‘‘(A) be an advanced practice nurse (such 
as a clinical nurse specialist or nurse practi-
tioner), a clinical social worker, a pharmacist, 
or student of psychology who is pursuing a doc-
torate or other advanced degree approved by 
the Secretary in geriatrics, long-term care, 
geropsychology, or chronic care management in 
an accredited health professions school that is 
approved by the Secretary; and 
‘‘(B) submit to the Secretary an applica-
tion at such time, in such manner, and con-
taining such information as the Secretary may 
require. 
‘‘(3) CONDITION OF AWARD.—As a condition of 
receiving an award under this subsection, an indi-
vidual shall agree that, following completion of the 
award period, the individual will teach or practice in 
the field of geriatrics, long-term care, or chronic 
care management for a minimum of 5 years under 
guidelines set by the Secretary. 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, $10,000,000 for the period of fiscal 
years 2011 through 2013.’’. 
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SEC. 105. NATIONAL CENTER FOR HEALTH WORKFORCE 
ANALYSIS. 
Part E of Title VII of the Public Health Service Act 
(42 U.S.C. 294n et seq.) is amended by adding at the end 
the following: 
‘‘Subpart 3—National Center for Health Workforce 
Analysis 
‘‘SEC. 774. ACTIVITIES OF THE NATIONAL CENTER FOR 
HEALTH WORKFORCE ANALYSIS. 
‘‘In addition to any activities being carried out at the 
National Center for Health Workforce Analysis of the 
Health Resources and Services Administration as of the 
day before the date of enactment of the Retooling the 
Health Care Workforce for an Aging America Act of 2009, 
the head of such Center shall analyze— 
‘‘(1) current and projected needs for health and 
long-term care workforce demand and supply, and 
training and education needs specific to older adults 
and adults with functional limitations; 
‘‘(2) turnover and retention for professionals 
and paraprofessionals in these fields, including ad-
ministrators, medical directors and direct care staff 
of nursing homes, assisted living facilities and home 
and community-based settings, or any other setting 
or provider the Secretary determines appropriate; 
and 
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‘‘(3) diversity of racial and ethnic minority 
groups represented by professionals and paraprofes-
sionals in these fields. 
‘‘SEC. 775. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There is authorized to be appropriated to the Na-
tional Center for Workforce Analysis to carry out this sub-
part $6,000,000 for the period of fiscal years 2011 
through 2013.’’. 
Subtitle B—Improved Nursing 
Services 
SEC. 121. COMPREHENSIVE GERIATRIC EDUCATION NURS-
ING GRANT PROGRAM. 
Section 855 of the Public Health Service Act (42 
U.S.C. 298) is amended— 
(1) in subsection (b)— 
(A) in paragraph (3), by striking ‘‘or’’; 
(B) in paragraph (4), by striking the pe-
riod and inserting ‘‘; or’’; and 
(C) by inserting after paragraph (4) the 
following: 
‘‘(5) establish Federal traineeships to individ-
uals who are preparing for advanced degrees in geri-
atric nursing, long-term care, and gero-psychiatric 
nursing.’’; and 
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(2) in subsection (e), by inserting before the pe-
riod the following: ‘‘, $12,000,000 for each of fiscal 
years 2011 through 2013 to provide assistance 
under this section to support additional training for 
nurses who care for the elderly and individuals with 
disabilities and for the development and dissemina-
tion of curricula relating to geriatric nursing care, 
the training of nursing faculty in geriatrics, and the 
provision of continuing education for nurses prac-
ticing in geriatrics, and $25,000,000 for each of fis-
cal years 2011 through 2013 to provide assistance 
under 
this 
section 
to 
support 
the 
Federal 
traineeships established under subsection (b)(5)’’. 
TITLE II—AMENDMENTS TO THE 
WORKFORCE 
INVESTMENT 
ACT OF 1998 
SEC. 201. CORE SERVICES. 
Section 134(d)(2)(E)(iii) of the Workforce Invest-
ment Act of 1998 (29 U.S.C. 2864(d)(2)(E)(iii)) is 
amended to read as follows: 
‘‘(iii) information relating to local oc-
cupations in demand, including health care 
and long-term care occupations, and the 
earnings and skill requirements for such 
local occupations;’’. 
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SEC. 202. INDIVIDUAL TRAINING ACCOUNTS. 
Section 134(d)(4)(G)(iii) of the Workforce Invest-
ment Act of 1998 (29 U.S.C. 2864(d)(4)(G)(iii)) is 
amended to read as follows: 
‘‘(iii) LINKAGE
TO
OCCUPATIONS
IN 
DEMAND.—Training 
services 
provided 
under this paragraph shall be directly 
linked to occupations, including health care 
and long-term care occupations, that are in 
demand in the local area, or in another 
area to which an adult or dislocated work-
er receiving such services is willing to relo-
cate, except that a local board may ap-
prove training services for occupations de-
termined by the local board to be in sectors 
of the economy that have a high potential 
for sustained demand or growth in the 
local area. In making determinations of de-
mand or potential demand or growth under 
this clause, a local board shall consult local 
and State health agencies, employers, and 
other organizations that the local board de-
termines to be appropriate.’’. 
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SEC. 203. COLLABORATION BETWEEN STATE BOARDS AND 
THE VETERANS AGENCIES OF THE STATES. 
Section 112(b) of the Workforce Investment Act of 
1998 (29 U.S.C. 2822(b)) is amended— 
(1) in paragraph (17), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (18), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(19) a description of how the State board will 
collaborate with the veterans agency of the State, in-
cluding entering into a memorandum of under-
standing with the veterans agency of the State speci-
fying— 
‘‘(A) the manner in which the State board 
and the veterans agency of the State will pro-
vide information on health care workforce em-
ployment and training opportunities available to 
individuals, including veterans who are receiving 
core services described in section 134(d)(2) at 
a one-stop center and are receiving assistance 
from the Veterans’ Employment and Training 
Service of the Department of Labor; and 
‘‘(B) the manner in which the State board 
and the veterans agency of the State will obtain 
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and provide information to one-stop operators 
in the State, for distribution through one-stop 
centers, about training, internship, and employ-
ment opportunities in geriatrics, gerontology, 
and long-term care, including, as available, op-
portunities at geriatric research, education and 
clinical centers operated by the Department of 
Veterans Affairs.’’. 
SEC. 204. COLLABORATION BETWEEN DEPARTMENT OF 
LABOR AND DEPARTMENT OF VETERANS AF-
FAIRS. 
The Secretary of Labor, acting through the Assistant 
Secretary for Veterans’ Employment and Training, and 
the Secretary of Veterans Affairs, shall develop memo-
randa of understanding outlining how veterans seeking 
employment information through the Local Veterans’ Em-
ployment Representative Program and the Transition As-
sistance Program will be provided with information about 
training, internship, and employment opportunities in ger-
iatrics, gerontology, and long-term care, including oppor-
tunities at geriatric research, education and clinical cen-
ters operated by the Department of Veterans Affairs. 
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SEC. 205. TRAINING OPPORTUNITIES FOR DIRECT CARE 
WORKERS. 
(a) IN GENERAL.—Section 171 of the Workforce In-
vestment Act of 1998 (29 U.S.C. 2916) is amended by 
adding at the end the following new subsection: 
‘‘(f) TRAINING OPPORTUNITIES FOR DIRECT CARE 
WORKERS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants to eligible entities to enable such entities to 
provide new training opportunities for direct care 
workers (including certified nursing assistants, home 
health aides, and personal or home care aides) who 
are employed in long-term care settings such as 
nursing homes (as defined in section 1908(e)(1) of 
the Social Security Act (42 U.S.C. 1396g(e)(1)), as-
sisted living facilities, home care settings, and any 
other setting the Secretary determines to be appro-
priate. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under paragraph (1), an entity shall— 
‘‘(A) be an institution of higher education 
(as defined in section 102 of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1002)) that— 
‘‘(i) is accredited by a nationally rec-
ognized accrediting agency or association 
listed under section 101(c) of the Higher 
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Education 
Act 
of 
1965 
(20 
U.S.C. 
1001(c)); and 
‘‘(ii) has established a public-private 
educational partnership with a nursing 
home, home health agency, or other long- 
term care provider; and 
‘‘(B) submit to the Secretary an applica-
tion at such time, in such manner, and con-
taining such information as the Secretary may 
require. 
‘‘(3) PRIORITY.—In making grants to eligible 
entities, the Secretary shall give priority to entities 
that demonstrate that the entities will coordinate ac-
tivities with one-stop operators and one-stop part-
ners at local one-stop centers referred to in section 
134(c). 
‘‘(4) USE OF FUNDS.—An eligible entity shall 
use amounts awarded under a grant under para-
graph (1) to provide assistance to eligible individuals 
to offset the cost of tuition and required fees for en-
rollment in academic programs provided by such en-
tity, including— 
‘‘(A) the provision of stipends to such indi-
viduals for a period of not to exceed 2 years; 
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‘‘(B) the lowering of fees assessed with re-
spect to eligible individuals who are enrolled in 
programs leading to a licensed practical nursing 
degree, a registered nursing degree, or any 
other advanced nursing degree; and 
‘‘(C) the lowering of fees assessed with re-
spect to eligible individuals who are enrolled in 
courses aimed at improving direct care skills for 
the treatment of specialized conditions that are 
common in the long-term care sector, such as 
wound care, brain trauma, immobility, inconti-
nence, functional impairment, and dementia. 
‘‘(5) ELIGIBLE INDIVIDUAL.— 
‘‘(A) ELIGIBILITY.—To be eligible for as-
sistance under paragraph (4), an individual 
shall be enrolled in courses provided by a grant-
ee under this subsection and maintain satisfac-
tory academic progress in such courses. 
‘‘(B) CONDITION
OF
ASSISTANCE.—As a 
condition of receiving assistance under para-
graph (4), an individual shall agree that, fol-
lowing completion of the assistance period, the 
individual will work in the field of geriatrics, 
long-term care, or chronic care management for 
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a minimum of 2 years under guidelines set by 
the Secretary. 
‘‘(6) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection, $10,000,000 for the period of fiscal 
years 2011 through 2013.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 174(b)(1) of the Workforce Invest-
ment Act of 1998 (29 U.S.C. 2919(b)(1)) is amend-
ed by inserting ‘‘and except as provided in section 
171(f),’’ after ‘‘paragraph (2),’’. 
(2) Section 174(b)(2)(B)(ii) of the Workforce 
Investment Act (29 U.S.C. (b)(2)(B)(ii)) is amended 
to read as follows: 
‘‘(ii) except as provided in section 
171(f), for each of the fiscal years 2000 
through 2003, reserve not less than 45 
percent for carrying out section 171;’’. 
TITLE 
III—AMENDMENTS 
TO 
THE OLDER AMERICANS ACT 
OF 1965 
SEC. 301. FAMILY CAREGIVER TRAINING. 
(a) IN GENERAL.—Part E of title III of the Older 
Americans Act of 1965 (42 U.S.C. 3030s et seq.) is 
amended by adding at the end the following: 
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‘‘SEC. 375. FAMILY CAREGIVER TRAINING. 
‘‘(a) DEVELOPMENT OF MATERIALS.— 
‘‘(1) IN
GENERAL.—The Assistant Secretary 
shall, directly or by contract, develop family care-
giver training materials, working with an advisory 
committee, comprised of experts on matters related 
to family caregivers, including researchers, clini-
cians, representatives of nursing homes and State 
Long-Term Care Ombudsman programs, representa-
tives of community colleges and vocational schools, 
family caregivers, and representatives of organiza-
tions for family caregivers. The materials shall be 
suitable to provide online training for family care-
givers, and grandparents or older individuals who 
are relative caregivers, in providing personal care to 
care recipients. 
‘‘(2) CONTENT.—The materials shall include 
written materials and videos, designed to be easily 
downloaded, that demonstrate techniques for key 
personal care activities. The materials shall dem-
onstrate ways of safely lifting and transferring indi-
viduals with disabilities, means of preventing falls, 
and other means of providing assistance with activi-
ties of daily living, and instrumental activities of 
daily living such as medication management. The 
materials shall provide information on behavioral 
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management and communication techniques for care 
recipients that are individuals with Alzheimer’s dis-
ease or a related disorder with neurological and or-
ganic brain dysfunction. 
‘‘(b) DISTRIBUTION OF MATERIALS.—The Assistant 
Secretary shall make the training described in subsection 
(a)(1) available online, free of cost to users. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) CARE RECIPIENT.—The term ‘care recipi-
ent’— 
‘‘(A) used with respect to a family care-
giver, means an older individual or an indi-
vidual with Alzheimer’s disease or a related dis-
order with neurological and organic brain dys-
function; and 
‘‘(B) used with respect to a grandparent or 
older individual who is a relative caregiver, 
means an individual with a disability. 
‘‘(2) COMMUNITY COLLEGE.—The term ‘com-
munity college’ means an institution of higher edu-
cation (as defined in section 101(a) of the Higher 
Education Act of 1965 (20 U.S.C. 1001(a))) that 
offers a 2-year program of study. 
‘‘(3) INDIVIDUAL
WITH
A
DISABILITY.—The 
term ‘individual with a disability’ means an indi-
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vidual with a disability, within the meaning of sec-
tion 372(a)(1). 
‘‘(4) VOCATIONAL
SCHOOL.—The term ‘voca-
tional school’ means an area career and technical 
education school, as defined in section 3 of the Carl 
D. Perkins Career and Technical Education Act of 
2006 (20 U.S.C. 2302).’’. 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 
303(e) of the Older Americans Act of 1965 (42 U.S.C. 
3023(e)) is amended— 
(1) in paragraph (2), by inserting ‘‘, other than 
section 375’’ after ‘‘part E’’; and 
(2) by adding at the end the following: 
‘‘(4) There is authorized to be appropriated to carry 
out section 375, $5,000,000 for the period of fiscal years 
2011 through 2013.’’. 
SEC. 
302. 
REDESIGNATIONS 
IN 
PROVISIONS 
FOR 
MULTIGENERATIONAL AND CIVIC ENGAGE-
MENT ACTIVITIES. 
(a) REDESIGNATIONS.—Section 417 of the Older 
Americans Act of 1965 is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by redesignating 
subparagraphs (A) and (B) as clauses (i) and 
(ii), respectively, and indenting accordingly; 
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(B) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively, 
and indenting accordingly; and 
(C) by inserting all that precedes ‘‘The As-
sistant Secretary’’ and inserting the following: 
‘‘(a) DEMONSTRATION, SUPPORT, AND RESEARCH 
PROJECTS.— 
‘‘(1) GRANTS AND CONTRACTS.—’’; 
(2) in subsection (b)— 
(A) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively, 
and indenting accordingly; and 
(B) by inserting all that precedes ‘‘An eli-
gible’’ and inserting the following: 
‘‘(2) USE OF FUNDS.—’’; 
(3) in subsection (c)— 
(A) 
by 
redesignating 
paragraphs 
(1) 
through (4) as subparagraphs (A) through (D), 
respectively, and indenting accordingly; and 
(B) by striking all that precedes ‘‘In 
awarding’’ and inserting the following: 
‘‘(3) PREFERENCE.—’’; 
(4) in subsection (d), by striking all that pre-
cedes ‘‘To be’’ and inserting the following: 
‘‘(4) APPLICATION.—’’; 
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(5) in subsection (e)— 
(A) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively, 
and indenting accordingly; and 
(B) by inserting all that precedes ‘‘Organi-
zations’’ and inserting the following: 
‘‘(5) ELIGIBLE ORGANIZATIONS.—’’; 
(6) in subsection (f)— 
(A) in paragraph (1), by redesignating 
subparagraphs (A), (B), and (C) as clauses (i), 
(ii), and (iii), respectively, and indenting ac-
cordingly; 
(B) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively, 
and indenting accordingly; and 
(C) by inserting all that precedes subpara-
graph (A) (as redesignated by subparagraph 
(B) of this paragraph) and inserting the fol-
lowing: 
‘‘(6) LOCAL EVALUATION AND REPORT.—’’; 
(7) in subsection (g)— 
(A) 
by 
redesignating 
paragraphs 
(1) 
through (8) as subparagraphs (A) through (H), 
respectively, and indenting accordingly; and 
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(B) by inserting all that precedes ‘‘Not 
later’’ and inserting the following: 
‘‘(7) REPORT TO CONGRESS.—’’; and 
(8) in subsection (h)— 
(A) in paragraph (2)— 
(i) in subparagraph (B), by redesig-
nating clauses (i) and (ii) as subclauses (I) 
and (II), respectively, and indenting ac-
cordingly; and 
(ii) by redesignating subparagraphs 
(A) and (B) as clauses (i) and (ii), respec-
tively, and indenting accordingly; 
(B) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively, 
and indenting accordingly; and 
(C) by inserting all that precedes ‘‘As 
used’’ and inserting the following: 
‘‘(8) DEFINITIONS.—’’. 
(b) CONFORMING AMENDMENTS.—Section 417 of the 
Older Americans Act of 1965 is amended— 
(1) by striking ‘‘this section’’ each place it ap-
pears and inserting ‘‘this subsection’’; 
(2) by striking ‘‘subsection (a)(1)’’ each place it 
appears and inserting ‘‘paragraph (1)(A)’’; 
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(3) by striking ‘‘subsection (a)(2)’’ each place it 
appears and inserting ‘‘paragraph (1)(B)’’; 
(4) except as provided in paragraphs (2) and 
(3), by striking ‘‘subsection (a)’’ each place it ap-
pears and inserting ‘‘paragraph (1)’’; and 
(5) in subsection (a) (as redesignated by sub-
section (a) of this section)— 
(A) in paragraph (2)(B), by striking ‘‘sub-
section (f)’’ and inserting ‘‘paragraph (6)’’; and 
(B) in paragraph (7)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘subsection (f)(2)’’ 
and inserting ‘‘paragraph (6)(B)’’; and 
(ii) in subparagraph (G), by striking 
‘‘paragraph (1)’’ and inserting ‘‘subpara-
graph (A)’’. 
SEC. 303. NATIONAL RESOURCE CENTER ON VOLUNTEERS, 
STUDENTS, AND SENIORS. 
Section 417 of the Older Americans Act of 1965 (42 
U.S.C. 3032f), as amended by section 302, is further 
amended by adding at the end the following: 
‘‘(b) NATIONAL RESOURCE CENTER
ON VOLUN-
TEERS, STUDENTS, AND SENIORS.— 
‘‘(1) IN GENERAL.— 
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‘‘(A) GRANT.—The Assistant Secretary 
shall award a grant for the establishment and 
operation of a National Resource Center on 
Volunteers, Students, and Seniors (referred to 
in this subsection as the ‘Center’). The Center 
shall— 
‘‘(i) promote partnerships between en-
tities in the aging network, and institu-
tions of higher education and secondary 
schools, in order to expand the capacity of 
individuals to serve in, and in order to at-
tract new leaders for and professionals 
into, the aging network; and 
‘‘(ii) encourage projects that involve 
underserved communities, including rural 
communities and racial and ethnic minor-
ity communities. 
‘‘(B) PARTNERSHIPS.—Such partnerships 
may involve— 
‘‘(i) State agencies, area agencies on 
aging, or other local government agencies, 
Aging and Disability Resource Centers, 
tribal organizations, nonprofit health or so-
cial service organizations, community clin-
ics, adult day care centers, senior housing 
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providers, and other providers that provide 
direct services to older individuals and that 
are determined to be appropriate by the 
Assistant Secretary; and 
‘‘(ii) local institutions of higher edu-
cation and secondary schools. 
‘‘(2) CENTER.—The Center shall use the funds 
made available through the grant to— 
‘‘(A) identify and disseminate information 
(including information about best practices) 
concerning how entities described in paragraph 
(1)(B) can establish partnerships in a manner 
that provides volunteers and students in nurs-
ing, social work, gerontology, psychology, dental 
hygiene, music and recreational therapy, nutri-
tion, and other disciplines identified by the As-
sistant Secretary with opportunities, approved 
by the Assistant Secretary, to gain experience 
working with older individuals, including older 
individuals with dementia or cognitive impair-
ment, receiving services under this Act; 
‘‘(B) develop and implement a model dem-
onstration grant program to— 
‘‘(i) promote new partnerships be-
tween the entities described in paragraph 
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(1)(B) and incorporate activities of the 
partnerships into established curricula of 
institutions of higher education and sec-
ondary schools; and 
‘‘(ii) promote and sponsor internship 
programs, career development seminars, 
and continuing education and lifelong 
learning programs; and 
‘‘(C) develop and implement a model ca-
reer ladder program that will disseminate infor-
mation on best practices designed to enable 
mid-level professionals to advance in the field of 
aging. 
‘‘(3) DEFINITION.—In this subsection, the term 
‘secondary school’ has the meaning given the term in 
section 9101 of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 8801). 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection $3,000,000 for fiscal year 2011, 
$3,500,000 for fiscal year 2012, and $4,000,000 for 
fiscal year 2013.’’. 
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TITLE IV—AMENDMENTS TO THE 
SOCIAL SECURITY ACT 
SEC. 401. DEMONSTRATION PROGRAM FOR PERSONAL OR 
HOME CARE AIDES, NURSE AIDES, AND HOME 
HEALTH AIDES IN LONG-TERM CARE SET-
TINGS. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—The Secretary shall establish 
a demonstration program (in this section referred to 
as the ‘‘program’’) to make grants to participating 
States to develop core training competencies for eli-
gible personal or home care aides and additional 
training content for nurse aides and home health 
aides to supplement training for nurse aides and 
home health aides that is required under Federal 
law or regulation, and to evaluate the effectiveness 
of such competencies and additional training con-
tent. Such program shall evaluate the efficacy of— 
(A) the core training competencies devel-
oped under subsection (b)(2)(A); 
(B) the additional training content devel-
oped under subsection (b)(2)(B); and 
(C) the method of implementation of such 
core training competencies and additional train-
ing content against a ‘‘control’’ group being 
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trained under a participating State’s existing 
training protocols. 
(2) DURATION.—The program shall be con-
ducted for not less than 4 years. 
(b) ESTABLISHMENT OF EXPERT PANEL.— 
(1) IN
GENERAL.—Not later than 120 days 
after the date of enactment of this Act, the Sec-
retary shall establish a panel of long-term care work-
force experts (in this section referred to as the ‘‘ex-
pert panel’’). 
(2) DUTIES.—The expert panel shall carry out 
the following duties: 
(A)(i) Subject to clause (ii), developing 
core training competencies for personal or home 
care aides, including such competencies with re-
spect to the following areas: 
(I) The role of the personal or home 
care aide (including differences between a 
personal or home care aide employed by an 
agency and a personal or home care aide 
employed directly by the health care con-
sumer or an independent provider). 
(II) Consumer rights, ethics, and con-
fidentiality (including the role of proxy de-
cision-makers in the case where a health 
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care consumer has impaired decision-mak-
ing capacity). 
(III) Communication, cultural and lin-
guistic competence and sensitivity, problem 
solving, behavior management, and rela-
tionship skills. 
(IV) Personal care skills. 
(V) Health care support. 
(VI) Nutritional support. 
(VII) Infection control. 
(VIII) Safety and emergency training. 
(IX) Training specific to an individual 
consumer’s needs (including older individ-
uals, younger individuals with disabilities, 
individuals with developmental disabilities, 
individuals with dementia, and individuals 
with mental and behavioral health needs). 
(X) Self-Care. 
(ii) For purposes of the program, the core 
training competencies developed under clause 
(i) shall only apply with respect to newly hired 
personal or home care aides. 
(B)(i) Subject to clause (ii), developing ad-
ditional training content for home health aides 
and nurse aides which is not required under 
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Federal law as of the date of enactment of this 
Act, including such content with respect to the 
following areas: 
(I) Culturally and linguistically com-
petent practice. 
(II) Standardized direct care worker 
communication protocols (such as Situa-
tion, Background, Assessment, and Rec-
ommendation communication tools). 
(III) Palliative and end-of-life care. 
(IV) Injury prevention. 
(V) Wound and decubitus care. 
(VI) Medication management, adher-
ence, and safe disposal. 
(VII) Mental and behavioral health. 
(VIII) Additional aspects of dementia 
care training (such as understanding de-
mentia and Alzheimer’s disease, dealing 
with challenging behavior, developing com-
munication skills, working with family 
caregivers, and ensuring physical health 
and safety). 
(IX) Prevention and reporting of 
abuse and caregiver burnout. 
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(ii) For purposes of the program, the addi-
tional training content developed under clause 
(i) shall only apply with respect to newly hired 
home health aides and nurse aides. 
(C)(i) Subject to clause (ii), making rec-
ommendations regarding how training shall be 
provided under the program, including rec-
ommendations with respect to the following: 
(I) The length of the training. 
(II) The appropriate trainer to stu-
dent ratio. 
(III) The amount of instruction time 
spent in the classroom as compared to on- 
site in the home or a facility. 
(IV) Trainer qualifications. 
(V) Content for a ‘‘hands-on’’ and 
written certification exam. 
(VI) Continuing education require-
ments. 
(VII) Ways to integrate the core 
training competencies developed for per-
sonal and home care aides under subpara-
graph (A) with the additional training con-
tent developed for home health aides and 
nurse aides under subparagraph (B). 
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(ii) The recommendations under clause (i) 
shall ensure that the number of hours of train-
ing provided under the program are not less 
than the number of hours of training required 
under any applicable State or Federal law or 
regulation. 
(3) MEMBERSHIP.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the expert panel shall be composed 
of 11 members appointed by the Secretary from 
among leading experts in the long-term care 
field, including representatives of— 
(i) personal or home care agencies; 
(ii) home health care agencies; 
(iii) nursing homes and residential 
care facilities; 
(iv) the disability community (includ-
ing the mental retardation and develop-
mental disability communities); 
(v) the nursing community; 
(vi) national advocacy organizations 
and unions that represent direct care 
workers; 
(vii) older individuals and family care-
givers; 
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(viii) State Medicaid waiver program 
officials; 
(ix) curriculum developers with exper-
tise in adult learning; 
(x) researchers on direct care workers 
and the long-term care workforce; and 
(xi) geriatric pharmacists. 
(B) INCLUSION OF REPRESENTATIVES OF 
CERTAIN INDIVIDUALS.—Not less than 2 of the 
11 members appointed by the Secretary under 
subparagraph (A) shall represent the interests 
of individuals who rely on long-term care serv-
ices, including the interests of those individuals 
described in clause (vii) of such subparagraph. 
(4) REPORT.—Not later than 1 year after the 
date of enactment of this Act, the expert panel shall 
submit to the Secretary a report containing— 
(A) the core training competencies devel-
oped under paragraph (2)(A); 
(B) the additional training content devel-
oped under paragraph (2)(B); 
(C) any recommendations of the expert 
panel under paragraph (2)(C); and 
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(D) recommendations for such legislation 
or administrative action as the expert panel de-
termines appropriate. 
(5) TERMINATION.—The expert panel shall ter-
minate 180 days after it submits the report under 
paragraph (4). 
(c) APPLICATION AND SELECTION CRITERIA.— 
(1) IN GENERAL.— 
(A) SOLICITATION.—Not later than 2 
years after the date of enactment of this Act, 
the Secretary shall issue a proposal soliciting 
States to voluntarily participate in the program. 
(B) AGREEMENTS.—The Secretary shall 
enter into agreements with not more than 4 
States to conduct the program in such States. 
(C) REQUIREMENTS
FOR
STATES.—An 
agreement entered into under subparagraph (B) 
shall require that a participating State— 
(i) use grant funds made available to 
the State under the program to recruit eli-
gible health and long-term care providers 
to— 
(I) participate in the program; 
and 
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(II) implement the core training 
competencies developed under sub-
section (b)(2)(A) and the additional 
training content developed under sub-
section (b)(2)(B); and 
(ii) develop written materials and pro-
tocols for such core training competencies 
and such additional training content, in-
cluding the development of a certification 
test for personal or home care aides who 
have completed such training competencies 
and, if applicable, additional training con-
tent. 
(D) CONSULTATION AND COLLABORATION 
WITH
COMMUNITY
AND
VOCATIONAL
COL-
LEGES.—The Secretary shall encourage partici-
pating States to consult with community and 
vocational colleges regarding the development of 
curricula to implement the program, which may 
include consideration of such colleges as part-
ners in such implementation. 
(2) APPLICATION AND ELIGIBILITY.—A State 
seeking to participate in the program shall— 
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(A) submit an application to the Secretary 
containing such information and at such time 
as the Secretary may specify; 
(B) meet the selection criteria established 
under paragraph (3); and 
(C) meet such additional criteria as the 
Secretary may specify. 
(3) SELECTION CRITERIA.—In selecting States 
to participate in the program, the Secretary shall es-
tablish criteria to ensure— 
(A) geographic and demographic diversity; 
(B) that participating States offer medical 
assistance for personal care services under the 
State Medicaid plan; 
(C) that the existing training standards for 
personal or home care aides, home health aides, 
and nurse aides in each participating State— 
(i) are different from such standards 
in the other participating States; and 
(ii) are different from the core train-
ing competencies developed under sub-
section (b)(2)(A) and the additional train-
ing content developed under subsection 
(b)(2)(B); 
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(D) that participating States do not reduce 
the number of hours of training required under 
applicable State law or regulation after being 
selected to participate in the program; and 
(E) that States recruit a minimum number 
of eligible health and long-term care providers 
to participate in the program. 
(4) TECHNICAL
ASSISTANCE.—The Secretary 
shall provide technical assistance to States in devel-
oping written materials and protocols for such core 
training competencies and such additional training 
content under paragraph (1)(C)(ii). 
(d) EVALUATION AND REPORT.— 
(1) EVALUATION.—The Secretary shall develop 
an experimental or control group testing protocol in 
consultation with an independent evaluation con-
tractor selected by the Secretary. Such contractor 
shall evaluate— 
(A) the impact of core training com-
petencies developed under subsection (b)(2)(A), 
including curricula developed to implement such 
core training competencies, for personal or 
home care aides within each participating State 
on job satisfaction, mastery of job skills, bene-
ficiary and family caregiver satisfaction with 
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services, and additional measures determined by 
the Secretary in consultation with the expert 
panel established under subsection (b); 
(B) the impact of incorporating the addi-
tional training content developed under sub-
section (b)(2)(B) into existing training stand-
ards for home health aides and certified nurse 
aides within each participating State; 
(C) the impact of providing such core 
training competencies and additional training 
content on the existing training infrastructure 
and resources of States; 
(D) whether the minimum number of 
hours of initial training required for nurse aides 
under 
sections 
1819(f)(2)(A)(i)(II) 
and 
1919(f)(2)(A)(i)(II) of the Social Security Act 
(42 
U.S.C. 
1395i–3(f)(2)(A)(i)(II); 
1396r(f)(2)(A)(i)(II)) should be increased; and 
(E) whether a minimum number of hours 
of initial training should be required for per-
sonal or home care aides and, if so, what min-
imum number of hours should be required. 
(2) REPORT.—Not later than 1 year after the 
completion of the program, the Secretary shall sub-
mit to Congress a report containing the results of 
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the evaluations conducted under paragraph (1), to-
gether with such recommendations for legislation or 
administrative action as the Secretary determines 
appropriate. 
(e) FUNDING.—Out of any funds in the Treasury not 
otherwise appropriated, there are appropriated to the Sec-
retary to carry out the program under this section for the 
period of fiscal years 2011 through 2016, $14,000,000. 
(f) DEFINITIONS.—In this section: 
(1) ELIGIBLE HEALTH AND LONG-TERM CARE 
PROVIDER.—The term ‘‘eligible health and long-term 
care provider’’ means a personal or home care agen-
cy (including personal or home care public authori-
ties), a nursing home, a home health agency (as de-
fined in section 1861(o)) of the Social Security Act 
(42 U.S.C. 1395x(o)), or any other health care pro-
vider the Secretary determines appropriate which— 
(A) is licensed or authorized to provide 
services in a participating State; and 
(B) receives payment for services under 
title XVIII or XIX of the Social Security Act. 
(2) HOME
HEALTH
AIDE.—The term ‘‘home 
health aide’’ has the meaning given such term in 
section 1891(a)(3)(E) of the Social Security Act (42 
U.S.C. 1395bbb(a)(3)(E)). 
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(3) NURSE AIDE.—The term ‘‘nurse aide’’ has 
the 
meaning 
given 
such 
term 
in 
section 
1819(b)(5)(F) of the Social Security Act (42 U.S.C. 
1395i–3(b)(5)(F)). 
(4) PERSONAL
CARE
SERVICES.—The term 
‘‘personal care services’’ has the meaning given such 
term for purposes of title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.). 
(5) PERSONAL
OR
HOME
CARE
AIDE.—The 
term ‘‘personal or home care aide’’ means an indi-
vidual who helps individuals who are elderly, dis-
abled, ill, or mentally disabled (including an indi-
vidual with Alzheimer’s disease or other dementia) 
to live in their own home or a residential care facil-
ity (such as a nursing home, assisted living facility, 
or any other facility the Secretary determines appro-
priate) by providing routine personal care services 
and other appropriate services to the individual. 
(6) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
SEC. 402. MEDICARE FAMILY CAREGIVER INFORMATION 
AND REFERRAL. 
State health insurance assistance programs, the Ad-
ministrator of the Centers for Medicare & Medicaid Serv-
ices, and the Assistant Secretary of the Administration on 
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Aging shall, in collaboration with each other, directly or 
by contract, develop practical, easy-to-understand infor-
mation and referral protocols for health care providers, so-
cial workers, and other appropriate individuals to provide 
to family caregivers of Medicare beneficiaries either on ad-
mission to or discharge from a hospital (including a dis-
charge from a hospital emergency room or a hospital out-
patient department which has furnished a surgical service) 
or a post-acute care setting (including a skilled nursing 
facility (as defined in section 1819(a) of the Social Secu-
rity Act (42 U.S.C. 1395i–3(a)), a comprehensive rehabili-
tation facility (as defined in section 1861(cc)(2) of such 
Act (42 U.S.C. 1395x(cc)(2)) or a rehabilitation agency, 
a provider of long-term care services, and a home health 
agency (as defined in section 1861(o) of such Act (42 
U.S.C. 1395x(o)). Information developed under the pre-
ceding sentence shall— 
(1) include information on national, State, and 
community-based resources for seniors, individuals 
with disabilities and their caregivers, which shall be 
updated on a semi-annual basis (or as frequently as 
practicable); 
(2) be disseminated by health care providers, 
social workers, and other appropriate individuals as 
printed materials (including materials in Spanish 
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and other languages (other than English) as appro-
priate); and 
(3) be made available on the Internet websites 
of State health insurance assistance programs, the 
Centers for Medicare & Medicaid Services, and the 
Administration on Aging. 
SEC. 403. MEDICAID ASSESSMENT OF FAMILY CAREGIVER 
SUPPORT NEEDS. 
(a) IN GENERAL.—Section 1915 of the Social Secu-
rity Act (42 U.S.C. 1396n) is amended— 
(1) in subsection (c)(2)— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (E), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(F) under such waiver the State may pro-
vide for an assessment of family caregiver sup-
port needs (in accordance with subsection 
(k)).’’; 
(2) in subsection (d)(2)— 
(A) in subparagraph (B), by striking 
‘‘and’’ at the end; 
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(B) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(D) under such waiver the State may pro-
vide for an assessment of family caregiver sup-
port needs (in accordance with subsection 
(k)).’’; 
(3) in subsection (i)(1)(F), by adding at the 
end the following new clause: 
‘‘(vii) Where appropriate, an assess-
ment of family caregiver support needs (in 
accordance with subsection (k)).’’; and 
(4) by adding at the end the following new sub-
section: 
‘‘(k) ASSESSMENT OF FAMILY CAREGIVER SUPPORT 
NEEDS.— 
‘‘(1) IN GENERAL.—In the case of an individual 
who is determined to be eligible for home and com-
munity-based services under a waiver under sub-
section (c) or (d) or under section 1115, under a 
State plan amendment under subsection (i), under 
an MFP demonstration project established under 
section 6071 of the Deficit Reduction Act of 2005, 
or as part of self-directed personal assistance serv-
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ices provided pursuant to a written plan of care in 
accordance with the requirements of subsection (j), 
and who is dependent upon the assistance of a fam-
ily caregiver, the State may provide for an assess-
ment of the family caregiver support needs of the in-
dividual. Such assessment shall, to the extent fea-
sible, be conducted at the same time as, or closely 
coordinated with, the determination of the eligibility 
of the individual for such services. 
‘‘(2) QUESTIONNAIRE.— 
‘‘(A) IN GENERAL.—Such assessment shall 
include asking the family caregiver of the indi-
vidual questions in order to determine whether 
they would benefit from targeted support serv-
ices (such as those services described in para-
graph (3)). 
‘‘(B) COMPLETION
ON
A
VOLUNTARY 
BASIS.—The answering of questions under sub-
paragraph (A) by a family caregiver shall be on 
a voluntary basis. 
‘‘(3) 
TARGETED
SUPPORT
SERVICES
DE-
SCRIBED.—The following targeted support services 
are described in this paragraph: 
‘‘(A) Respite care and emergency back-up 
services (including short-term help for the indi-
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vidual that gives the family caregiver a break 
from providing such care). 
‘‘(B) Individual counseling (including ad-
vice and consultation sessions to bolster emo-
tional support for the family caregiver to make 
well-informed decisions about how to cope with 
the strain of supporting the individual). 
‘‘(C) Support groups, including groups 
which provide help for family caregivers to— 
‘‘(i) locate a support group either lo-
cally or online to share experiences and re-
duce isolation; 
‘‘(ii) make well-informed decisions 
about caring for the individual; and 
‘‘(iii) reduce isolation. 
‘‘(D) Information and assistance (including 
brochures and online resources for researching 
a disease or disability or learning and managing 
a regular caregiving role, new technologies that 
can assist family caregivers, and practical as-
sistance for locating services). 
‘‘(E) Chore services (such as house clean-
ing). 
‘‘(F) Personal care (including outside 
help). 
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