownfields; 
‘‘(F) establish or support land banks; 
‘‘(G) support energy conservation; and 
‘‘(H) support historic preservation. 
‘‘(7) A strategy for continuing the community’s 
economic adjustment to the impact of trade after the 
completion of such projects. 
‘‘(8) A description of the educational and train-
ing programs and the potential employment opportu-
nities available to workers in the community, includ-
ing for workers under the age of 25, and the future 
employment needs of the community. 
‘‘(9) An assessment of— 
‘‘(A) the cost of implementing the strategic 
plan; and 
‘‘(B) the timing of funding required by the 
community to implement the strategic plan. 
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‘‘(10) A description of the methods of financing 
to be used to implement the strategic plan, includ-
ing— 
‘‘(A) an implementation grant received 
under section 274 or under other authorities; 
‘‘(B) a loan, including the establishment of 
a revolving loan fund; or 
‘‘(C) other types of financing. 
‘‘(11) An assessment of how the community will 
address unemployment among agricultural com-
modity producers, if applicable. 
‘‘(d) APPROVAL; CEDS EQUIVALENT.— 
‘‘(1) APPROVAL.—The Secretary shall approve 
the strategic plan developed by an eligible commu-
nity under this section if the Secretary determines 
that the strategic plan meets the requirements of 
this section. 
‘‘(2) CEDS OR EQUIVALENT.—The Secretary 
may deem an eligible community’s Comprehensive 
Economic Development Strategy that substantially 
meets the requirements of this section to be an ap-
proved strategic plan for purposes of this sub-
chapter. 
‘‘(e) ALLOCATION.—Of the funds appropriated to 
carry out this chapter for each of the fiscal years 2022 
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through 2026, the Secretary may make available not more 
than $50,000,000 to award grants under section 
274(a)(1). 
‘‘SEC. 276. COORDINATION OF FEDERAL RESPONSE AND 
OTHER 
ADDITIONAL 
TECHNICAL 
ASSIST-
ANCE. 
‘‘(a) IN GENERAL.—The Secretary shall coordinate 
the Federal response with respect to an eligible community 
that is awarded an implementation grant under section 
274(a)(2) to implement the community’s strategic plan 
that meets the requirements of section 275 by— 
‘‘(1) identifying and consulting, as appropriate, 
with any other Federal, State, regional, or local gov-
ernment agency; 
‘‘(2) assisting the community to access assist-
ance from other available Federal sources as nec-
essary to fulfill the community’s strategic plan devel-
oped under section 275; and 
‘‘(3) ensuring that such assistance is provided 
in a targeted, integrated manner. 
‘‘(b) TRANSFER OF FUNDS.— 
‘‘(1) TRANSFER OF FUNDS TO OTHER FEDERAL 
AGENCIES.—Funds appropriated to carry out this 
chapter may be transferred between Federal agen-
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cies, if the funds are used for the purposes for which 
the funds are specifically appropriated. 
‘‘(2) TRANSFER OF FUNDS FROM OTHER FED-
ERAL AGENCIES.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), for the purposes of this chapter, the 
Secretary may accept transfers of funds from 
other Federal agencies if the funds are used for 
the purposes for which (and in accordance with 
the terms under which) the funds are specifi-
cally appropriated. 
‘‘(B) USE
OF
FUNDS.—The transferred 
funds— 
‘‘(i) shall remain available until ex-
pended; and 
‘‘(ii) may, to the extent necessary to 
carry out this chapter, be transferred to 
and merged by the Secretary with the ap-
propriations for salaries and expenses. 
‘‘(c) ADDITIONAL TECHNICAL ASSISTANCE.—In ad-
dition to the coordination and assistance described in sub-
section (a), the Secretary shall provide technical assistance 
for communities— 
‘‘(1) to identify significant impediments to eco-
nomic development that result from the impact of 
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trade on the community, including in the course of 
developing a strategic plan under section 275; and 
‘‘(2) to access assistance under other available 
sources, including State, local, or private sources, to 
implement projects that diversify and strengthen the 
economy in the community. 
‘‘SEC. 277. GENERAL PROVISIONS. 
‘‘(a) REGULATIONS.— 
‘‘(1) IN GENERAL.—The Secretary shall, sub-
ject to paragraph (3), promulgate such regulations 
as may be necessary to carry out this subchapter, in-
cluding with respect to— 
‘‘(A) administering the awarding of grants 
under section 274, including establishing guide-
lines for the submission and evaluation of grant 
applications under such section; and 
‘‘(B) establishing guidelines for the evalua-
tion of strategic plans developed to meet the re-
quirements of section 275. 
‘‘(2) CONSULTATIONS.—The Secretary shall 
consult with the Committee on Ways and Means of 
the House of Representatives and the Committee on 
Finance of the Senate not later than 90 days prior 
to promulgating any final rule or regulation under 
this subsection. 
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‘‘(3) RELATIONSHIP
TO
EXISTING
REGULA-
TIONS.—The Secretary, to the maximum extent 
practicable, shall— 
‘‘(A) rely on and apply regulations promul-
gated to carry out other economic development 
programs of the Department of Commerce in 
carrying out this subchapter; and 
‘‘(B) provide guidance regarding the man-
ner and extent to which such other economic 
development programs relate to this subchapter. 
‘‘(b) RESOURCES.—The Secretary shall allocate such 
resources as may be necessary to provide sufficiently indi-
vidualized assistance to each eligible community that re-
ceives a grant under section 274(a) or seeks technical as-
sistance under section 276(c) to develop and implement 
a strategic plan that meets the requirements of section 
275.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
for the Trade Act of 1974 is amended by striking the 
items relating to chapter 4 of title II and inserting the 
following: 
‘‘CHAPTER 4—TRADE ADJUSTMENT ASSISTANCE FOR COMMUNITIES 
‘‘SUBCHAPTER A—TRADE ADJUSTMENT ASSISTANCE FOR COMMUNITIES 
‘‘Sec. 271. Definitions. 
‘‘Sec. 272. Establishment of trade adjustment assistance for communities pro-
gram. 
‘‘Sec. 273. Eligibility; notification of eligibility. 
‘‘Sec. 274. Grants to eligible communities. 
‘‘Sec. 275. Strategic plans. 
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‘‘Sec. 276. Coordination of Federal response and other additional technical as-
sistance. 
‘‘Sec. 277. General provisions. 
‘‘SUBCHAPTER B—COMMUNITY COLLEGE AND CAREER TRAINING GRANT 
PROGRAM 
‘‘Sec. 279. Community College and Career Training Grant Program. 
‘‘Sec. 279A. Authorization of appropriations.’’. 
SEC. 133302. TRADE ADJUSTMENT ASSISTANCE FOR COM-
MUNITY COLLEGES AND CAREER TRAINING. 
Section 279 of the Trade Act of 1974, as redesig-
nated by section 133301(a)(2), is amended as follows: 
(1) In subsection (a)— 
(A) in paragraph (1), by striking ‘‘eligible 
institutions’’ and inserting ‘‘eligible entities’’; 
and 
(B) in paragraph (2)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘eligible institution’’ 
and inserting ‘‘eligible entity’’; and 
(ii) in subparagraph (B)— 
(I) by striking ‘‘$1,000,000’’ and 
inserting ‘‘$2,500,000’’; 
(II) by striking ‘‘(B)’’ and insert-
ing ‘‘(B)(i) in the case of an eligible 
institution,’’; 
(III) by striking the period at the 
end and inserting ‘‘; or’’; and 
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(IV) by adding at the end the fol-
lowing: 
‘‘(ii) in the case of a consortium of eligible 
institutions, a grant under this section in excess 
of $15,000,000.’’. 
(2) In subsection (b), by adding at the end the 
following: 
‘‘(3) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means an eligible institution or a consortium of 
eligible institutions. 
‘‘(4) UNDERSERVED
COMMUNITY.—The term 
‘underserved community’ has the meaning given that 
term in section 247.’’. 
(3) In subsection (c)— 
(A) by striking ‘‘eligible institution’’ each 
place it appears and inserting ‘‘eligible entity’’; 
and 
(B) in paragraph (5)(A)(i)— 
(i) in subclause (I), by striking ‘‘and’’ 
at the end; and 
(ii) by adding at the end the fol-
lowing: 
‘‘(III) any opportunities to sup-
port industry or sector partnerships to 
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develop or expand quality academic 
programs and curricula; and’’. 
(4) In subsection (d), by striking ‘‘eligible insti-
tution’’ each place it appears and inserting ‘‘eligible 
entity’’. 
(5) By redesignating subsection (e) as sub-
section (h) and inserting after subsection (d) the fol-
lowing: 
‘‘(e) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—An eligible entity shall use 
a grant awarded under this section to establish and 
scale career training programs, including career and 
technical education programs, and career pathways 
and supports for students participating in such pro-
grams. 
‘‘(2) STUDENT
SUPPORT
AND
EMERGENCY 
SERVICES.—Not less than 15 percent of the amount 
of a grant awarded to an eligible entity under this 
section shall be used to carry out student support 
services, which may include the following: 
‘‘(A) 
Supportive 
services, 
including 
childcare, transportation, mental health serv-
ices, or substance use disorder prevention and 
treatment, assistance in obtaining health insur-
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ance coverage, housing, and other benefits, as 
appropriate. 
‘‘(B) Connecting students to State or Fed-
eral means-tested benefits programs. 
‘‘(C) The provision of direct financial as-
sistance to help students facing financial hard-
ships that may impact enrollment in or comple-
tion of a program supported by such funds. 
‘‘(D) Navigation, coaching, mentorship, 
and case management services, including pro-
viding information and outreach to the popu-
lation described in subparagraph (C) to take 
part in such a program. 
‘‘(E) Providing access to necessary sup-
plies, materials, technological devices, or re-
quired equipment, and other supports necessary 
to participate in such a program. 
‘‘(f) PLAN FOR OUTREACH TO UNDERSERVED COM-
MUNITIES.— 
‘‘(1) IN GENERAL.—In awarding grants under 
this section, the Secretary shall— 
‘‘(A) ensure that eligible institutions effec-
tively serve individuals from underserved com-
munities; and 
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‘‘(B) develop a plan to ensure that grants 
provided under this subchapter effectively serve 
individuals from underserved communities. 
‘‘(2) UPDATES.—The Secretary shall update 
the plan required by paragraph (1)(B) on an annual 
basis. 
‘‘(3) SUBMISSION
TO
CONGRESS.—The Sec-
retary shall submit the plan required by paragraph 
(1)(B) and each update to the plan required by 
paragraph (2) to Congress. 
‘‘(g) GEOGRAPHIC DIVERSITY.—The Secretary shall, 
in awarding grants under this section, ensure that grants 
are awarded with respect to eligible entities from geo-
graphically diverse areas.’’. 
PART 4—TRADE ADJUSTMENT ASSISTANCE FOR 
FARMERS 
SEC. 133401. DEFINITIONS. 
Section 291 of the Trade Act of 1974 (19 U.S.C. 
2401) is amended— 
(1) by striking paragraph (3); 
(2) by redesignating paragraphs (4) through 
(7) as paragraphs (3) through (6), respectively; and 
(3) by adding at the end the following: 
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‘‘(7) UNDERSERVED
COMMUNITY.—The term 
‘underserved community’ has the meaning given that 
term in section 247.’’. 
SEC. 133402. GROUP ELIGIBILITY REQUIREMENTS. 
Section 292 of the Trade Act of 1974 (19 U.S.C. 
2401a) is amended— 
(1) in subsection (c)— 
(A) in paragraph (1)— 
(i) by striking ‘‘85 percent of’’ each 
place it appears; and 
(ii) in subparagraph (D), by adding 
‘‘and’’ at the end; 
(B) in paragraph (2), by striking ‘‘(2)’’ 
and inserting ‘‘(2)(A)(i)’’; 
(C) by redesignating paragraph (3) as 
clause (ii) of paragraph (2)(A) (as designated 
by subparagraph (B)); 
(D) in clause (ii) of paragraph (2)(A) (as 
redesignated by subparagraph (C))— 
(i) by striking ‘‘importantly’’; and 
(ii) by striking the period at the end 
and inserting ‘‘; or’’ ; and 
(E) in paragraph (2), by adding at the end 
the following: 
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‘‘(B)(i) the volume of exports of the agricultural 
commodity produced by the group in the marketing 
year with respect to which the group files the peti-
tion decreased compared to the average volume of 
such exports during the 3 marketing years preceding 
such marketing year; and 
‘‘(ii) the decrease in such exports contributed to 
the decrease in the national average price, quantity 
of production, or value of production of, or cash re-
ceipts for, the agricultural commodity, as described 
in paragraph (1).’’; and 
(2) in subsection (e)(3), by adding at the end 
before the period the following: ‘‘or exports’’. 
SEC. 133403. BENEFIT INFORMATION TO AGRICULTURAL 
COMMODITY PRODUCERS. 
Section 295(a) of the Trade Act of 1974 (19 U.S.C. 
2401d(a)) is amended by adding at the end the following: 
‘‘The Secretary shall develop a plan to conduct targeted 
sustained outreach and offer assistance to agricultural 
commodity producers from underserved communities’’. 
SEC. 133404. QUALIFYING REQUIREMENTS AND BENEFITS 
FOR 
AGRICULTURAL 
COMMODITY 
PRO-
DUCERS. 
Section 296 of the Trade Act of 1974 (19 U.S.C. 
2401e) is amended— 
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(1) in subsection (a)(1)(A), by striking ‘‘90 
days’’ and inserting ‘‘120 days’’; 
(2) in subsection (b)— 
(A) in paragraph (3)(B), by striking 
‘‘$4,000’’ and inserting ‘‘$12,000’’; and 
(B) in paragraph (4)(C), by striking 
‘‘$8,000’’ and inserting ‘‘$24,000’’; 
(3) in subsection (c), by striking ‘‘$12,000’’ and 
inserting ‘‘$36,000’’; and 
(4) by adding at the end the following new sub-
section: 
‘‘(e) ADJUSTMENTS FOR INFLATION.— 
‘‘(1) IN
GENERAL.—The Secretary of Agri-
culture shall adjust each dollar amount limitation 
described in this section on the date that is 30 days 
after the date of the enactment of this subsection, 
and at the beginning of each fiscal year thereafter, 
to reflect the percentage (if any) of the increase in 
the average of the Consumer Price Index for the 
preceding 12-month period compared to the Con-
sumer Price Index for fiscal year 2020. 
‘‘(2) SPECIAL RULES FOR CALCULATION OF AD-
JUSTMENT.—In making an adjustment under para-
graph (1), the Secretary— 
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‘‘(A) shall round the amount of any in-
crease in the Consumer Price Index to the near-
est dollar; and 
‘‘(B) may ignore any such increase of less 
than 1 percent. 
‘‘(3) CONSUMER PRICE INDEX DEFINED.—For 
purposes of this subsection, the term ‘Consumer 
Price Index’ means the Consumer Price Index for 
All Urban Consumers published by the Bureau of 
Labor Statistics of the Department of Labor.’’. 
PART 5—APPROPRIATIONS AND OTHER MATTERS 
SEC. 133501. EXTENSION OF AND APPROPRIATIONS FOR 
TRADE ADJUSTMENT ASSISTANCE PROGRAM. 
(a) EXTENSION
OF TERMINATION PROVISIONS.— 
Section 285 of the Trade Act of 1974 (19 U.S.C. 2271 
note) is amended by striking ‘‘2021’’ each place it appears 
and inserting ‘‘2028’’. 
(b) TRAINING FUNDS.—Section 236(a)(2)(A) of the 
Trade Act of 1974 (19 U.S.C. 2296(a)(2)(A)) , as amend-
ed by section 133110(c)(2)(B), is further amended— 
(1) by striking ‘‘shall not exceed $450,000,000’’ 
and inserting the following: ‘‘shall not exceed— 
‘‘(i) $450,000,000’’; 
(2) by striking the period at the end and insert-
ing ‘‘; and’’; and 
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(3) by adding at the end the following: 
‘‘(ii) $1,000,000,000 for each of the fiscal years 2022 
through 2028.’’. 
(c) REEMPLOYMENT TRADE ADJUSTMENT ASSIST-
ANCE.—Section 246(b)(1) of the Trade Act of 1974 (19 
U.S.C. 2318(b)(1)) is amended by striking ‘‘2021’’ and 
inserting ‘‘2028’’. 
(d) AUTHORIZATIONS OF APPROPRIATIONS.— 
(1) TRADE
ADJUSTMENT
ASSISTANCE
FOR 
WORKERS.—Section 245 of the Trade Act of 1974 
(19 U.S.C. 2317) is amended— 
(A) in subsection (a), by striking ‘‘2021’’ 
and inserting ‘‘2028’’; and 
(B) by adding at the end the following: 
‘‘(d) RESERVATION
BY
THE SECRETARY.—Of the 
funds appropriated to carry out this chapter for any fiscal 
year, the Secretary of Labor may reserve not more than 
0.5 percent for technical assistance, pilots and demonstra-
tions, and the evaluation of activities carried out under 
this chapter.’’. 
(2) TRADE
ADJUSTMENT
ASSISTANCE
FOR 
FIRMS.—Section 255(a) of the Trade Act of 1974 
(19 U.S.C. 2345(a)) is amended in the first sentence 
by adding at the end before the period the following: 
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‘‘and $50,000,000 for each of the fiscal years 2022 
through 2028’’. 
(3) TRADE
ADJUSTMENT
ASSISTANCE
FOR 
FARMERS.—Section 298 of the Trade Act of 1974 
(19 U.S.C. 2401g(a)) is amended— 
(A) in subsection (a)— 
(i) by striking ‘‘$90,000,000’’ and in-
serting ‘‘$50,000,000’’; and 
(ii) by striking ‘‘2021’’ and inserting 
‘‘2028’’; and 
(B) by adding at the end the following: 
‘‘(c) RESERVATION
BY
THE SECRETARY.—Of the 
funds appropriated to carry out this chapter for any fiscal 
year, the Secretary of Agriculture may not reserve more 
than 5 percent for technical assistance, pilots and dem-
onstrations, and the evaluation of activities carried out 
under this chapter.’’. 
(e) APPROPRIATIONS.— 
(1) TRADE
ADJUSTMENT
ASSISTANCE
FOR 
WORKERS.—In addition to amounts otherwise avail-
able, there is appropriated for each of fiscal years 
2022 through 2028, out of any money in the Treas-
ury not otherwise appropriated, $1,000,000,000, to 
remain available until expended, to carry out the 
purposes of chapter 2 of title II of the Trade Act 
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of 1974, as authorized by section 245 of the Trade 
Act of 1974 (19 U.S.C. 2317) (as amended by sub-
section (d)). 
(2) TRADE
ADJUSTMENT
ASSISTANCE
FOR 
FIRMS.—In addition to amounts otherwise available, 
there is appropriated for each of fiscal years 2022 
through 2028, out of any money in the Treasury not 
otherwise appropriated, $50,000,000, to remain 
available until expended, to carry out the provisions 
of chapter 3 of title II of the Trade Act of 1974, 
as authorized by section 255 of the Trade Act of 
1974 (19 U.S.C. 2345) (as amended by subsection 
(d)). 
(3) TRADE ADJUSTMENT ASSISTANCE FOR COM-
MUNITIES.— 
(A) IN GENERAL.—In addition to amounts 
otherwise available, there is appropriated for 
each of fiscal years 2022 through 2026, out of 
any money in the Treasury not otherwise ap-
propriated, $1,000,000,000, to remain available 
until expended, to carry out subchapter A of 
chapter 4 of title II of the Trade Act of 1974, 
as added by section 133301 of this Act, as 
added by subsection (d). 
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(B) SALARIES
AND
EXPENSES.—Of the 
amounts appropriated pursuant subparagraph 
(A) for each of fiscal years 2022 through 2026, 
not more than $40,000,000 shall be made avail-
able for the salaries and expenses of personnel 
administering subchapter A of chapter 4 of title 
II of the Trade Act of 1974. 
(C) SUPPLEMENT AND NOT SUPPLANT.— 
Amounts appropriated pursuant to subpara-
graph (A) for each of the fiscal years 2022 
through 2026 shall be used to supplement, and 
not supplant, other Federal, State, regional, 
and local government funds made available to 
provide economic development assistance for 
communities. 
(4) TRADE ADJUSTMENT ASSISTANCE FOR COM-
MUNITY COLLEGES AND CAREER TRAINING.— 
(A) IN GENERAL.—In addition to amounts 
otherwise available, there is appropriated for 
each of fiscal years 2022 through 2028, out of 
any money in the Treasury not otherwise ap-
propriated, $1,300,000,000, to remain available 
until expended, to carry out subchapter B of 
chapter 4 of title II of the Trade Act of 1974, 
as designated by section 13301 of this Act, as 
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authorized by section 279A of such subchapter 
B (as redesignated). 
(B) RESERVATION BY THE SECRETARY.— 
Of the funds appropriated to carry out sub-
chapter B of chapter 4 of title II of the Trade 
Act of 1974 for each of fiscal years 2002 
through 2028, the Secretary of Labor may re-
serve not more than 5 percent for administra-
tion of the program, including providing tech-
nical assistance, sustained outreach to eligible 
institutions effectively serving underserved com-
munities, pilots and demonstrations, and a rig-
orous third-party evaluation of the program 
carried out under such subchapter. 
(5) TRADE
ADJUSTMENT
ASSISTANCE
FOR 
FARMERS.—In addition to amounts otherwise avail-
able, there is appropriated for each of fiscal years 
2022 through 2028, out of any money in the Treas-
ury not otherwise appropriated, $50,000,000, to re-
main available until expended, to carry out the pur-
poses of chapter 6 of title II of the Trade Act of 
1974, as authorized by section 298 of the Trade Act 
of 1974 (19 U.S.C. 2401) (as amended by sub-
section (d)). 
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SEC. 133502. APPLICABILITY OF TRADE ADJUSTMENT AS-
SISTANCE PROVISIONS. 
(a) WORKERS CERTIFIED BEFORE DATE OF ENACT-
MENT.— 
(1) IN GENERAL.—Except as provided in para-
graphs (2) and (3), a worker certified as eligible for 
adjustment assistance under section 222 of the 
Trade Act of 1974 before the date of the enactment 
of this Act shall be eligible, on and after such date 
of enactment, to receive benefits only under the pro-
visions of chapter 2 of title II of the Trade Act of 
1974, as in effect on such date of enactment, or as 
such provisions may be amended after such date of 
enactment. 
(2) COMPUTATION OF MAXIMUM BENEFITS.— 
Benefits received by a worker described in para-
graph (1) under chapter 2 of title II of the Trade 
Act of 1974 before the date of the enactment of this 
Act shall be included in any determination of the 
maximum benefits for which the worker is eligible 
under the provisions of chapter 2 of title II of the 
Trade Act of 1974, as in effect on the date of the 
enactment of this Act, or as such provisions may be 
amended after such date of enactment. 
(3) AUTHORITY
TO
MAKE
ADJUSTMENTS
TO 
BENEFITS.—For the 90-day period beginning on the 
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date of the enactment of this Act, the Secretary is 
authorized to make any adjustments to benefits to 
workers described in paragraph (1) that the Sec-
retary determines to be necessary and appropriate in 
applying and administering the provisions of chapter 
2 of title II of the Trade Act of 1974, as in effect 
on the date of the enactment of this Act, or as such 
provisions may be amended after such date of enact-
ment, in a manner that ensures parity of treatment 
between the benefits of such workers and the bene-
fits of workers certified after such date of enact-
ment. 
(b) WORKERS NOT CERTIFIED PURSUANT TO CER-
TAIN PETITIONS FILED BEFORE DATE
OF ENACT-
MENT.— 
(1) CERTIFICATIONS
OF
WORKERS
NOT
CER-
TIFIED BEFORE DATE OF ENACTMENT.— 
(A) CRITERIA IF A DETERMINATION HAS 
NOT BEEN MADE.—If, as of the date of the en-
actment of this Act, the Secretary of Labor has 
not made a determination with respect to 
whether to certify a group of workers as eligible 
to apply for adjustment assistance under sec-
tion 222 of the Trade Act of 1974 pursuant to 
a petition described in subparagraph (C), the 
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Secretary shall make that determination based 
on the requirements of section 222 of the Trade 
Act of 1974, as in effect on such date of enact-
ment. 
(B) RECONSIDERATION
OF
DENIALS
OF 
CERTIFICATIONS.—If, before the date of the en-
actment of this Act, the Secretary made a de-
termination not to certify a group of workers as 
eligible to apply for adjustment assistance 
under section 222 of the Trade Act of 1974 
pursuant to a petition described in subpara-
graph (C), the Secretary shall— 
(i) reconsider that determination; and 
(ii) if the group of workers meets the 
requirements of section 222 of the Trade 
Act of 1974, as in effect on such date of 
enactment, certify the group of workers as 
eligible to apply for adjustment assistance. 
(C) PETITION DESCRIBED.—A petition de-
scribed in this subparagraph is a petition for a 
certification of eligibility for a group of workers 
filed under section 221 of the Trade Act of 
1974 on or after January 1, 2021, and before 
the date of the enactment of this Act. 
(2) ELIGIBILITY FOR BENEFITS.— 
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bility under section 251 of the Trade Act 
of 1974 on a date during the period begin-
ning on January 1, 2021, and ending on 
the day before the date of the enactment 
of this Act; and 
(ii) the provisions of chapter 3 of title 
II of the Trade Act of 1974, as in effect 
on such date of enactment, had been in ef-
fect on that date during the period de-
scribed in clause (i). 
Subtitle E 
PART 1—PROVISIONS RELATING TO PATHWAYS 
TO HEALTH CAREERS 
SEC. 134101. PATHWAYS TO HEALTH CAREERS ACT. 
(a) TRANSITION FUNDING.—There is appropriated, 
out of any funds in the Treasury not otherwise appro-
priated, $15,000,000 to the Secretary of Health and 
Human Services to provide technical assistance and cover 
administrative costs associated with implementing section 
2071 of the Social Security Act (as added by subsection 
(b)). 
(b) CAREER PATHWAYS THROUGH HEALTH PROFES-
SION OPPORTUNITY GRANTS.—Effective October 1, 2021, 
title XX of the Social Security Act (42 U.S.C. 1397- 
1397n–13) is amended by adding at the end the following: 
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‘‘Subtitle 
D—Career 
Pathways 
Through Health Profession Op-
portunity Grants 
‘‘SEC. 2071. CAREER PATHWAYS THROUGH HEALTH PRO-
FESSION OPPORTUNITY GRANTS. 
‘‘(a) APPLICATION REQUIREMENTS.—An eligible en-
tity desiring a grant under this section for a project shall 
submit to the Secretary an application for the grant, that 
includes the following: 
‘‘(1) A description of how the applicant will use 
a career pathways approach to train eligible individ-
uals for health professions that pay well or will put 
eligible individuals on a career path to an occupation 
that pays well, under the project. 
‘‘(2) A description of the adult basic education 
and literacy activities, work readiness activities, 
training activities, and case management and career 
coaching services that the applicant will use to assist 
eligible individuals to gain work experience, connec-
tion to employers, and job placement, and a descrip-
tion of the plan for recruiting, hiring, and training 
staff to provide the case management, mentoring, 
and career coaching services, under the project di-
rectly or through local governmental, apprenticeship, 
educational, or charitable institutions. 
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‘‘(3) In the case of an application for a grant 
under this section for a demonstration project de-
scribed in subsection (c)(2)(B)(i)(I)— 
‘‘(A) a demonstration that the State in 
which the demonstration project is to be con-
ducted has in effect policies or laws that permit 
certain allied health and behavioral health care 
credentials to be awarded to people with certain 
arrest or conviction records (which policies or 
laws shall include appeals processes, waivers, 
certificates, and other opportunities to dem-
onstrate rehabilitation to obtain credentials, li-
censure, and approval to work in the proposed 
health careers), and a plan described in the ap-
plication that will use a career pathway to as-
sist participants with such a record in acquiring 
credentials, licensing, and employment in the 
specified careers; 
‘‘(B) a discussion of how the project or fu-
ture strategic hiring decisions will demonstrate 
the experience and expertise of the project in 
working with job seekers who have arrest or 
conviction records or employers with experience 
working with people with arrest or conviction 
records; 
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‘‘(C) an identification of promising innova-
tions or best practices that can be used to pro-
vide the training; 
‘‘(D) a proof of concept or demonstration 
that the applicant has done sufficient research 
on workforce shortage or in-demand jobs for 
which people with certain types of arrest or 
conviction records can be hired; 
‘‘(E) a plan for recruiting students who 
are eligible individuals into the project; and 
‘‘(F) a plan for providing post-employment 
support and ongoing training as part of a ca-
reer pathway under the project. 
‘‘(4) In the case of an application for a grant 
under this section for a demonstration project de-
scribed in subsection (c)(2)(B)(i)(II)— 
‘‘(A) a description of the partnerships, 
strategic staff hiring decisions, tailored program 
activities, or other programmatic elements of 
the project, such as training plans for doulas 
and other community health workers and train-
ing plans for midwives and other allied health 
professions, that are designed to support a ca-
reer pathway in pregnancy, birth, or post- 
partum services; and 
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‘‘(B) a demonstration that the State in 
which the demonstration project is to be con-
ducted recognizes doulas or midwives, as the 
case may be. 
‘‘(5) A demonstration that the applicant has ex-
perience working with low-income populations, or a 
description of the plan of the applicant to work with 
a partner organization that has the experience. 
‘‘(6) A plan for providing post-employment sup-
port and ongoing training as part of a career path-
way under the project. 
‘‘(7) A description of the support services that 
the applicant will provide under the project, includ-
ing a plan for how child care and transportation 
support services will be guaranteed and, if the appli-
cant will provide a cash stipend or wage supplement, 
how the stipend or supplement would be calculated 
and distributed. 
‘‘(8) A certification by the applicant that the 
project development included— 
‘‘(A) consultation with a local workforce 
development board established under section 
107 of the Workforce Innovation and Oppor-
tunity Act; 
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‘‘(B) consideration of apprenticeship and 
pre-apprenticeship models registered under the 
Act of August 16, 1937 (also known as the 
‘National Apprenticeship Act’); 
‘‘(C) consideration of career pathway pro-
grams in the State in which the project is to be 
conducted; and 
‘‘(D) a review of the State plan under sec-
tion 102 or 103 of the Workforce Innovation 
and Opportunity Act. 
‘‘(9) A description of the availability and rel-
evance of recent labor market information and other 
pertinent evidence of in-demand jobs or worker 
shortages. 
‘‘(10) A certification that the applicant will di-
rectly provide or contract for the training services 
described in the application. 
‘‘(11) A commitment by the applicant that, if 
the grant is made to the applicant, the applicant 
will— 
‘‘(A) during the planning period for the 
project, provide the Secretary with any informa-
tion needed by the Secretary to establish ade-
quate data reporting and administrative struc-
ture for the project; 
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‘‘(B) hire a person to direct the project not 
later than the end of the planning period appli-
cable to the project; 
‘‘(C) accept all technical assistance offered 
by the Secretary with respect to the grant; 
‘‘(D) participate in peer technical assist-
ance conferences as are regularly scheduled by 
the Secretary; and 
‘‘(E) provide all data required by the Sec-
retary under subsection (g). 
‘‘(b) PREFERENCES
IN
CONSIDERING
APPLICA-
TIONS.—In considering applications for a grant under this 
section, the Secretary shall give preference to— 
‘‘(1) applications submitted by applicants to 
whom a grant was made under this section or any 
predecessor to this section; 
‘‘(2) applications submitted by applicants who 
have business and community partners in each of 
the following categories: 
‘‘(A) State and local government agencies 
and social service providers, including a State 
or local entity that administers a State program 
funded under part A of this title; 
‘‘(B) institutions of higher education, ap-
prenticeship programs, and local workforce de-
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velopment boards established under section 107 
of the Workforce Innovation and Opportunity 
Act; and 
‘‘(C) health care employers, health care in-
dustry or sector partnerships, labor unions, and 
labor-management partnerships; 
‘‘(3) applications that include opportunities for 
mentoring or peer support, and make career coach-
ing available, as part of the case management plan; 
‘‘(4) applications which describe a project that 
will serve a rural area in which— 
‘‘(A) the community in which the individ-
uals to be enrolled in the project reside is lo-
cated; 
‘‘(B) the project will be conducted; or 
‘‘(C) an employer partnership that has 
committed to hiring individuals who successfully 
complete all activities under the project is lo-
cated; 
‘‘(5) applications that include a commitment to 
providing project participants with a cash stipend or 
wage supplement; and 
‘‘(6) applications which have an emergency cash 
fund to assist project participants financially in 
emergency situations. 
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‘‘(c) GRANTS.— 
‘‘(1) COMPETITIVE GRANTS.— 
‘‘(A) GRANT AUTHORITY.— 
‘‘(i) IN
GENERAL.—The Secretary 
may make a grant in accordance with this 
paragraph to an eligible entity whose appli-
cation for the grant is approved by the 
Secretary, to conduct a project designed to 
train low-income individuals for allied 
health professions, health information tech-
nology, physicians assistants, nursing as-
sistants, registered nurse, advanced prac-
tice nurse, and other professions consid-
ered part of a health care career pathway 
model. 
‘‘(ii) GUARANTEE
OF
GRANTEES
IN 
EACH STATE AND THE DISTRICT OF CO-
LUMBIA.—For each grant cycle, the Sec-
retary shall award a grant under this para-
graph to at least 2 eligible entities in each 
State that is not a territory, to the extent 
there are a sufficient number of applica-
tions submitted by the entities that meet 
the requirements applicable with respect to 
such a grant. If, for a grant cycle, there 
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are fewer than 2 such eligible entities in a 
State, the Secretary shall include that in-
formation in the report required by sub-
section (g)(2) that covers the fiscal year. 
‘‘(B) GUARANTEE OF GRANTS FOR INDIAN 
POPULATIONS.—From the amount reserved 
under subsection (i)(2)(B) for each fiscal year, 
the Secretary shall award a grant under this 
paragraph to at least 10 eligible entities that 
are an Indian tribe, a tribal organization, or a 
tribal college or university, to the extent there 
are a sufficient number of applications sub-
mitted by the entities that meet the require-
ments applicable with respect to such a grant. 
‘‘(C) GUARANTEE OF GRANTEES IN THE 
TERRITORIES.—From 
the 
amount 
reserved 
under subsection (i)(2)(C) for each fiscal year, 
the Secretary shall award a grant under this 
paragraph to at least 2 eligible entities that are 
located in a territory, to the extent there are a 
sufficient number of applications submitted by 
the entities that meet the requirements applica-
ble with respect to such a grant. 
‘‘(2) 
GRANTS
FOR
DEMONSTRATION 
PROJECTS.— 
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‘‘(A) GRANT AUTHORITY.—The Secretary 
shall make a grant in accordance with this sub-
section to an eligible entity whose application 
for the grant is approved by the Secretary, to 
conduct a demonstration project that meets the 
requirements of subparagraph (B). 
‘‘(B) REQUIREMENTS.—The requirements 
of this subparagraph are the following: 
‘‘(i) TYPE
OF
PROJECT.—The dem-
onstration project shall be of 1 of the fol-
lowing types: 
‘‘(I) INDIVIDUALS WITH ARREST 
OR
CONVICTION
RECORDS
DEM-
ONSTRATION.—The 
demonstration 
project shall be of a type designed to 
provide education and training for eli-
gible individuals with arrest or convic-
tion records to enter and follow a ca-
reer pathway in the health professions 
through occupations that pay well and 
are expected to experience a labor 
shortage or be in high demand. 
‘‘(II) PREGNANCY
AND
CHILD-
BIRTH
CAREER
PATHWAY
DEM-
ONSTRATION.—The 
demonstration 
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project shall be of a type designed to 
provide education and training for eli-
gible individuals to enter and follow a 
career pathway in the field of preg-
nancy, childbirth, post-partum, or 
childbirth and post-partum, in a State 
that recognizes doulas or midwives 
and that provides payment for serv-
ices provided by doulas or midwives, 
as the case may be, under private or 
public health insurance plans. 
‘‘(ii) DURATION.—The demonstration 
project shall be conducted for not less than 
5 years. 
‘‘(C) MINIMUM
ALLOCATION
OF
FUNDS 
FOR
EACH
TYPE
OF
DEMONSTRATION 
PROJECT.— 
‘‘(i) INDIVIDUALS
WITH
ARREST
OR 
CONVICTION
RECORDS
DEMONSTRA-
TIONS.—Not less than $6,375,000 of the 
amounts made available for grants under 
this paragraph shall be used to make 
grants for demonstration projects of the 
type described in subparagraph (B)(i)(I). 
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‘‘(ii) PREGNANCY
AND
CHILDBIRTH 
CAREER
PATHWAY
DEMONSTRATIONS.— 
Not less than $6,375,000 of the amounts 
made available for grants under this para-
graph shall be used to make grants for 
demonstration projects of the type de-
scribed in subparagraph (B)(i)(II). 
‘‘(3) GRANT
CYCLE.—The grant cycle under 
this section shall be not less than 5 years, with a 
planning period of not more than the first 12 
months of the grant cycle. During the planning pe-
riod, the amount of the grant shall be in such lesser 
amount as the Secretary determines appropriate. 
‘‘(d) USE OF GRANT.— 
‘‘(1) IN GENERAL.—An entity to which a grant 
is made under this section shall use the grant in ac-
cordance with the approved application for the 
grant. 
‘‘(2) SUPPORT TO BE PROVIDED.— 
‘‘(A) REQUIRED SUPPORT.—A project for 
which a grant is made under this section shall 
include the following: 
‘‘(i) An assessment for adult basic 
skill competency, and provision of adult 
basic skills education if necessary for 
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lower-skilled eligible individuals to enroll in 
the project and go on to enter and com-
plete 
post-secondary 
training, 
through 
means including the following: 
‘‘(I) Establishing a network of 
partners that offer pre-training activi-
ties for project participants who need 
to improve basic academic skills or 
English language proficiency before 
entering a health occupational train-
ing career pathway program. 
‘‘(II) Offering resources to enable 
project participants to continue ad-
vancing adult basic skill proficiency 
while enrolled in a career pathway 
program. 
‘‘(III) Embedding adult basic 
skill maintenance as part of ongoing 
post-graduation career coaching and 
mentoring. 
‘‘(ii) A guarantee that child care is an 
available and affordable support service for 
project participants through means such as 
the following: 
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‘‘(I) Referral to, and assistance 
with, enrollment in a subsidized child 
care program. 
‘‘(II) Direct payment to a child 
care provider if a slot in a subsidized 
child care program is not available or 
reasonably accessible. 
‘‘(III) Payment of co-payments 
or associated fees for child care. 
‘‘(iii) Case management plans that in-
clude career coaching (with the option to 
offer appropriate peer support and men-
toring opportunities to help develop soft 
skills and social capital), which may be of-
fered on an ongoing basis before, during, 
and after initial training as part of a ca-
reer pathway model. 
‘‘(iv) A plan to provide project partici-
pants with transportation through means 
such as the following: 
‘‘(I) Referral to, and assistance 
with enrollment in, a subsidized trans-
portation program. 
‘‘(II) If a subsidized transpor-
tation program is not reasonably 
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available, direct payments to subsidize 
transportation costs. 
For purposes of this clause, the term 
‘transportation’ includes public transit, or 
gasoline for a personal vehicle if public 
transit is not reasonably accessible or 
available. 
‘‘(v) In the case of a demonstration 
project of the type described in subsection 
(c)(2)(B)(i)(I), access to legal assistance 
for project participants for the purpose of 
addressing arrest or conviction records and 
associated workforce barriers. 
‘‘(B) ALLOWED SUPPORT.—The goods and 
services provided under a project for which a 
grant is made under this section may include 
the following: 
‘‘(i) A cash stipend. 
‘‘(ii) A reserve fund for financial as-
sistance to project participants in emer-
gency situations. 
‘‘(iii) Tuition, and training materials 
such as books, software, uniforms, shoes, 
and hair nets, and personal protective 
equipment. 
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‘‘(iv) In-kind resource donations such 
as interview clothing and conference at-
tendance fees. 
‘‘(v) Assistance with accessing and 
completing high school equivalency or adult 
basic education courses as necessary to 
achieve success in the project and make 
progress toward career goals. 
‘‘(vi) Assistance with programs and 
activities, 
including 
legal 
assistance, 
deemed necessary to address arrest or con-
viction records as an employment barrier. 
‘‘(vii) 
Other 
support 
services 
as 
deemed necessary for family well-being, 
success in the project, and progress toward 
career goals. 
‘‘(3) TRAINING.—The number of hours of train-
ing provided to an eligible individual under a project 
for which a grant is made under this section, for a 
recognized postsecondary credential (including an in-
dustry-recognized 
credential, 
and 
a 
certificate 
awarded by a local workforce development board es-
tablished under section 107 of the Workforce Inno-
vation and Opportunity Act), which is awarded in 
recognition of attainment of measurable technical or 
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occupational skills necessary to gain employment or 
advance within an occupation, shall be— 
‘‘(A) not less than the number of hours of 
training required for certification in that level 
of skill by the State in which the project is con-
ducted; or 
‘‘(B) if there is no such requirement, such 
number of hours of training as the Secretary 
finds is necessary to achieve that skill level. 
‘‘(4) INCLUSION OF TANF RECIPIENTS.—In the 
case of a project for which a grant is made under 
this section that is conducted in a State that has a 
program funded under part A of title IV, at least 10 
percent of the eligible individuals to whom support 
is provided under the project shall meet the income 
eligibility requirements under that State program, 
without regard to whether the individuals receive 
benefits or services directly under that State pro-
gram. 
‘‘(5) INCOME LIMITATION.—An entity to which 
a grant is made under this section shall not use the 
grant to provide support to a person who is not an 
eligible individual. 
‘‘(6) PROHIBITION.—An entity to which a grant 
is made under this section shall not use the grant 
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for purposes of entertainment, except that case man-
agement and career coaching services may include 
celebrations of specific career-based milestones such 
as completing a semester, graduation, or job place-
ment. 
‘‘(e) TECHNICAL ASSISTANCE.— 
‘‘(1) IN GENERAL.—The Secretary shall provide 
technical assistance— 
‘‘(A) to assist eligible entities in applying 
for grants under this section; 
‘‘(B) that is tailored to meet the needs of 
grantees at each stage of the administration of 
projects for which grants are made under this 
section; 
‘‘(C) that is tailored to meet the specific 
needs of Indian tribes, tribal organizations, and 
tribal colleges and universities; 
‘‘(D) that is tailored to meet the specific 
needs of the territories; 
‘‘(E) that is tailored to meet the specific 
needs of eligible entities in carrying out dem-
onstration projects for which a grant is made 
under this section; and 
‘‘(F) to facilitate the exchange of informa-
tion among eligible entities regarding best prac-
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tices and promising practices used in the 
projects. 
‘‘(2) CONTINUATION OF PEER TECHNICAL AS-
SISTANCE CONFERENCES.—The Secretary shall con-
tinue to hold peer technical assistance conferences 
for entities to which a grant is made under this sec-
tion or was made under the immediate predecessor 
of this section. The preceding sentence shall not be 
interpreted to require any such conference to be held 
in person. 
‘‘(f) EVALUATION OF DEMONSTRATION PROJECTS.— 
‘‘(1) IN
GENERAL.—The Secretary shall, by 
grant, contract, or interagency agreement, conduct 
rigorous and well-designed evaluations of the dem-
onstration projects for which a grant is made under 
this section. 
‘‘(2) REQUIREMENT APPLICABLE TO INDIVID-
UALS WITH ARREST OR CONVICTION RECORDS DEM-
ONSTRATION.—In the case of a project of the type 
described in subsection (c)(2)(B)(i)(I), the evalua-
tion shall include identification of successful activi-
ties for creating opportunities for developing and 
sustaining, particularly with respect to low-income 
individuals with arrest or conviction records, a 
health professions workforce that has accessible 
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entry points, that meets high standards for edu-
cation, training, certification, and professional devel-
opment, and that provides increased wages and af-
fordable benefits, including health care coverage, 
that are responsive to the needs of the workforce. 
‘‘(3) REQUIREMENT
APPLICABLE
TO
PREG-
NANCY AND CHILDBIRTH CAREER PATHWAY DEM-
ONSTRATION.—In the case of a project of the type 
described in subsection (c)(2)(B)(i)(II), the evalua-
tion shall include identification of successful activi-
ties for creating opportunities for developing and 
sustaining, particularly with respect to low-income 
individuals and other entry-level workers, a career 
pathway that has accessible entry points, that meets 
high standards for education, training, certification, 
and professional development, and that provides in-
creased wages and affordable benefits, including 
health care coverage, that are responsive to the 
needs of the birth, pregnancy, and post-partum 
workforce. 
‘‘(4) RULE OF INTERPRETATION.—Evaluations 
conducted pursuant to this subsection may include a 
randomized controlled trial, but this subsection shall 
not be interpreted to require an evaluation to include 
such a trial. 
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‘‘(g) REPORTS.— 
‘‘(1) TO THE SECRETARY.—An eligible entity 
awarded a grant to conduct a project under this sec-
tion shall submit interim reports to the Secretary on 
the activities carried out under the project, and, on 
the conclusion of the project, a final report on the 
activities. Each such report shall include data on 
participant outcomes related to earnings, employ-
ment in health professions, graduation rate, gradua-
tion timeliness, credential attainment, participant 
demographics, and other data specified by the Sec-
retary. 
‘‘(2) TO THE CONGRESS.—During each Con-
gress, the Secretary shall submit to the Committee 
on Ways and Means of the House of Representatives 
and the Committee on Finance of the Senate a re-
port— 
‘‘(A) on the demographics of the partici-
pants in the projects for which a grant is made 
under this section; 
‘‘(B) on the rate of which project partici-
pants 
completed 
all 
activities 
under 
the 
projects; 
‘‘(C) on the employment credentials ac-
quired by project participants; 
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‘‘(D) on the employment of project partici-
pants on completion of activities under the 
projects, and the earnings of project partici-
pants at entry into employment; 
‘‘(E) on best practices and promising prac-
tices used in the projects; 
‘‘(F) on the nature of any technical assist-
ance provided to grantees under this section; 
‘‘(G) on, with respect to the period since 
the period covered in the most recent prior re-
port submitted under this paragraph— 
‘‘(i) the number of applications sub-
mitted under this section, with a separate 
statement of the number of applications re-
ferred to in subsection (b)(5); 
‘‘(ii) the number of applications that 
were approved, with a separate statement 
of the number of such applications referred 
to in subsection (b)(5); and 
‘‘(iii) a description of how grants were 
made in any case described in the last sen-
tence of subsection (c)(1)(A)(ii); and 
‘‘(H) that includes an assessment of the ef-
fectiveness of the projects with respect to ad-
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dressing health professions workforce shortages 
or in-demand jobs. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) ALLIED HEALTH PROFESSION.—The term 
‘allied health profession’ has the meaning given in 
section 799B(5) of the Public Health Service Act. 
‘‘(2) CAREER
PATHWAY.—The term ‘career 
pathway’ has the meaning given that term in section 
3(7) of the Workforce Innovation and Opportunity 
Act. 
‘‘(3) DOULA.—The term ‘doula’ means an indi-
vidual who— 
‘‘(A) is certified by an organization that 
has been established for not less than 5 years 
and that requires the completion of continuing 
education to maintain the certification, to pro-
vide non-medical advice, information, emotional 
support, and physical comfort to an individual 
during the individual’s pregnancy, childbirth, 
and post-partum period; and 
‘‘(B) maintains the certification by com-
pleting the required continuing education. 
‘‘(4) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means any of the following entities that dem-
onstrates in an application submitted under this sec-
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tion that the entity has the capacity to fully develop 
and administer the project described in the applica-
tion: 
‘‘(A) A local workforce development board 
established under section 107 of the Workforce 
Innovation and Opportunity Act. 
‘‘(B) A State or territory, a political sub-
division of a State or territory, or an agency of 
a State, territory, or such a political subdivi-
sion, including a State or local entity that ad-
ministers a State program funded under part A 
of this title. 
‘‘(C) An Indian tribe, a tribal organization, 
or a tribal college or university. 
‘‘(D) An institution of higher education (as 
defined in the Higher Education Act of 1965). 
‘‘(E) A hospital (as defined in section 
1861(e)). 
‘‘(F) A high-quality skilled nursing facility. 
‘‘(G) A Federally qualified health center 
(as defined in section 1861(aa)(4)). 
‘‘(H) A nonprofit organization described in 
section 501(c)(3) of the Internal Revenue Code 
of 1986, a labor organization, or an entity with 
shared labor-management oversight, that has a 
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demonstrated history of providing health profes-
sion training to eligible individuals. 
‘‘(I) In the case of a demonstration project 
of 
the 
type 
provided 
for 
in 
subsection 
(c)(2)(B)(i)(II) of this section, an entity recog-
nized by a State, Indian tribe, or tribal organi-
zation as qualified to train doulas or midwives, 
if midwives or doulas, as the case may be, are 
permitted to practice in the State involved. 
‘‘(J) An opioid treatment program (as de-
fined in section 1861(jjj)(2)), and other high 
quality comprehensive addiction care providers. 
‘‘(5) ELIGIBLE INDIVIDUAL.—The term ‘eligible 
individual’ means an individual whose family income 
does not exceed 200 percent of the Federal poverty 
level. 
‘‘(6) FEDERAL
POVERTY
LEVEL.—The term 
‘Federal poverty level’ means the poverty line (as de-
fined in section 673(2) of the Omnibus Budget Rec-
onciliation Act of 1981, including any revision re-
quired by such section applicable to a family of the 
size involved). 
‘‘(7) INDIAN TRIBE; TRIBAL ORGANIZATION.— 
The terms ‘Indian tribe’ and ‘tribal organization’ 
have the meaning given the terms in section 4 of the 
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Indian Self-Determination and Education Assistance 
Act (25 U.S.C. 450b). 
‘‘(8) INSTITUTION OF HIGHER EDUCATION.— 
The term ‘institution of higher education’ has the 
meaning given the term in section 101 or 
102(a)(1)(B) of the Higher Education Act of 1965. 
‘‘(9) TERRITORY.—The term ‘territory’ means 
the Commonwealth of Puerto Rico, the United 
States Virgin Islands, Guam, the Northern Mariana 
Islands, and American Samoa. 
‘‘(10) TRIBAL COLLEGE OR UNIVERSITY.—The 
term ‘tribal college or university’ has the meaning 
given the term in section 316(b) of the Higher Edu-
cation Act of 1965. 
‘‘(i) FUNDING.— 
‘‘(1) IN GENERAL.—Out of any funds in the 
Treasury of the United States not otherwise appro-
priated, there are appropriated to the Secretary to 
carry out this section $425,000,000 for each of fis-
cal years 2022 through 2026. 
‘‘(2) ALLOCATION OF FUNDS.—Of the amount 
appropriated for a fiscal year under paragraph (1) 
of this subsection— 
‘‘(A) $318,750,000 shall be available for 
grants under subsection (c)(1)(A); 
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‘‘(B) $17,000,000 shall be reserved for 
grants under subsection (c)(1)(B); 
‘‘(C) $21,250,000 shall be reserved for 
grants under subsection (c)(1)(C); 
‘‘(D) $25,5000,000 shall be available for 
demonstration project grants under subsection 
(c)(2); 
‘‘(E) $25,500,000, plus all amounts re-
ferred to in subparagraphs (A) through (D) of 
this paragraph that remain unused after all 
grant awards are made for the fiscal year, shall 
be available for the provision of technical assist-
ance and associated staffing; and 
‘‘(F) $17,000,000 shall be available for 
studying the effects of the demonstration and 
non-demonstration projects for which a grant is 
made under this section, and for associated 
staffing, for the purpose of supporting the rig-
orous evaluation of the demonstration projects, 
and supporting the continued study of the 
short-, medium-, and long-term effects of all 
such projects, including the effectiveness of new 
or added elements of the non-demonstration 
projects.’’. 
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PART 2—PROVISIONS RELATING TO ELDER 
JUSTICE 
SEC. 134201. REAUTHORIZATION OF FUNDING FOR PRO-
GRAMS 
TO 
PREVENT 
AND 
INVESTIGATE 
ELDER 
ABUSE, 
NEGLECT, 
AND 
EXPLOI-
TATION. 
(a) LONG-TERM CARE STAFF TRAINING GRANTS.— 
Section 2041 of the Social Security Act (42 U.S.C. 
1397m) is amended to read as follows: 
‘‘SEC. 2041. NURSING HOME WORKER TRAINING GRANTS. 
‘‘(a) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to the Secretary for each of fiscal years 2022 
through 2025— 
‘‘(1) $392,000,000for grants under subsection 
(b)(1); and 
‘‘(2) $8,000,000 for grants under subsection 
(b)(2). 
‘‘(b) GRANTS.— 
‘‘(1) STATE ENTITLEMENT.— 
‘‘(A) IN GENERAL.—Each State shall be 
entitled to receive from the Secretary for each 
fiscal year specified in subsection (a) a grant in 
an amount equal to the amount allotted to the 
State under subparagraph (B) of this para-
graph. 
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‘‘(B) STATE
ALLOTMENTS.—The amount 
allotted to a State under this subparagraph for 
a fiscal year shall be— 
‘‘(i) the amount made available by 
subsection (a) for the fiscal year that is 
not required to be reserved by subsection 
(a); multiplied by 
‘‘(ii)(I) the number of State residents 
who have attained 65 years of age or are 
individuals with a disability, as determined 
by the Secretary using the most recent 
version of the American Community Sur-
vey published by the Bureau of the Census 
or a successor data set; divided by 
‘‘(II) the total number of such resi-
dents of all States. 
‘‘(2) GRANTS TO INDIAN TRIBES AND TRIBAL 
ORGANIZATIONS.— 
‘‘(A) IN GENERAL.—The Secretary, in con-
sultation with the Indian tribes and tribal orga-
nizations, shall make grants in accordance with 
this section to Indian tribes and tribal organiza-
tions who operate at least 1 eligible setting. 
‘‘(B) GRANT FORMULA.—The Secretary, in 
consultation with the Indian tribes and tribal 
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organizations, shall devise a formula for distrib-
uting among Indian tribes and tribal organiza-
tions the amount required to be reserved by 
subsection (a) for each fiscal year. 
‘‘(3) SUB-GRANTS.—A State, Indian tribe, or 
tribal organization to which an amount is paid under 
this paragraph may use the amount to make sub- 
grants to local organizations, including community 
organizations, local non-profits, elder rights and jus-
tice groups, and workforce development boards for 
any purpose described in paragraph (1) or (2) of 
subsection (c). 
‘‘(c) USE OF FUNDS.— 
‘‘(1) REQUIRED USES.—A State to which an 
amount is paid under subsection (b) shall use the 
amount to— 
‘‘(A) provide wage subsidies to eligible in-
dividuals; 
‘‘(B) provide student loan repayment or 
tuition assistance to eligible individuals for a 
degree or certification in a field relevant to 
their 
position 
referred 
to 
in 
subsection 
(f)(1)(A); 
‘‘(C) guarantee affordable and accessible 
child care for eligible individuals, including help 
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with referrals, co-pays, or other direct assist-
ance; and 
‘‘(D) provide assistance where necessary 
with obtaining appropriate transportation, in-
cluding public transportation if available, or gas 
money or transit vouchers for ride share, taxis, 
and similar types of transportation if public 
transportation is unavailable or impractical 
based on work hours or location. 
‘‘(2) AUTHORIZED USES.—A State to which an 
amount is paid under subsection (b) may use the 
amount to— 
‘‘(A) establish a reserve fund for financial 
assistance to eligible individuals in emergency 
situations; 
‘‘(B) provide in-kind resource donations, 
such as interview clothing and conference at-
tendance fees; 
‘‘(C) provide assistance with programs and 
activities, including legal assistance, deemed 
necessary to address arrest or conviction 
records that are an employment barrier; 
‘‘(D) support employers operating an eligi-
ble setting in the State in providing employees 
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with not less than 2 weeks of paid leave per 
year; or 
‘‘(E) provide other support services the 
Secretary deems necessary to allow for success-
ful recruitment and retention of workers. 
‘‘(3) PROVISION
OF
FUNDS
ONLY
FOR
THE 
BENEFIT
OF
ELIGIBLE
INDIVIDUALS
IN
ELIGIBLE 
SETTINGS.—A State to which an amount is paid 
under subsection (b) may provide the amount to only 
an eligible individual or a partner organization serv-
ing an eligible individual. 
‘‘(4) NONSUPPLANTATION.—A State to which 
an amount is paid under subsection (b) shall not use 
the amount to supplant the expenditure of any State 
funds for recruiting or retaining employees in an eli-
gible setting. 
‘‘(d) ADMINISTRATION.—A State to which a grant is 
made under subsection (b) shall reserve not more than 10 
percent of the grant to— 
‘‘(1) administer subgrants in accordance with 
this section; 
‘‘(2) provide technical assistance and support 
for applying for and accessing such a subgrant op-
portunity; 
‘‘(3) publicize the availability of the subgrants; 
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‘‘(4) carry out activities to increase the supply 
of eligible individuals; and 
‘‘(5) provide technical assistance to help sub-
grantees find and train individuals to provide the 
services for which they are contracted. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE INDIVIDUAL.—The term ‘eligible 
individual’ means an individual who— 
‘‘(A)(i) is a qualified home health aide, as 
defined in section 484.80(a) of title 42, Code of 
Federal Regulations; 
‘‘(ii) is a nurse aide approved by the State 
as meeting the requirements of sections 
483.150 through 483.154 of such title, and is 
listed in good standing on the State nurse aide 
registry; 
‘‘(iii) is a personal care aide approved by 
the State, and furnishes personal care services, 
as defined in section 440.167 of such title; 
‘‘(iv) is a qualified hospice aide, as defined 
in section 418.76 of such title; or 
‘‘(v) is a licensed practical nurse or a li-
censed or certified social worker; or 
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‘‘(vi) is receiving training to be certified or 
licensed as such an aide, nurse, or social work-
er; and 
‘‘(B) provides (or, in the case of a trainee, 
intends to provide) services as such an aide, 
nurse, or social worker in an eligible setting. 
‘‘(2) ELIGIBLE
SETTING.—The term ‘eligible 
setting’ means— 
‘‘(A) a skilled nursing facility, as defined 
in section 1819; 
‘‘(B) a nursing facility, as defined in sec-
tion 1919; 
‘‘(C) a home health agency, as defined in 
section 1891; 
‘‘(D) a facility provider approved to deliver 
home or community-based services authorized 
under State options described in subsection (c) 
or (i) of section 1915 or, as relevant, dem-
onstration projects authorized under section 
1115; 
‘‘(E) a hospice, as defined in section 1814; 
or 
‘‘(F) a tribal assisted living facility. 
‘‘(3) TRIBAL ORGANIZATION.—The term ‘tribal 
organization’ has the meaning given the term in sec-
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tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act.’’. 
(b) ADULT PROTECTIVE SERVICES FUNCTIONS AND 
GRANT PROGRAMS.— 
(1) DIRECT FUNDING; STATE ENTITLEMENT.— 
Section 2042 of the Social Security Act (42 U.S.C. 
1397m–1) is amended— 
(A) in subsection (a)— 
(i) in paragraph (1)(A)— 
(I) by striking ‘‘offices’’ and in-
serting ‘‘programs’’; and 
(II) by inserting ‘‘and adults who 
are under a disability (as defined in 
section 216(i)(1))’’ before the semi-
colon; and 
(ii) by striking paragraph (2) and in-
serting the following: 
‘‘(2) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary $8,000,000 for each of 
fiscal years 2023 through 2025 to carry out this 
subsection.’’; 
(B) in subsection (b)— 
(i) in paragraph (2)— 
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(I) in subparagraph (A), by strik-
ing ‘‘the availability of appropriations 
and’’; and 
(II) in subparagraph (B)— 
(aa) in the heading for 
clause (i), by inserting ‘‘AND THE 
DISTRICT
OF
COLUMBIA’’ after 
‘‘STATES’’; and 
(bb) in clause (ii), by insert-
ing ‘‘or the District of Columbia’’ 
after ‘‘States’’; and 
(ii) by striking paragraph (5) and in-
serting the following: 
‘‘(5) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary for each of fiscal years 
2023 through 2025— 
‘‘(A) $392,000,000 for grants to States 
under this subsection; and 
‘‘(B) $8,000,000 for grants to Indian 
tribes and tribal organizations under this sub-
section.’’; and 
(C) in subsection (c), by striking para-
graph (6) and inserting the following: 
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‘‘(6) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary $75,000,000 for each 
of fiscal years 2023 through 2025 to carry out this 
subsection.’’. 
(2) STATE ENTITLEMENT; GRANTS TO INDIAN 
TRIBES AND TRIBAL ORGANIZATIONS.—Section 2042 
of such Act (42 U.S.C. 1397m–1) is amended— 
(A) in subsection (a)(1)(A), by striking 
‘‘State and local’’ and inserting ‘‘State, local, 
and tribal’’; 
(B) in subsection (b)(1), by striking ‘‘the 
Secretary shall annually award grants to States 
in the amounts calculated under paragraph (2)’’ 
and inserting ‘‘each State shall be entitled to 
annually receive from the Secretary in the 
amounts calculated under paragraph (2), and 
the Secretary may annually award to each In-
dian tribe and tribal organization in accordance 
with paragraph (3), grants’’; 
(C) in subsection (b)(2)— 
(i) in the paragraph heading, by in-
serting ‘‘FOR A STATE’’ after ‘‘PAYMENT’’; 
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(ii) in subparagraph (A), by striking 
‘‘to carry out’’ and inserting ‘‘for grants to 
States under’’; and 
(iii) in subparagraph (B)(i), by strik-
ing ‘‘such year’’ and inserting ‘‘for grants 
to States under this subsection for the fis-
cal year’’; and 
(D) in subsection (b), by redesignating 
paragraphs (3) through (5) as paragraphs (4) 
through (6), respectively, and inserting after 
paragraph (2) the following: 
‘‘(3) AMOUNT OF PAYMENT TO INDIAN TRIBE 
OR TRIBAL ORGANIZATION.—The Secretary, in con-
sultation with Indian tribes and tribal organizations, 
shall determine the amount of any grant to be made 
to each Indian tribe and tribal organization under 
this subsection. Paragraphs (4) and (5) shall apply 
to grantees under this paragraph in the same man-
ner in which the paragraphs apply to States.’’; 
(E) in subsection (c)— 
(i) in paragraph (1), by striking ‘‘to 
States’’ and inserting ‘‘to States, Indian 
tribes, and tribal organizations’’; 
(ii) in paragraph (2)— 
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(I) in the matter preceding sub-
paragraph (A), by inserting ‘‘and In-
dian tribes and tribal organizations’’ 
after ‘‘government’’; and 
(II) in subparagraph (D), by in-
serting ‘‘or Indian tribe or tribal orga-
nization, as the case may be’’ after 
‘‘government’’; 
(iii) in paragraph (4), by inserting ‘‘or 
Indian tribe or tribal organization’’ after 
‘‘a State’’ the 1st place it appears; and 
(iv) in paragraph (5)— 
(I) by inserting ‘‘or Indian tribe 
or tribal organization’’ after ‘‘Each 
State’’; and 
(II) by inserting ‘‘or Indian tribe 
or tribal organization, as the case may 
be’’ after ‘‘the State’’; and 
(F) by adding at the end the following: 
‘‘(d) DEFINITIONS OF INDIAN TRIBE AND TRIBAL 
ORGANIZATION.—In this section, the terms ‘Indian tribe’ 
and ‘tribal organization’ have the meanings given the 
terms in section 419.’’. 
(3) 
CONFORMING
AMENDMENT.—Section 
2011(2) of such Act (42 U.S.C. 1397j(2)) is amend-
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ed by striking ‘‘such services provided to adults as 
the Secretary may specify’’ and inserting ‘‘services 
provided by an entity authorized by or under State 
law address neglect, abuse, and exploitation of older 
adults and people with disabilities’’. 
(c) LONG-TERM
CARE
OMBUDSMAN
PROGRAM 
GRANTS AND TRAINING.—Section 2043 of the Social Se-
curity Act (42 U.S.C. 1397m–2) is amended— 
(1) in subsection (a), by striking paragraph (2) 
and inserting the following: 
‘‘(2) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary to carry out this sub-
section— 
‘‘(A) $22,500,000 for fiscal year 2023; and 
‘‘(B) $30,000,000 for each of fiscal years 
2024 and 2025.’’; and 
(2) in subsection (b), by striking paragraph (2) 
and inserting the following: 
‘‘(2) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary $30,000,000 for each 
of fiscal years 2023 through 2025 to carry out this 
subsection.’’. 
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(d) INCENTIVES FOR DEVELOPING AND SUSTAINING 
STRUCTURAL COMPETENCY IN PROVIDING HEALTH AND 
HUMAN SERVICES.—Part II of subtitle B of title XX of 
the Social Security Act (42 U.S.C. 1397m-1397m–5) is 
amended by adding at the end the following: 
‘‘SEC. 2047. INCENTIVES FOR DEVELOPING AND SUS-
TAINING STRUCTURAL COMPETENCY IN PRO-
VIDING HEALTH AND HUMAN SERVICES. 
‘‘(a) GRANTS TO STATES TO SUPPORT LINKAGES TO 
LEGAL
SERVICES
AND
MEDICAL
LEGAL
PARTNER-
SHIPS.— 
‘‘(1) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary $500,000,000 for fis-
cal year 2022, to remain available for the purposes 
of this subsection through fiscal year 2028. 
‘‘(2) GRANTS.—Within 2 years after the date of 
the enactment of this section, the Secretary shall es-
tablish and administer a program of grants to States 
to support the adoption of evidence-based ap-
proaches to establishing or improving and maintain-
ing real-time linkages between health and social 
services and supports for vulnerable elders or in con-
junction with authorized representatives of vulner-
able elders, including through the following: 
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‘‘(A) MEDICAL-LEGAL
PARTNERSHIPS.— 
The establishment and support of medical-legal 
partnerships, the incorporation of the partner-
ships in the elder justice framework and health 
and human services safety net, and the imple-
mentation and operation of such a partnership 
by an eligible grantee— 
‘‘(i) at the option of a State, in con-
junction with an area agency on aging; 
‘‘(ii) in a solo provider practice in a 
health professional shortage area (as de-
fined in section 332(a) of the Public 
Health Service Act), a medically under-
served community (as defined in section 
399V of such Act), or a rural area (as de-
fined in section 330J of such Act); 
‘‘(iii) in a minority-serving institution 
of higher learning with health, law, and so-
cial services professional programs; 
‘‘(iv) in a federally qualified health 
center, as described in section 330 of the 
Public Health Service Act, or look-alike, as 
described in section 1905(l)(2)(B) of this 
Act; or 
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‘‘(v) in certain hospitals that are crit-
ical access hospitals, Medicare-dependent 
hospitals, sole community hospitals, rural 
emergency hospitals, or that serve a high 
proportion of Medicare or Medicaid pa-
tients. 
‘‘(B) LEGAL HOTLINES DEVELOPMENT OR 
EXPANSION.—The provision of incentives to de-
velop, enhance, and integrate platforms, such as 
legal assistance hotlines, that help to facilitate 
the identification of older adults who could ben-
efit from linkages to available legal services 
such as those described in subparagraph (A). 
‘‘(3) STATE REPORTS.—Each State to which a 
grant is made under this subsection shall submit to 
the Secretary biannual reports on the activities car-
ried out by the State pursuant to this subsection, 
which shall include assessments of the effectiveness 
of the activities with respect to— 
‘‘(A) the number of unique individuals 
identified through the mechanism outlined in 
paragraph (2)(B) who are referred to services 
described in paragraph (2)(A), and the average 
time period associated with resolving issues; 
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1541 
‘‘(B) the success rate for referrals to com-
munity-based resources; and 
‘‘(C) other factors determined relevant by 
the Secretary. 
‘‘(4) EVALUATION.—The Secretary shall, by 
grant, contract, or interagency agreement, evaluate 
the activities conducted pursuant to this subsection, 
which shall include a comparison among the States. 
‘‘(5) SUPPLEMENT
NOT
SUPPLANT.—Support 
provided to area agencies on aging, State units on 
aging, eligible entities, or other community-based or-
ganizations pursuant to this subsection shall be used 
to supplement and not supplant any other Federal, 
State, or local funds expended to provide the same 
or comparable services described in this subsection. 
‘‘(b) GRANTS
AND TRAINING
TO SUPPORT AREA 
AGENCIES ON AGING OR OTHER COMMUNITY-BASED OR-
GANIZATIONS TO ADDRESS SOCIAL ISOLATION AMONG 
VULNERABLE OLDER ADULTS AND PEOPLE WITH DIS-
ABILITIES.— 
‘‘(1) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary $250,000,000, to re-
main available for the purposes of this subsection 
through fiscal year 2028. 
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‘‘(2) GRANTS.—The Secretary shall make 
grants to eligible area agencies on aging or other 
community-based organizations for the purpose of— 
‘‘(A) conducting outreach to individuals at 
risk for, or already experiencing, social isolation 
or loneliness, through established screening 
tools or other methods identified by the Sec-
retary; 
‘‘(B) developing community-based interven-
tions for the purposes of mitigating loneliness 
or social isolation (including evidence-based pro-
grams, as defined by the Secretary, developed 
with multi-stakeholder input for the purposes of 
promoting social connection, mitigating social 
isolation or loneliness, or preventing social iso-
lation or loneliness) among at-risk individuals; 
‘‘(C) connecting at-risk individuals with 
community social and clinical supports; and 
‘‘(D) evaluating the effect of programs de-
veloped and implemented under subparagraphs 
(B) and (C). 
‘‘(3) TRAINING.—The Secretary shall establish 
programs to provide and improve training for area 
agencies on aging or community-based organizations 
with respect to addressing and preventing social iso-
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lation and loneliness among older adults and people 
with disabilities. 
‘‘(4) EVALUATION.—Not later than 3 years 
after the date of the enactment of this section and 
at least once after fiscal year 2025, the Secretary 
shall submit to the Congress a written report which 
assesses the extent to which the programs estab-
lished under this subsection address social isolation 
and loneliness among older adults and people with 
disabilities. 
‘‘(5) COORDINATION.—The Secretary shall co-
ordinate with resource centers, grant programs, or 
other funding mechanisms established under section 
411(a)(18) of the Older Americans Act (42 U.S.C. 
3032(a)(18)), section 417(a)(1) of such Act (42 
U.S.C. 3032F(a)(1)), or other programs as deter-
mined by the Secretary. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) AREA AGENCY ON AGING.—The term ‘area 
agency on aging’ means an area agency on aging 
designated under section 305 of the Older Ameri-
cans Act of 1965. 
‘‘(2) SOCIAL ISOLATION.—The term ‘social iso-
lation’ means objectively being alone, or having few 
relationships or infrequent social contact. 
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‘‘(3) 
LONELINESS.—The 
term 
‘loneliness’ 
means subjectively feeling alone, or the discrepancy 
between one’s desired level of social connection and 
one’s actual level of social connection. 
‘‘(4) SOCIAL
CONNECTION.—The term ‘social 
connection’ means the variety of ways one can con-
nect to others socially, through physical, behavioral, 
social–cognitive, and emotional channels. 
‘‘(5) COMMUNITY-BASED ORGANIZATION.—The 
term ‘community-based organization’ includes, ex-
cept as otherwise provided by the Secretary, a non-
profit community-based organization, a consortium 
of nonprofit community-based organizations, a na-
tional nonprofit organization acting as an inter-
mediary for a community-based organization, or a 
community-based organization that has a fiscal 
sponsor that allows the organization to function as 
an organization described in section 501(c)(3) of the 
Internal Revenue Code of 1986 and exempt from 
taxation under section 501(a) of such Code.’’. 
(e) TECHNICAL AMENDMENT.—Section 2011(12)(A) 
of the Social Security Act (42 U.S.C. 1397j(12)(A)) is 
amended by striking ‘‘450b’’ and inserting ‘‘5304’’. 
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SEC. 134202. APPROPRIATION FOR ASSESSMENTS. 
Out of any money in the Treasury not otherwise ap-
propriated, there are appropriated to the Secretary of 
Health and Human Services $5,000,000 for each of fiscal 
years 2022 through 2025 to prepare and submit to the 
Committee on Ways and Means of the House of Rep-
resentatives and the Committee on Finance of the Senate, 
not later than 3 years after the date of enactment of this 
Act, and at least once after fiscal year 2025, reports on 
the programs, coordinating bodies, registries, and activi-
ties established or authorized under subtitle B of title XX 
of the Social Security Act (42 U.S.C. 1397l et seq.) or 
section 6703(b) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 1395i–3a), which shall assess the ex-
tent to which such programs, coordinating bodies, reg-
istries, and activities have improved access to, and the 
quality of, resources available to aging Americans and 
their caregivers to ultimately prevent, detect, and treat 
abuse, neglect, and exploitation, and shall include, as ap-
propriate, recommendations to Congress on funding levels 
and policy changes to help these programs, coordinating 
bodies, registries, and activities better prevent, detect, and 
treat abuse, neglect, and exploitation of aging Americans. 
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PART 3—SKILLED NURSING FACILITIES 
SEC. 134301. FUNDING TO IMPROVE THE ACCURACY AND 
RELIABILITY OF CERTAIN SKILLED NURSING 
FACILITY DATA. 
Section 1888 of the Social Security Act (42 U.S.C. 
1395yy) is amended— 
(1) in subsection (h)(12)— 
(A) in subparagraph (A), by striking ‘‘and 
the data submitted under subsection (e)(6)’’ 
and inserting ‘‘, the data submitted under sub-
section (e)(6), and, during the period beginning 
with fiscal year 2024 and ending with fiscal 
year 2031, the resident assessment data de-
scribed in section 1819(b)(3) and the direct 
care staffing information described in section 
1128I(g)’’; and 
(B) in subparagraph (B)— 
(i) by striking ‘‘FUNDING.—For pur-
poses’’ and inserting ‘‘FUNDING.— 
‘‘(i) FISCAL
YEARS
2023
THROUGH 
2025.—For purposes’’; and 
(ii) by adding at the end the following 
new clause: 
‘‘(ii) FISCAL
YEARS
2026
THROUGH 
2031.—There is appropriated to the Sec-
retary, out of any monies in the Treasury 
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not otherwise appropriated, $50,000,000 
for the period of fiscal years 2026 through 
2031 for purposes of carrying out this 
paragraph.’’; and 
(2) in subsection (e)(6)(A)— 
(A) in the header, by striking ‘‘FOR FAIL-
URE TO REPORT’’; and 
(B) in clause (i)— 
(i) by striking ‘‘For fiscal years’’ and 
inserting the following: 
‘‘(I) FAILURE TO REPORT.—For 
fiscal years’’; and 
(ii) by adding at the end the following 
new subclause: 
‘‘(II) 
REPORTING
OF
INAC-
CURATE
INFORMATION.—For fiscal 
years during the period beginning 
with fiscal year 2025 and ending with 
fiscal year 2031, in the case of a 
skilled nursing facility that submits 
data under this paragraph, measures 
under subsection (h), resident assess-
ment 
data 
described 
in 
section 
1819(b)(3), or direct care staffing in-
formation 
described 
in 
section 
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1128I(g) with respect to such fiscal 
year that is inaccurate (as determined 
by the Secretary through the valida-
tion process described in section 
1888(h)(12) or otherwise), after de-
termining the percentage described in 
paragraph (5)(B)(i), and after appli-
cation of clauses (ii) and (iii) of para-
graph (5)(B) and of subclause (I) of 
this clause (if applicable), the Sec-
retary shall reduce such percentage 
for payment rates during such fiscal 
year by 2 percentage points.’’. 
SEC. 134302. ENSURING ACCURATE INFORMATION ON COST 
REPORTS. 
Section 1888(f) of the Social Security Act (42 U.S.C. 
1395yy(f)) is amended by adding at the end the following 
new paragraph: 
‘‘(5) AUDIT OF COST REPORTS.—There is ap-
propriated to the Secretary, out of any monies in the 
Treasury not otherwise appropriated, $250,000,000 
for fiscal year 2023 to remain available until ex-
pended, for purposes of conducting an annual audit 
(beginning with 2022 and ending with 2031) of cost 
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reports submitted under this title for a representa-
tive sample of skilled nursing facilities.’’. 
SEC. 134303. SURVEY IMPROVEMENTS. 
Section 1819 of the Social Security Act (42 U.S.C. 
1395i–3) is amended by adding at the end the following 
new subsection: 
‘‘(l) SURVEY IMPROVEMENTS.— 
‘‘(1) IN GENERAL.—There is appropriated to 
the Secretary, out of any monies in the Treasury not 
otherwise appropriated, $325,000,000, for the period 
of fiscal years 2022 through 2031, for purposes of— 
‘‘(A) conducting reviews and identifying 
plans under paragraph (2); and 
‘‘(B) providing training, tools, technical as-
sistance, and financial support in accordance 
with paragraph (3). 
‘‘(2) REVIEW.—The Secretary shall conduct re-
views, during the period specified in paragraph (1), 
of (and, as appropriate, identify plans to improve) 
the following: 
‘‘(A) The extent to which surveys con-
ducted under subsection (g) and the enforce-
ment process under subsection (h) result in in-
creased compliance with requirements under 
this section and subpart B of part 483 of title 
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42, Code of Federal Regulations, with respect 
to skilled nursing facilities (in this subsection 
referred to as ‘facilities’). 
‘‘(B) The timeliness and thoroughness of 
State agency verification of deficiency correc-
tions at facilities. 
‘‘(C) The appropriateness of the scoping 
and substantiation of cited deficiencies at facili-
ties. 
‘‘(D) The accuracy of the identification 
and appropriateness of the scoping of life safe-
ty, infection control, and emergency prepared-
ness deficiencies at facilities. 
‘‘(E) The timeliness of State agency inves-
tigations of— 
‘‘(i) complaints at facilities; and 
‘‘(ii) reported allegations of abuse, ne-
glect, and exploitation at facilities. 
‘‘(F) The consistency of facility reporting 
of substantiated complaints to law enforcement. 
‘‘(G) The ability of the State agency to 
sufficiently hire, train, and retain individuals 
who conduct surveys. 
‘‘(H) Any other area related to surveys of 
facilities, or the individuals conducting such 
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surveys, determined appropriate by the Sec-
retary. 
‘‘(3) SUPPORT.—Based on the review under 
paragraph (2), the Secretary shall, during the period 
specified in paragraph (1), provide training, tools, 
technical assistance, and financial support to State 
agencies that perform surveys of facilities for the 
purpose of improving the surveys conducted under 
subsection (g) and the enforcement process under 
subsection (h) with respect to the areas reviewed 
under paragraph (2).’’. 
SEC. 134304. NURSE STAFFING REQUIREMENTS. 
Section 1819(d) of the Social Security Act (42 U.S.C. 
1395i–3(d)) is amended— 
(1) in paragraph (4)(A), by inserting ‘‘and any 
regulations promulgated under paragraph (5)(C)’’ 
after ‘‘section 1124’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(5) NURSE STAFFING REQUIREMENTS.— 
‘‘(A) FUNDING.—There is appropriated to 
the Secretary, out of any monies in the Treas-
ury not otherwise appropriated, $50,000,000 
for the period of fiscal years 2022 through 
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2031 for purposes of carrying out this para-
graph. 
‘‘(B) STUDY.—Not later than 3 years after 
the date of the enactment of this paragraph, 
and not less frequently than once every 5 years 
thereafter, the Secretary shall, out of funds ap-
propriated under subparagraph (A), conduct a 
study and submit to Congress a report on the 
appropriateness of establishing minimum staff 
to resident ratios for nursing staff for skilled 
nursing facilities. Each such report shall in-
clude— 
‘‘(i) with respect to the first such re-
port, recommendations regarding appro-
priate minimum ratios of registered nurses 
(and, if practicable, licensed practical 
nurses (or licensed vocational nurses) and 
certified nursing assistants) to residents at 
such skilled nursing facilities; and 
‘‘(ii) with respect to each subsequent 
such report, recommendations regarding 
appropriate minimum ratios of registered 
nurses, licensed practical nurses (or li-
censed vocational nurses), and certified 
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nursing assistants to residents at such 
skilled nursing facilities. 
‘‘(C) PROMULGATION OF REGULATIONS.— 
‘‘(i) IN GENERAL.—Not later than 2 
years after the Secretary first submits a 
report under subparagraph (B), the Sec-
retary shall, out of funds appropriated 
under subparagraph (A)— 
‘‘(I) specify through regulations, 
consistent with such report, appro-
priate minimum ratios (if any) of reg-
istered nurses (and, if practicable, li-
censed practical nurses (or licensed 
vocational nurses) and certified nurs-
ing assistants) to residents at skilled 
nursing facilities; and 
‘‘(II) except as provided in clause 
(ii), require such skilled nursing facili-
ties to comply with such ratios. 
‘‘(ii) EXCEPTION.— 
‘‘(I) IN
GENERAL.—In addition 
to the authority to waive the applica-
tion of clause (i)(II) under section 
1135, the Secretary may waive the 
application of such clause with respect 
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to a skilled nursing facility if the Sec-
retary finds that— 
‘‘(aa) the facility is located 
in a rural area and the supply of 
skilled nursing facility services in 
such area is not sufficient to 
meet the needs of individuals re-
siding therein; 
‘‘(bb) the Secretary provides 
notice of the waiver to the State 
long-term care ombudsman (es-
tablished 
under 
section 
307(a)(12) of the Older Ameri-
cans Act of 1965) and the pro-
tection and advocacy system in 
the State for the mentally ill; and 
‘‘(cc) the facility that is 
granted such a waiver notifies 
residents of the facility (or, 
where appropriate, the guardians 
or legal representatives of such 
residents) and members of their 
immediate families of the waiver. 
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‘‘(II) RENEWAL.—Any waiver in 
effect under this clause shall be sub-
ject to annual renewal. 
‘‘(iii) UPDATE.—Not later than 2 
years after the submission of each subse-
quent report under subparagraph (B), the 
Secretary shall, out of funds appropriated 
under subparagraph (A) and consistent 
with such report, update the regulations 
described in clause (i)(I) to reflect appro-
priate minimum ratios (if any) of reg-
istered nurses, licensed practical nurses (or 
licensed vocational nurses), and certified 
nursing assistants to residents at skilled 
nursing facilities.’’. 
PART 4—MEDICARE DENTAL, HEARING, AND 
VISION COVERAGE 
SEC. 134401. PROVIDING COVERAGE FOR DENTAL AND 
ORAL HEALTH CARE UNDER THE MEDICARE 
PROGRAM. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (GG), by striking ‘‘and’’ 
after the semicolon at the end; 
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(2) in subparagraph (HH), by striking the pe-
riod at the end and adding ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(II) dental and oral health services (as defined 
in subsection (lll));’’. 
(b) DENTAL
AND ORAL HEALTH SERVICES DE-
FINED.—Section 1861 of the Social Security Act (42 
U.S.C. 1395x) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(lll) DENTAL AND ORAL HEALTH SERVICES.— 
‘‘(1) IN GENERAL.—The term ‘dental and oral 
health services’ means items and services (other 
than such items and services for which payment may 
be made under part A as inpatient hospital services) 
that are furnished during 2028 or a subsequent 
year, for which coverage was not provided under 
part B as of the date of the enactment of this sub-
section, and that are— 
‘‘(A) the preventive and screening services 
described in paragraph (2) furnished by a doc-
tor of dental surgery or of dental medicine (as 
described in subsection (r)(2)) or an oral health 
professional (as defined in paragraph (4)); or 
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‘‘(B) the basic treatments specified for 
such year by the Secretary pursuant to para-
graph (3)(A) and the major treatments speci-
fied for such year by the Secretary pursuant to 
paragraph (3)(B) furnished by such a doctor or 
such a professional. 
‘‘(2) PREVENTIVE
AND
SCREENING
SERV-
ICES.—The preventive and screening services de-
scribed in this paragraph are the following: 
‘‘(A) Oral exams. 
‘‘(B) Dental cleanings. 
‘‘(C) Dental x-rays performed in the office 
of a doctor or professional described in para-
graph (1)(A). 
‘‘(D) Fluoride treatments. 
‘‘(3) BASIC
AND
MAJOR
TREATMENTS.—For 
2028 and each subsequent year, the Secretary shall 
specify— 
‘‘(A) basic treatments (which may include 
basic tooth restorations, basic periodontal serv-
ices, tooth extractions, and oral disease man-
agement services); and 
‘‘(B) major treatments (which may include 
major tooth restorations, major periodontal 
services, bridges, crowns, and root canals); 
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that shall be included as dental and oral health serv-
ices for such year. 
‘‘(4) ORAL HEALTH PROFESSIONAL.—The term 
‘oral health professional’ means, with respect to den-
tal and oral health services, a health professional 
(other than a doctor of dental surgery or of dental 
medicine (as described in subsection (r)(2))) who is 
licensed to furnish such services, acting within the 
scope of such license, by the State in which such 
services are furnished.’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)) is 
amended— 
(A) in subparagraph (N), by inserting 
‘‘and dental and oral health services (as defined 
in 
section 
1861(lll))’’ 
after 
‘‘section 
1861(hhh)(1))’’; 
(B) by striking ‘‘and’’ before ‘‘(DD)’’; and 
(C) by inserting before the semicolon at 
the end the following: ‘‘and (EE) with respect 
to dental and oral health services (as defined in 
section 1861(lll)), the amount paid shall be the 
payment 
amount 
specified 
under 
section 
1834(z)’’. 
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(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m) 
is amended by adding at the end the following new 
subsection: 
‘‘(z) PAYMENT AND LIMITS FOR DENTAL AND ORAL 
HEALTH SERVICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for dental and oral health services 
(as defined in section 1861(lll)) shall be, subject to 
paragraph (3), the applicable percent (specified in 
paragraph (2)) of the lesser of— 
‘‘(A) the actual charge for the service; or 
‘‘(B) the amount determined under the 
payment basis determined under section 1848 
for the service, or, in lieu of such amount, if de-
termined appropriate by the Secretary, an 
amount specified by the Secretary for such 
service under a fee schedule determined appro-
priate by the Secretary, taking into account fee 
schedules for such services— 
‘‘(i) under the TRICARE program 
under chapter 55 of title 10 of the United 
States Code; 
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‘‘(ii) under the health insurance pro-
gram under chapter 89 of title 5 of such 
Code; 
‘‘(iii) under State plans (or waivers of 
such plans) under title XIX; 
‘‘(iv) under Medicare Advantage plans 
under part C; 
‘‘(v) established by the Secretary of 
Veterans Affairs; and 
‘‘(vi) established by other health care 
payers. 
‘‘(2) APPLICABLE PERCENT.—For purposes of 
paragraph (1), the applicable percent specified in 
this paragraph is, with respect to dental and oral 
health services (as defined in section 1861(lll)) fur-
nished in a year— 
‘‘(A) that are preventive and screening 
services described in paragraph (2) or basic 
treatments specified for such year pursuant to 
paragraph (3)(A) of such section, 80 percent; 
and 
‘‘(B) that are major treatments specified 
for such year pursuant to paragraph (3)(B) of 
such section— 
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‘‘(i) in the case such services are fur-
nished during 2028, 10 percent; 
‘‘(ii) in the case such services are fur-
nished during 2029 or a subsequent year 
before 2032, the applicable percent speci-
fied under this subparagraph for the pre-
vious year, increased by 10 percentage 
points; and 
‘‘(iii) in the case such services are fur-
nished during 2032 or a subsequent year, 
50 percent. 
‘‘(3) LIMITATIONS.—With respect to dental and 
oral health services that are— 
‘‘(A) preventive and screening oral exams, 
payment may be made under this part for not 
more than two such exams during a 12-month 
period; 
‘‘(B) dental cleanings, payment may be 
made under this part for not more than two 
such cleanings during a 12-month period; and 
‘‘(C) not described in subparagraph (A) or 
(B), payment may be made under this part only 
at such frequencies and under such cir-
cumstances determined appropriate by the Sec-
retary. 
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‘‘(4) USE OF BUNDLED PAYMENTS.—The Sec-
retary may make payment for dentures and associ-
ated professional services, and for any other dental 
and oral health services, as bundled payments as the 
Secretary determines appropriate. 
‘‘(5) LIMITATION ON JUDICIAL REVIEW.—There 
shall be no administrative or judicial review under 
section 1869 or otherwise of— 
‘‘(A) 
the 
determination 
of 
payment 
amounts under this subsection for dental and 
oral health services and under subsection (h)(6) 
or subsection (z)(4) for dentures; 
‘‘(B) the determination of what services 
are basic and major services under subpara-
graphs (A) and (B) of section 1861(lll)(3); or 
‘‘(C) the determination of the frequency 
and circumstance limitations for dental and oral 
health services under paragraph (3)(C).’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
(1) IN
GENERAL.—Section 1848(j)(3) of the 
Social Security Act (42 U.S.C. 1395w–4(j)(3)) is 
amended by inserting ‘‘(2)(II),’’ before ‘‘(3)’’. 
(2) 
EXCLUSION
FROM
MIPS.—Section 
1848(q)(1)(C)(ii) of the Social Security Act (42 
U.S.C. 1395w–4(q)(1)(C)(ii)) is amended— 
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(A) in subclause (II), by striking ‘‘or’’ at 
the end; 
(B) in subclause (III), by striking the pe-
riod at the end and inserting ‘‘; or’’; and 
(C) by adding at the end the following new 
subclause: 
‘‘(IV) with respect to 2028 and 
each subsequent year, is a doctor of 
dental surgery or of dental medicine 
(as described in section 1861(r)(2)) or 
is an oral health professional (as de-
fined in section 1861(lll)(4)).’’. 
(3) INCLUSION
OF
ORAL
HEALTH
PROFES-
SIONALS
AS
CERTAIN
PRACTITIONERS.—Section 
1842(b)(18)(C) of the Social Security Act (42 
U.S.C. 1395u(b)(18)(C)) is amended by adding at 
the end the following new clause: 
‘‘(vii) With respect to 2028 and each subse-
quent year, an oral health professional (as defined in 
section 1861(lll)(4)).’’. 
(e) DENTURES.— 
(1) IN
GENERAL.—Section 1861(s)(8) of the 
Social Security Act (42 U.S.C. 1395x(s)(8)) is 
amended— 
(A) by striking ‘‘(other than dental)’’; and 
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(B) by inserting ‘‘and excluding dental, ex-
cept for a full or partial set of dentures (as de-
scribed in section 1834(h)(6)) furnished on or 
after January 1, 2028’’ after ‘‘colostomy care’’. 
(2) SPECIAL PAYMENT RULES.— 
(A) LIMITATIONS.—Section 1834(h) of the 
Social Security Act (42 U.S.C. 1395m(h)) is 
amended by adding at the end the following 
new paragraph: 
‘‘(6) SPECIAL
PAYMENT
RULE
FOR
DEN-
TURES.—Payment may be made under this part 
with respect to an individual for dentures— 
‘‘(A) not more than once during any 5-year 
period (except in the case that a doctor de-
scribed in section 1861(lll)(1)(A) determines 
such dentures do not fit the individual); and 
‘‘(B) only to the extent that such dentures 
are furnished pursuant to a written order of 
such a doctor or professional.’’. 
(B) APPLICATION OF COMPETITIVE ACQUI-
SITION.— 
(i) 
IN
GENERAL.—Section 
1834(h)(1)(H) of the Social Security Act 
(42 U.S.C. 1395m(h)(1)(H)) is amended— 
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(I) in the subparagraph heading, 
by inserting ‘‘, 
DENTURES’’ after 
‘‘ORTHOTICS’’; 
(II) by inserting ‘‘, of dentures 
described in paragraph (2)(D) of such 
section,’’ after ‘‘2011,’’; and 
(III) in clause (i), by inserting ‘‘, 
such dentures’’ after ‘‘orthotics’’. 
(ii) CONFORMING AMENDMENT.—Sec-
tion 1847(a)(2) of the Social Security Act 
(42 U.S.C. 1395w–3(a)(2)) is amended by 
adding at the end the following new sub-
paragraph: 
‘‘(D) DENTURES.—Dentures described in 
section 1861(s)(8) for which payment would 
otherwise be made under section 1834(h).’’. 
(iii) EXEMPTION OF CERTAIN ITEMS 
FROM
COMPETITIVE
ACQUISITION.—Sec-
tion 1847(a)(7) of the Social Security Act 
(42 U.S.C. 1395w–3(a)(7)) is amended by 
adding at the end the following new sub-
paragraph: 
‘‘(C) CERTAIN
DENTURES.—Those items 
and services described in paragraph (2)(D) if 
furnished by a physician or other practitioner 
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