IB 
Union Calendar No. 211 
116TH CONGRESS 
1ST SESSION H. R. 3398 
[Report No. 116–265] 
To provide low-income individuals with opportunities to enter and follow 
a career pathway in the health professions, to extend and expand dem-
onstration projects, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 21, 2019 
Mr. DANNY K. DAVIS of Illinois introduced the following bill; which was 
referred to the Committee on Ways and Means 
OCTOBER 29, 2019 
Additional sponsors: Mr. SABLAN, Mr. BEYER, Mr. BLUMENAUER, Mr. 
BRENDAN F. BOYLE of Pennsylvania, Ms. JUDY CHU of California, Ms. 
DELBENE, Mr. EVANS, Mr. GOMEZ, Mr. HIGGINS of New York, Mr. 
HORSFORD, Mr. KILDEE, Mr. LEWIS, Ms. MOORE, Mrs. MURPHY of 
Florida, Mr. PANETTA, Mr. PASCRELL, Ms. SEWELL of Alabama, Mr. 
SUOZZI, Ms. SA´NCHEZ, Mr. LARSON of Connecticut, Mr. SAN NICOLAS, 
Mr. SCHNEIDER, Mr. THOMPSON of California, Mr. TONKO, Ms. NOR-
TON, Mr. CARSON of Indiana, Mr. CLAY, Mr. KHANNA, Mr. RUSH, Mrs. 
WATSON COLEMAN, Ms. BLUNT ROCHESTER, and Mr. CLEAVER 
OCTOBER 29, 2019 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on June 21, 2019] 
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A BILL 
To provide low-income individuals with opportunities to enter 
and follow a career pathway in the health professions, 
to extend and expand demonstration projects, and for 
other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Pathways to Health Ca-
reers Act’’. 
SEC. 2. EXTENSION THROUGH FISCAL YEAR 2020 OF FUND-
ING FOR DEMONSTRATION PROJECTS TO AD-
DRESS HEALTH PROFESSIONS WORKFORCE 
NEEDS. 
(a) IN GENERAL.—Section 2008(c)(1) of the Social Se-
curity Act (42 U.S.C. 1397g(c)(1)) is amended by striking 
‘‘2019.’’ and inserting ‘‘2020, and to provide technical as-
sistance and cover administrative costs associated with im-
plementing the successor to this section $15,000,000 for fis-
cal year 2020.’’. 
(b) AVAILABILITY OF OTHER FUNDS.—Upon the date 
of the enactment of this section— 
(1) amounts expended pursuant to section 1501 
of division B of Public Law 116–59, or any other 
prior law making amounts available for fiscal year 
2020 for activities authorized by section 2008 of the 
Social Security Act, shall be charged to the appro-
priation made by subsection (c)(1) of such section 
2008 for fiscal year 2020 (not including the amount 
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for technical assistance and administrative costs); 
and 
(2) if such enactment occurs on or before Novem-
ber 21, 2019, the availability of funds appropriated 
in, and the authority provided under, such section 
1501 shall terminate. 
SEC. 3. CAREER PATHWAYS THROUGH HEALTH PROFES-
SION OPPORTUNITY GRANTS. 
Effective October 1, 2020, section 2008 of the Social 
Security Act (42 U.S.C. 1397g) is amended to read as fol-
lows: 
‘‘SEC. 2008. CAREER PATHWAYS THROUGH HEALTH PROFES-
SION OPPORTUNITY GRANTS. 
‘‘(a) APPLICATION REQUIREMENTS.—An eligible enti-
ty 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 
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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 directly or 
through local governmental, apprenticeship, edu-
cational, or charitable institutions. 
‘‘(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 assist 
participants with such a record in acquiring cre-
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dentials, licensing, and employment in the speci-
fied 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 con-
viction records or employers with experience 
working with people with arrest or conviction 
records; 
‘‘(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 career 
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)— 
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‘‘(A) a description of the partnerships, stra-
tegic staff hiring decisions, tailored program ac-
tivities, or other programmatic elements of the 
project, such as training plans for doulas and 
other community health workers and training 
plans for midwives and other allied health pro-
fessions, that are designed to support a career 
pathway in pregnancy, birth, or post-partum 
services; and 
‘‘(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 sup-
port services will be guaranteed and, if the applicant 
will provide a cash stipend or wage supplement, how 
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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 de-
velopment board established under section 107 of 
the Workforce Innovation and Opportunity Act; 
‘‘(B) consideration of apprenticeship and 
pre-apprenticeship models registered under the 
Act of August 16, 1937 (also known as the ‘Na-
tional 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 short-
ages. 
‘‘(10) A certification that the applicant will di-
rectly provide or contract for the training services de-
scribed in the application. 
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‘‘(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; 
‘‘(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 such in-person grantee 
conferences as are regularly scheduled by the Sec-
retary; 
‘‘(E) provide all data required by the Sec-
retary under subsection (g); and 
‘‘(F) notify the local disabled veterans’ out-
reach program specialists under section 4103A of 
title 38, United States Code, and the local vet-
erans’ employment representatives under section 
4104 of such title, of the grantee’s outreach plan 
for advertising training opportunities to poten-
tial participants in the project. 
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‘‘(b) PREFERENCES IN CONSIDERING APPLICATIONS.— 
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 devel-
opment 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 coaching 
available, as part of the case management plan; 
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‘‘(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 located; 
‘‘(B) the project will be conducted; or 
‘‘(C) an employer partnership that has com-
mitted 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. 
‘‘(c) GRANTS.— 
‘‘(1) COMPETITIVE GRANTS.— 
‘‘(A) GRANT AUTHORITY.— 
‘‘(i) IN GENERAL.—The Secretary, in 
consultation with the Secretary of Labor 
and the Secretary of Education, may make 
a grant in accordance with this paragraph 
to an eligible entity whose application for 
the grant is approved by the Secretary, to 
conduct a project designed to train low-in-
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come individuals for allied health profes-
sions, health information technology, physi-
cians assistants, nursing assistants, reg-
istered nurse, advanced practice nurse, and 
other professions considered part of a health 
care career pathway model. 
‘‘(ii) GUARANTEE
OF
GRANTEES
IN 
EACH STATE AND THE DISTRICT OF COLUM-
BIA.—For each grant cycle, the Secretary 
shall award a grant under this paragraph 
to at least 2 eligible entities in each State 
that is not a territory, 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. If, for a grant cycle, there are fewer 
than 2 such eligible entities in a State, the 
Secretary shall include that information in 
the report required by subsection (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 Sec-
retary shall award a grant under this paragraph 
to at least 10 eligible entities that are an Indian 
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tribe, a tribal organization, or a tribal college or 
university, to the extent there are a sufficient 
number of applications submitted by the entities 
that meet the requirements applicable with re-
spect 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 Sec-
retary 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 applicable with re-
spect to such a grant. 
‘‘(2) GRANTS FOR DEMONSTRATION PROJECTS.— 
‘‘(A) GRANT
AUTHORITY.—The Secretary, 
in consultation with the Secretary of Labor and 
the Secretary of Education (and, with respect to 
demonstration projects of the type described in 
subparagraph (B)(i)(I), the Attorney General) 
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 con-
duct a demonstration project that meets the re-
quirements of subparagraph (B). 
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‘‘(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 DEMONSTRA-
TION.—The demonstration project shall 
be of a type designed to provide edu-
cation and training for eligible indi-
viduals with arrest or conviction 
records to enter and follow a career 
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 DEMONSTRA-
TION.—The demonstration project shall 
be of a type designed to provide edu-
cation and training for eligible indi-
viduals to enter and follow a career 
pathway in the field of pregnancy, 
childbirth, or post-partum, in a State 
that recognizes doulas or midwives and 
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that provides payment for services pro-
vided 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 DEMONSTRATIONS.— 
Not less than 25 percent of the amounts 
made available for grants under this para-
graph shall be used to make grants for dem-
onstration projects of the type described in 
subparagraph (B)(i)(I). 
‘‘(ii) PREGNANCY AND CHILDBIRTH CA-
REER
PATHWAY
DEMONSTRATIONS.—Not 
less than 25 percent of the amounts made 
available for grants under this paragraph 
shall be used to make grants for demonstra-
tion projects of the type described in sub-
paragraph (B)(i)(II). 
‘‘(3) GRANT CYCLE.—The grant cycle under this 
section shall be not less than 5 years, with a planning 
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period of not more than the 1st 12 months of the 
grant cycle. During the planning period, the amount 
of the grant shall be in such lesser amount as the Sec-
retary 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 lower-skilled 
eligible individuals to enroll in the project 
and go on to enter and complete post-sec-
ondary 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 en-
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tering a health occupational training 
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 men-
toring. 
‘‘(ii) A guarantee that child care is an 
available and affordable support service for 
project participants through means such as 
the following; 
‘‘(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. 
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‘‘(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 
available, direct payments to subsidize 
transportation costs. 
For purposes of this clause, the term ‘trans-
portation’ includes public transit, or gaso-
line 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 
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project participants for the purpose of ad-
dressing arrest or conviction records and as-
sociated 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 that is at least 
monthly. 
‘‘(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. 
‘‘(iv) In-kind resource donations such 
as interview clothing and conference attend-
ance 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 ac-
tivities, including legal assistance, deemed 
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necessary to address arrest or conviction 
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. 
‘‘(C) TREATMENT OF SUPPORT FOR PUR-
POSES
OF
MEANS-TESTED
PROGRAMS.—Any 
goods or services provided to an eligible indi-
vidual participating in a project for which a 
grant is made under this section shall not be 
considered income, and shall not be taken into 
account for purposes of determining the eligi-
bility of the individual for, or amount of benefits 
to be provided to the individual, under any 
means-tested program. 
‘‘(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, which is awarded in rec-
ognition of attainment of measurable technical or oc-
cupational skills necessary to gain employment or ad-
vance within an occupation (including a certificate 
awarded by a local workforce development board es-
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tablished under section 107 of the Workforce Innova-
tion and Opportunity Act), 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) 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. 
‘‘(5) 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 pro-
gram funded under part A of title IV, at least 10 per-
cent of the eligible individuals to whom support is 
provided under the project shall meet the income eligi-
bility requirements under that State program, with-
out regard to whether the individuals receive benefits 
or services directly under that State program. 
‘‘(6) PROHIBITION.—An entity to which a grant 
is made under this section shall not use the grant for 
purposes of entertainment, except that case manage-
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‘‘(2) CONTINUATION OF PEER TECHNICAL ASSIST-
ANCE CONFERENCES.—The Secretary shall continue to 
hold peer technical assistance conferences for entities 
to which a grant is made under this section or was 
made under the immediate predecessor of this section. 
‘‘(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 INDIVIDUALS 
WITH ARREST OR CONVICTION RECORDS DEMONSTRA-
TION.—In the case of a project of the type described 
in subsection (c)(2)(B)(i)(I), the evaluation shall in-
clude identification of successful activities for creating 
opportunities for developing and sustaining, particu-
larly with respect to low-income individuals with ar-
rest or conviction records, a health professions work-
force that has accessible entry points, that meets high 
standards for education, training, certification, and 
professional development, and that provides increased 
wages and affordable benefits, including health care 
coverage, that are responsive to the needs of the work-
force. 
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‘‘(3) REQUIREMENT APPLICABLE TO PREGNANCY 
AND
CHILDBIRTH
CAREER
PATHWAY
DEMONSTRA-
TION.—In the case of a project of the type described 
in subsection (c)(2)(B)(i)(II), the evaluation shall in-
clude identification of successful activities for creating 
opportunities for developing and sustaining, particu-
larly 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 de-
velopment, and that provides increased wages and af-
fordable 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. 
‘‘(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 ac-
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tivities. Each such report shall include data on par-
ticipant outcomes related to earnings, employment in 
health professions, graduation rate, graduation time-
liness, credential attainment, participant demo-
graphics, and other data specified by the Secretary. 
‘‘(2) TO THE CONGRESS.—During each Congress, 
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 report— 
‘‘(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; 
‘‘(D) on the employment of project partici-
pants on completion of activities under the 
projects, and the earnings of project participants 
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; 
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‘‘(G) on, with respect to the period since the 
period covered in the most recent prior report 
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 address-
ing 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 path-
way’ has the meaning given that term in section 3(7) 
of the Workforce Innovation and Opportunity Act. 
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‘‘(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 edu-
cation to maintain the certification, to provide 
non-medical advice, information, emotional sup-
port, and physical comfort to an individual dur-
ing 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 enti-
ty’ means any of the following entities that dem-
onstrates in an application submitted under this sec-
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 subdivision, 
including a State or local entity that admin-
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isters 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 
(as defined in section 1819(a)). 
‘‘(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 
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. 
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‘‘(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 ‘Fed-
eral poverty level’ means the poverty line (as defined 
in section 673(2) of the Omnibus Budget Reconcili-
ation Act of 1981, including any revision required by 
such section applicable to a family of the size in-
volved). 
‘‘(7) HIGH-QUALITY
SKILLED
NURSING
FACIL-
ITY.—The term ‘high-quality skilled nursing facility’ 
means a facility (as defined in section 1819(a)) that 
has at least a 5-star rating for staffing to participate 
based on the data from section 1819(i)(1)(A)(i) and 
not have an immediate jeopardy violation as de-
scribed in section 1819(h)(1)(A) within the preceding 
3 years. 
‘‘(8) INDIAN TRIBE; TRIBAL ORGANIZATION.—The 
terms ‘Indian tribe’ and ‘tribal organization’ have the 
meaning given the terms in section 4 of the Indian 
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Self-Determination and Education Assistance Act (25 
U.S.C. 450b). 
‘‘(9) 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. 
‘‘(10) TERRITORY.—The term ‘territory’ means 
the Commonwealth of Puerto Rico, the United States 
Virgin Islands, Guam, the Northern Mariana Islands, 
and American Samoa. 
‘‘(11) 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 fiscal 
years 2021 through 2025. 
‘‘(2) ALLOCATION
OF
FUNDS.—Of the amount 
appropriated for a fiscal year under paragraph (1) of 
this subsection— 
‘‘(A) 75 percent shall be available for grants 
under subsection (c)(1)(A); 
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‘‘(B) 4 percent shall be reserved for grants 
under subsection (c)(1)(B); 
‘‘(C) 5 percent shall be reserved for grants 
under subsection (c)(1)(C); 
‘‘(D) 6 percent shall be available for dem-
onstration project grants under subsection (c)(2); 
‘‘(E) 6 percent, plus all amounts referred to 
in subparagraphs (A) through (D) of this para-
graph that remain unused after all grant awards 
are made for the fiscal year, shall be available 
for the provision of technical assistance and as-
sociated staffing; and 
‘‘(F) 4 percent shall be available for study-
ing the effects of the demonstration and non- 
demonstration projects for which a grant is 
made under this section, and for associated staff-
ing, for the purpose of supporting the rigorous 
evaluation of the demonstration projects, and 
supporting the continued study of the short-, me-
dium-, and long-term effects of all such projects, 
including the effectiveness of new or added ele-
ments of the non-demonstration projects. 
‘‘(j) NONAPPLICABILITY OF PRECEDING SECTIONS OF 
THIS SUBTITLE.— 
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‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the preceding sections of this subtitle shall 
not apply to a grant awarded under this section. 
‘‘(2) EXCEPTION FOR CERTAIN LIMITATIONS ON 
USE OF GRANTS.—Section 2005(a) (other than para-
graphs (2), (3), (5), (6), and (8)) shall apply to a 
grant awarded under this section to the same extent 
and in the same manner as such section applies to 
payments to States under this subtitle.’’. 
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