program registered under the Act of August 16, 
1937 (commonly known as the ‘‘National Appren-
ticeship Act’’; 50 Stat. 664, chapter 663; 29 U.S.C. 
50 et seq.), including any requirement, standard, or 
rule promulgated under such Act. 
(2) COMMUNITY COLLEGE.—The term ‘‘commu-
nity college’’ means a public institution of higher 
education at which the highest degree that is pre-
dominantly awarded to students is an associate’s de-
gree, including Tribal Colleges or Universities receiv-
ing grants under section 316 of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1059c) that offer a 
2-year program for completion of such degree and 
State public institutions of higher education that 
offer such a 2-year program. 
(3) DIRECT CARE PROFESSIONAL.—The term 
‘‘direct care professional’’— 
(A) means an individual who, in exchange 
for compensation, provides services to a person 
with a disability or an older adult that promotes 
the independence of such person or individual, 
including— 
(i) services that enhance the inde-
pendence and community inclusion for 
such person or individual, including trav-
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eling with such person or individual or at-
tending and assisting such person or indi-
vidual while visiting friends and family, 
shopping, or socializing; 
(ii) services such as coaching and sup-
porting such person or individual in com-
municating needs, achieving self-expres-
sion, pursuing personal goals, living inde-
pendently, and participating actively in em-
ployment or voluntary roles in the commu-
nity; 
(iii) services such as providing assist-
ance with activities of daily living (such as 
feeding, bathing, toileting, and ambulation) 
and with tasks such as meal preparation, 
shopping, light housekeeping, and laundry; 
(iv) services that support such person 
or individual at home, work, school, or in 
any other community setting; or 
(v) services that promote health and 
wellness, including scheduling and taking 
such person or individual to health care 
appointments, communicating with health 
and allied health professionals admin-
istering medications, implementing health 
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and behavioral health interventions and 
treatment plans, monitoring and recording 
health status and progress; and 
(B) may include— 
(i) a service provider supporting peo-
ple with intellectual disability and develop-
mental disabilities, and other disabilities; 
(ii) a home and community-based 
services manager or direct support profes-
sional manager; 
(iii) a self-directed care worker; 
(iv) a personal care service worker; 
(v) a direct care worker, as defined in 
section 799B of the Public Health Service 
Act (42 U.S.C. 295p); or 
(vi) any other position or job related 
to the home care or direct care workforce, 
such as positions or jobs in respite care, 
palliative care, community support, or peer 
support, as determined by the Secretary, in 
consultation with the Centers for Medicare 
& Medicaid Services and the Secretary of 
Labor. 
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(4) DIRECT CARE WORKFORCE.—The term ‘‘di-
rect care workforce’’ means the broad workforce of 
direct care professionals. 
(5) FAMILY
CAREGIVER.—The term ‘‘family 
caregiver’’ has the meaning given such term in sec-
tion 2 of the RAISE Family Caregivers Act (42 
U.S.C. 3030s note; Public Law 115–119) and in-
cludes paid and unpaid family caregivers. 
(6) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means an entity— 
(A) that is— 
(i) a State; 
(ii) a labor organization, joint labor- 
management organization, or employer of 
direct care professionals; 
(iii) a nonprofit entity with experience 
in aging, disability, or supporting the 
rights and interests of, training of, or edu-
cating direct care professionals or family 
caregivers; 
(iv) an Indian Tribe, Tribal organiza-
tion, or Urban Indian organization; 
(v) a community college or other insti-
tution of higher education; or 
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(vi) a consortium of entities listed in 
any of clauses (i) through (v); 
(B) that agrees to include, as applicable 
with respect to the type of grant the entity is 
seeking under this title and the activities sup-
ported through such grant, older adults, people 
with disabilities, direct care professionals, and 
family caregivers, as advisors and trainers in 
such activities; and 
(C) that agrees to consult with the State 
Medicaid agency of the State (or each State) 
served by the grant on the grant activities, to 
the extent that such agency (or each such agen-
cy) is not the eligible entity. 
(7) EMPLOYER.—The terms ‘‘employ’’ and 
‘‘employer’’ have the meanings given the terms in 
section 3 of the Fair Labor Standards Act of 1938 
(29 U.S.C. 203). 
(8) INDIAN
TRIBE; TRIBAL
ORGANIZATION.— 
The terms ‘‘Indian Tribe’’ and ‘‘Tribal organiza-
tion’’ have the meanings given such terms in section 
4 of the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 5304). 
(9) INSTITUTION OF HIGHER EDUCATION.—The 
term ‘‘institution of higher education’’ means— 
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(A) an institution of higher education de-
fined in section 101 of the Higher Education 
Act of 1965 (20 U.S.C. 1001); or 
(B) an institution of higher education de-
fined in section 102(a)(1)(B) of such Act (20 
U.S.C. 1002(a)(1)(B)). 
(10) OLDER ADULT.—The term ‘‘older adult’’ 
means an individual who is 60 years of age or older. 
(11) PERSON WITH A DISABILITY.—The term 
‘‘person with disability’’ means an individual with a 
disability, as defined in section 3 of the Americans 
with Disabilities Act of 1990 (42 U.S.C. 12102). 
(12) 
PROJECT
PARTICIPANT.—The 
term 
‘‘project participant’’ means an individual partici-
pating in a project or activity assisted with a grant 
under this title, including (as applicable for the cat-
egory of the grant) a direct care professional, or an 
individual training to be such a professional, or a 
family caregiver. 
(13) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Health and Human Services, 
acting through the Administrator for Community 
Living. 
(14) SELF-DIRECTED
CARE
PROFESSIONAL.— 
The term ‘‘self-directed care professional’’ means a 
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direct care professional who is employed by an indi-
vidual who is an older adult, a person with a dis-
ability, or a representative of such older adult or 
person with a disability, and such older adult or per-
son with a disability has the decision-making author-
ity over certain supports and services provided by 
the direct care professional and takes direct respon-
sibility to manage those supports and services. 
(15) SUPPORTIVE SERVICES.—The term ‘‘sup-
portive services’’ means services that are necessary 
to enable an individual to participate in activities as-
sisted with a grant under this title, such as trans-
portation, child care, dependent care, housing, work-
place accommodations, employee benefits such as 
paid sick leave and child care, workplace health and 
safety protections, wages and overtime pay, and 
needs-related payments. 
(16) URBAN INDIAN ORGANIZATION.—The term 
‘‘urban Indian organization’’ has the meaning given 
the term in section 4 of the Indian Health Care Im-
provement Act (25 U.S.C. 1603). 
(17) WORKFORCE
INNOVATION
AND
OPPOR-
TUNITY ACT TERMS.—The terms ‘‘career pathway’’, 
‘‘career planning’’, ‘‘in-demand industry sector or 
occupation’’, ‘‘individual with a barrier to employ-
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ment’’, ‘‘local board’’, ‘‘on-the-job training’’, ‘‘recog-
nized postsecondary credential’’, ‘‘region’’, and 
‘‘State board’’ have the meanings given such terms 
in section 3 of the Workforce Innovation and Oppor-
tunity Act (29 U.S.C. 3102). 
(18) 
WORK-BASED
LEARNING.—The 
term 
‘‘work-based learning’’ has the meaning given the 
term in section 3 of the Carl D. Perkins Career and 
Technical Education Act of 2006 (20 U.S.C. 2302). 
SEC. 302. AUTHORITY TO ESTABLISH A TECHNICAL ASSIST-
ANCE CENTER FOR BUILDING THE DIRECT 
CARE WORKFORCE. 
(a) PROGRAM AUTHORIZED.—The Secretary shall es-
tablish a national technical assistance center (referred to 
in this section as the ‘‘Center’’) for, in consultation with 
the Secretary of Labor, the Secretary of Education, the 
Administrator of the Centers for Medicare & Medicaid 
Services, and the heads of other entities as necessary— 
(1) supporting direct care workforce creation, 
training and education, recruitment, retention, and 
advancement; and 
(2) supporting family caregivers and activities 
of family caregivers as a critical part of the support 
team for older adults or people with disabilities. 
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(b) ADVISORY COUNCIL.—The Secretary shall con-
vene an advisory council to provide recommendations to 
the Center with respect to the duties of the Center under 
this section and may engage individuals and entities de-
scribed in paragraphs (3)(B), and (12), of section 304(b) 
(without regard to a specific project described in such 
paragraphs) for service on the advisory council. 
(c) ACTIVITIES.—The Center may— 
(1) develop recommendations for training and 
education curricula for direct care professionals, 
which such recommendations may include rec-
ommendations for curricula for higher education, 
postsecondary credentials, and programs with com-
munity colleges; 
(2) develop learning and dissemination strate-
gies to— 
(A) engage States and other entities in ac-
tivities supported under this title and best prac-
tices; and 
(B) distribute findings from activities sup-
ported by grants under this title; 
(3) develop recommendations for training and 
education curricula and other strategies for sup-
porting family caregivers; 
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(4) explore the national data gaps, workforce 
shortage areas, and data collection strategies for di-
rect care professionals and make recommendations 
to the Director of the Office of Management and 
Budget for an occupation category in the Standard 
Occupational Classification system for direct support 
professionals as a healthcare support occupation; 
(5) recommend career development and ad-
vancement opportunities for direct care profes-
sionals, which may include occupational frameworks, 
national standards, recruitment campaigns, pre-ap-
prenticeship and on-the-job training opportunities, 
apprenticeship programs, career ladders or path-
ways, specializations or certifications, or other activi-
ties; and 
(6) develop strategies for assisting with report-
ing and evaluation of grant activities under section 
305. 
SEC. 303. AUTHORITY TO AWARD GRANTS. 
(a) GRANTS.— 
(1) IN GENERAL.—Not later than 12 months 
after the date of enactment of this title, the Sec-
retary, in consultation with the Centers for Medicare 
& Medicaid Services, the Secretary of Labor, and the 
Secretary of Education, shall award grants described 
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in paragraph (2) to eligible entities. A grant award-
ed under this section may be in more than 1 cat-
egory described in such paragraph. 
(2) CATEGORIES OF GRANTS.—The categories 
of grants described in this paragraph are each of the 
following: 
(A) 
DIRECT
CARE
PROFESSIONAL 
GRANTS.—Grants to eligible entities to create 
and carry out projects for the purposes of re-
cruiting, retaining, or providing advancement 
opportunities for direct care professionals who 
are not described in subparagraph (B) or (C), 
including through education or training pro-
grams for such professionals or individuals 
seeking to become such professionals. 
(B) DIRECT
CARE
PROFESSIONAL
MAN-
AGERS GRANTS.—Grants to eligible entities to 
create and carry out projects for the purposes 
of recruiting, retaining, or providing advance-
ment opportunities for direct care professionals 
who are managers or supervisory staff that 
have coaching, training, managerial, super-
visory, or other oversight responsibilities, in-
cluding through education or training programs 
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for such professionals or individuals seeking to 
become such professionals. 
(C) SELF-DIRECTED CARE PROFESSIONALS 
GRANTS.—Grants to eligible entities to create 
and carry out projects for the purposes of re-
cruiting, retaining, or providing advancement 
opportunities for self-directed care profes-
sionals, including through education or training 
programs for such professionals or individuals 
seeking to become such professionals. 
(D) FAMILY CAREGIVER GRANTS.—Grants 
to eligible entities to create and carry out 
projects for providing support to paid or unpaid 
family caregivers through educational, training, 
or other resources, including resources for care-
giver self-care or educational or training re-
sources for individuals newly in a caregiving 
role or seeking additional support in the role of 
a family caregiver. 
(3) PROJECTS FOR ADVANCEMENT OPPORTUNI-
TIES.—Not less than 30 percent of projects assisted 
with grants under this title shall be projects to pro-
vide career pathways that offer opportunities for 
professional development and advancement opportu-
nities to direct care professionals. 
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(b) TREATMENT OF CONTINUATION ACTIVITIES.— 
An eligible entity that carries out activities described in 
subsection (a)(2) prior to receipt of a grant under this 
title may use such grant to continue carrying out such 
activities, and, in using such grant to continue such activi-
ties, shall be treated as an eligible entity carrying out a 
project through a grant under this title. 
SEC. 304. PROJECT PLANS. 
(a) IN GENERAL.—An eligible entity seeking a grant 
under this title shall submit to the Secretary a project plan 
for each project to be developed and carried out (or for 
activities to be continued as described in section 303(b)) 
with the grant at such time, in such manner, and con-
taining such information as the Secretary may require. 
(b) CONTENTS.—A project plan submitted by an eli-
gible entity under subsection (a) shall include a descrip-
tion of information determined relevant by the Secretary 
for purposes of the category of the grant and the activities 
to be carried out through the grant. Such information may 
include (as applicable) the following: 
(1) The demographics (as defined in section 2) 
of the population in the State or relevant geographic 
area, including a description of the populations likely 
to need long-term care services, such as people with 
disabilities and older adults. 
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(2) Projections of unmet need for services pro-
vided by direct care professionals based on enroll-
ment waiting lists under home and community-based 
waivers under section 1115 of the Social Security 
Act (42 U.S.C. 1315) or section 1915 of such Act 
(42 U.S.C. 1396n) and other relevant data to the 
extent practicable and feasible, such as direct care 
workforce vacancy rates, crude separation rates, and 
the number of direct care professionals, including 
such professionals who are managers or supervisors, 
in the region. 
(3) An advisory committee to advise the eligible 
entity on activities to be carried out through the 
grant. Such advisory committee— 
(A) may be comprised of entities listed in 
paragraph (12); and 
(B) shall include— 
(i) older adults or persons with a dis-
ability; 
(ii) organizations representing the 
rights and interests of people receiving 
services by the direct care professionals or 
family caregivers targeted by the project; 
(iii) individuals who are direct care 
professionals or family caregivers targeted 
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by the project and organizations rep-
resenting the rights and interests of direct 
care professionals or family caregivers; 
(iv) as applicable, employers of indi-
viduals described in clause (iii) and labor 
organizations representing such individ-
uals; 
(v) representatives of the State Med-
icaid agency, the State agency defined in 
section 102 of the Older Americans Act of 
1965 (42 U.S.C. 3002), the State develop-
mental disabilities office, and the State be-
havioral health agency, in the State (or 
each State) to be served by the project; 
and 
(vi) representatives reflecting diverse 
racial, cultural, ethnic, geographic, socio-
economic, and gender identity and sexual 
orientation perspectives. 
(4) Current or projected job openings for, or 
relevant labor market information related to, the di-
rect care professionals targeted by the project in the 
State or region to be served by the project, and the 
geographic scope of the workforce to be served by 
the project. 
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(5) Specific efforts and strategies that the 
project will undertake to reduce barriers to recruit-
ment, retention, or advancement of the direct care 
professionals targeted by the project, including an 
assurance that such efforts will include— 
(A) an assessment of the wages or other 
compensation or benefits necessary to recruit 
and retain the direct care professionals targeted 
by the project; 
(B) a description of the project’s projected 
compensation or benefits for the direct care 
professionals targeted by the project at the 
State or local level, including a comparison of 
such projected compensation or benefits to re-
gional and national compensation or benefits 
and a description of how wages and benefits re-
ceived by project participants will be impacted 
by the participation in and completion of the 
project; and 
(C) a description of the projected impact of 
workplace safety issues on the recruitment and 
retention of direct care professionals targeted 
by the project, including the availability of per-
sonal protective equipment. 
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(6) In the case of a project offering an edu-
cation or training program for direct care profes-
sionals, a description of such program (including 
how the core competencies identified by the Centers 
for Medicare & Medicaid Services will be incor-
porated, curricula, models, and standards used 
under the program, and any associated recognized 
postsecondary credentials for which the program 
provides preparation, as applicable), which shall in-
clude an assurance that such program will provide to 
each project participant in such program— 
(A) relevant training regarding the rights 
of recipients of home and community-based 
services, including their rights to— 
(i) receive services in integrated set-
tings that provide access to the broader 
community; 
(ii) exercise self-determination; 
(iii) be free from all forms of abuse, 
neglect, or exploitation; and 
(iv) person-centered planning and 
practices, including participation in plan-
ning activities; 
(B) relevant training to ensure that each 
project participant has the necessary skills to 
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recognize abuse and understand their obliga-
tions with regard to reporting and responding 
to abuse appropriately in accordance with rel-
evant Federal and State law; 
(C) relevant training regarding the provi-
sion of culturally competent and disability com-
petent supports to recipients of services pro-
vided by the direct care professionals targeted 
by the project; 
(D) an apprenticeship program, work- 
based learning, or on-the-job training opportu-
nities; 
(E) supervision or mentoring; and 
(F) for any on-the-job training portion of 
the program, a progressively increasing, clearly 
defined schedule of wages to be paid to each 
such participant that— 
(i) is consistent with skill gains or at-
tainment of a recognized postsecondary 
credential received as a result of participa-
tion in or completion of such program; and 
(ii) ensures the entry wage is not less 
than the greater of— 
(I) the minimum wage required 
under section 6(a) of the Fair Labor 
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Standards Act of 1938 (29 U.S.C. 
206(a)); or 
(II) the applicable wage required 
by other applicable Federal or State 
law, or a collective bargaining agree-
ment. 
(7) Any other innovative models or processes 
the eligible entity will implement to support the re-
tention and career advancement of the direct care 
professionals targeted by the project. 
(8) The supportive services and benefits to be 
provided to the project participants in order to sup-
port the employment, retention, or career advance-
ment of the direct care professionals targeted by the 
project. 
(9) How the eligible entity will make use of ca-
reer planning to support the identification of ad-
vancement opportunities and career pathways for 
the direct care professionals in the State or region 
to be served by the project. 
(10) How the eligible entity will collect and sub-
mit to the Secretary workforce data and outcomes of 
the project. 
(11) How the project— 
(A) will— 
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(i) provide adequate and safe equip-
ment and facilities for training and super-
vision, including a safe work environment 
free from discrimination, which may in-
clude the provision of personal protective 
equipment and other necessary equipment 
to prevent the spread of infectious disease 
among the direct care professionals tar-
geted by the project and recipients of serv-
ices provided by such professionals; 
(ii) incorporate remote training and 
education opportunities or technology-sup-
ported opportunities; 
(iii) for training and education cur-
ricula, 
incorporate 
evidenced-supported 
practices for adult learners and universal 
design for learning and ensure recipients 
of services provided by the direct care pro-
fessionals or family caregivers targeted by 
the project participate in the development 
and implementation of such training and 
education curricula; 
(iv) use outreach, recruitment, and re-
tention strategies designed to reach and re-
tain a diverse workforce; 
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(v) incorporate methods to monitor 
satisfaction with project activities for 
project participants and individuals receiv-
ing services from such participants; 
(vi) 
incorporate 
evidence-supported 
practices for family caregiver engagement; 
and 
(vii) incorporate core competencies 
identified by the Centers for Medicare & 
Medicaid Services; and 
(B) may incorporate continuing education 
programs and specialty training, with a specific 
focus on— 
(i) trauma-informed care; 
(ii) behavioral health, including co-oc-
curring behavioral health conditions and 
intellectual or developmental disabilities; 
(iii) Alzheimer’s and dementia care; 
(iv) chronic disease management; and 
(v) the use of supportive or assistive 
technology. 
(12) How the eligible entity will consult on the 
implementation of the project, or coordinate the 
project with, each of the following entities, to the ex-
tent that each such entity is not the eligible entity: 
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(A) The State Medicaid agency, State 
agency defined in section 102 of the Older 
Americans Act of 1965 (42 U.S.C. 3002), and 
the State developmental disabilities office for 
the State (or each State) to be served by the 
project. 
(B) The local board and State board for 
each region, or State, to be served by the 
project. 
(C) In the case of a project that carries 
out an education or training program, a non-
profit organization with demonstrated experi-
ence in the development or delivery of curricula 
or coursework. 
(D) A nonprofit organization, including a 
labor organization, that fosters the professional 
development and collective engagement of the 
direct care professionals targeted by the project. 
(E) Area agencies on aging, as defined in 
section 102 of the Older Americans Act of 1965 
(42 U.S.C. 3002). 
(F) Centers for independent living, as de-
scribed in part C of title VII of the Rehabilita-
tion Act of 1973 (29 U.S.C. 796f et seq.). 
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(G) The State Council on Developmental 
Disabilities (as such term is used in subtitle B 
of title I of the Developmental Disabilities As-
sistance and Bill of Rights Act of 2000 (42 
U.S.C. 15021 et seq.)) for the State (or each 
State) to be served by the project. 
(H) Aging and Disability Resource Centers 
(as defined in section 102 of the Older Ameri-
cans Act of 1965 (42 U.S.C. 3002)). 
(I) A nonprofit State provider association 
that represents providers who employ the direct 
care professionals targeted by the project, 
where such associations exist. 
(J) An entity that employs the direct care 
professionals targeted by the project. 
(K) University Centers for Excellence in 
Developmental 
Disabilities 
Education, 
Re-
search, and Services supported under subtitle D 
of title I of the Developmental Disabilities As-
sistance and Bill of Rights Act of 2000 (42 
U.S.C. 15061 et seq.). 
(L) The State protection and advocacy sys-
tem described in section 143 of such Act (42 
U.S.C. 15043) of the State (or each State) to 
be served by the project. 
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(M) Direct care professionals or direct care 
workforce organizations representing under-
served communities, including communities of 
color. 
(13) How the eligible entity will consult 
throughout the project with— 
(A) individuals employed or working as the 
direct care professionals or family caregivers 
targeted by the project; 
(B) representatives of such professionals or 
caregivers; 
(C) individuals assisted by such profes-
sionals or caregivers; 
(D) the families of such professionals or 
caregivers; and 
(E) individuals receiving education or 
training to become such professionals or care-
givers. 
(14) Outreach efforts to individuals for partici-
pation in such project, including targeted outreach 
efforts to— 
(A) individuals who are recipients of assist-
ance under a State program funded under part 
A of title IV of the Social Security Act (42 
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