dents who require publicly financed long-term serv-
ices. 
(d) APPLICATION.—To apply for a grant under this 
section, an entity shall submit an application to the Sec-
retary in such form, in such manner, and containing such 
information as the Secretary may require. At a minimum, 
each such application shall include a description of the ac-
tivities for which funds are sought and a budget for use 
of the funds. 
(e) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance to States, Indian tribes, and 
tribal organizations to develop comprehensive data collec-
tion and monitoring systems to assess the adequacy and 
stability of the State’s direct care workforce under sub-
section (b)(1). 
(f) STATE DEFINED.—For purposes of this section: 
(1) Subject to paragraph (2), the term ‘‘State’’ 
means any of the 50 States, the District of Colum-
bia, Puerto Rico, Guam, the United States Virgin 
Islands, American Samoa, and the Commonwealth of 
the Northern Mariana Islands. 
(2) The term ‘‘State’’ includes, in lieu of any 
State listed in paragraph (1), an entity designated 
by such State to apply for a grant under this sec-
tion. 
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(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section for each of fiscal years 
2012 through 2016. 
SEC. 7. DIRECT CARE WORKER RECRUITMENT, RETENTION, 
AND EDUCATION GRANT PROGRAM. 
(a) IN GENERAL.—The Secretary shall award grants 
on a competitive basis to States and other eligible entities 
for the purpose of improving the recruitment, retention, 
and education of direct care workers. 
(b) USE OF FUNDS.—A State or other eligible entity 
receiving a grant under subsection (a) shall use the grant 
to— 
(1) establish, expand, or upgrade training pro-
grams and infrastructure for direct care workers; 
(2) establish or expand recruitment and reten-
tion programs for direct care workers, including ini-
tiatives which— 
(A) improve the wages and benefits offered 
to direct care workers; and 
(B) create and implement career ladders 
for such workers; and 
(3) develop or expand programs that— 
(A) promote the role of direct care workers 
in new cost-effective models of providing serv-
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ices to persons with disabilities and to persons 
with chronic health conditions and other ex-
tended support needs; and 
(B) include approaches such as remote 
monitoring, wellness, and prevention. 
(c) DIVERSITY.—In selecting grant recipients under 
subsection (a), the Secretary shall ensure that grants are 
awarded to States or other eligible entities in a manner 
that ensures that grant funds are used to enhance the di-
rect care workforce— 
(1) in urban and rural communities; and 
(2) that serves a diverse patient population, in-
cluding with respect to— 
(A) age; 
(B) income level; 
(C) race and ethnicity; and 
(D) disability status. 
(d) GRANT PERIOD.—The Secretary— 
(1) may award grants under this section for pe-
riods of not more than 3 years; and 
(2) may extend the period of a grant under this 
section by not more than 3 years. 
(e) APPLICATION.—To apply for a grant under this 
section, an entity shall submit an application to the Sec-
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retary in such form, in such manner, and containing such 
information as the Secretary may require. 
(f) BASELINE MEASURES AND BENCHMARKS.—As a 
condition on the receipt of a grant under this section, the 
Secretary shall require each grantee to establish baseline 
measures and benchmarks (meeting such requirements as 
the Secretary may determine) in order to properly evaluate 
the impact of the work performed by the grantee through 
the grant. 
(g) SUPPLEMENT, NOT SUPPLANT.—The Secretary 
shall ensure that amounts provided to a grantee under this 
section are used to supplement and not supplant other 
Federal, State, or local public funds expended to improve 
the recruitment, retention, and education of the direct 
care workforce. 
(h) TERMINATION AUTHORITY.—The Secretary may 
terminate a grant agreement under this section for good 
cause. Such good cause shall include a determination that 
the grantee— 
(1) has misappropriated funds provided under 
this section; or 
(2) has failed to make adequate progress to-
ward accomplishing any benchmark established pur-
suant to subsection (f). 
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(i) REPORTS AND AUDITS.—As a condition on the re-
ceipt of a grant under this section, the Secretary shall re-
quire each grantee to agree— 
(1) to report to the Secretary on the activities 
carried out with the grant, including, at the request 
of the Secretary, periodic spending reports; and 
(2) to allow the Secretary to conduct periodic 
audits pertaining to funding received through the 
grant. 
(j) ELIGIBLE ENTITY.—For purposes of this section, 
the term ‘‘eligible entity’’ means— 
(1) a State or political subdivision of a State; 
or 
(2) any organization, including a labor-manage-
ment partnership, that is committed to carrying out 
the activities set forth in subsection (b), whether in 
cooperation with a State, on its own initiative, or in 
partnership with any other organization. 
SEC. 8. REPORTS BY SECRETARY. 
Not later than 3 years after the date of awarding the 
first grant under section 6 or section 7, the Secretary of 
Health and Human Services shall prepare and submit to 
the Congress a report that describes the effectiveness of 
grants awarded under such sections in achieving the pur-
poses of such grants, including the effectiveness of the 
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