‘‘(1) STATE ENTITLEMENT.— 
‘‘(A) IN GENERAL.—Each State shall be 
entitled to receive from the Secretary for each 
fiscal year specified in subsection (e)(1) a grant 
in an amount equal to the amount allotted to 
the State under subparagraph (B). 
‘‘(B) STATE ALLOTMENTS.— 
‘‘(i) IN GENERAL.—Subject to clauses 
(ii) and (iii), the amount allotted to a 
State under this subparagraph for a fiscal 
year shall be— 
‘‘(I) the number of State resi-
dents who have attained 65 years of 
age or are under a disability (as de-
fined in section 216(i)(1)), as deter-
mined by the Secretary using the 
most recent version of the American 
Community Survey published by the 
Bureau of the Census or a successor 
data set; divided by 
‘‘(II) the total number of such 
residents of all States. 
‘‘(ii) LIMITATION.—The amount allot-
ted to a State under this subparagraph for 
a fiscal year shall be not less than 0.25 
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percent of the available amount for the fis-
cal year. 
‘‘(iii) ADJUSTMENT OF STATE ALLOT-
MENTS.—Subject to clause (ii), the Sec-
retary shall proportionately increase or de-
crease the amounts allotted under this sub-
paragraph for a fiscal year as necessary to 
ensure that the available amount for the 
fiscal year is allotted among the States. 
‘‘(iv) REDETERMINATIONS.— 
‘‘(I) 
FREQUENCY.—The 
Sec-
retary shall make the determination 
referred to in clause (i)(I) every 5 
years. 
‘‘(II) LIMITATION.—Subject to 
clause (ii), the amount allotted to a 
State under this subparagraph, on the 
basis of such a determination, for a 
fiscal year after fiscal year 2029 shall 
be— 
‘‘(aa) not less than 90 per-
cent of the amount of the grant 
made to the State under this 
subparagraph for the then pre-
ceding fiscal year; and 
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‘‘(bb) not more than 110 
percent of the amount referred to 
in item (aa). 
‘‘(2) GRANTS TO INDIAN TRIBES AND TRIBAL 
ORGANIZATIONS.— 
‘‘(A) IN GENERAL.—The Secretary, in con-
sultation with the Secretary of the Interior, 
shall make grants in accordance with this sec-
tion to Indian tribes and tribal organizations 
who operate at least 1 eligible setting. 
‘‘(B) GRANT FORMULA.—The Secretary, in 
consultation with the Secretary of the Interior, 
shall devise a formula for distributing among 
Indian tribes and tribal organizations the 
amount required to be reserved by subsection 
(e)(1) for each fiscal year. 
‘‘(3) SUB-GRANTS.—A State, Indian tribe, or 
tribal organization to which an amount is paid under 
this section may use the amount to make sub-grants 
to local organizations, including community organi-
zations, local non-profits, elder rights and justice 
groups, and workforce development boards for any 
purpose described in paragraph (1) or (2) of sub-
section (b). 
‘‘(b) USE OF FUNDS.— 
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‘‘(1) REQUIRED USES.—A State to which an 
amount is paid under this section shall use the 
amount to— 
‘‘(A) provide wage subsidies to eligible in-
dividuals; 
‘‘(B) provide student loan repayment or 
tuition assistance to eligible individuals for a 
degree or certification in a field relevant to 
their position referred to in subsection (f)(2); 
‘‘(C) guarantee affordable and accessible 
child care for eligible individuals, including help 
with referrals, co-pays, or other direct assist-
ance; and 
‘‘(D) provide assistance where necessary 
with obtaining appropriate transportation, in-
cluding public transportation if available, or gas 
money if public transportation is unavailable or 
impractical based on work hours or location. 
‘‘(2) AUTHORIZED USES.—A State to which an 
amount is paid under this section may use the 
amount to— 
‘‘(A) establish a reserve fund for financial 
assistance to eligible individuals in emergency 
situations; 
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‘‘(B) provide in-kind resource donations, 
such as interview clothing and conference at-
tendance fees; 
‘‘(C) provide assistance with programs and 
activities, including legal assistance, deemed 
necessary to address arrest or conviction 
records that are an employment barrier; 
‘‘(D) support employers operating an eligi-
ble setting in the State in providing employees 
with not less than 2 weeks of paid leave per 
year; or 
‘‘(E) provide other support services the 
Secretary deems necessary to allow for success-
ful recruitment and retention of workers. 
‘‘(3) PROVISION
OF
FUNDS
ONLY
FOR
THE 
BENEFIT
OF
ELIGIBLE
INDIVIDUALS
IN
ELIGIBLE 
SETTINGS.—A State to which an amount is paid 
under this section may provide the amount to only 
an eligible individual or a partner organization serv-
ing an eligible individual. 
‘‘(4) NONSUPPLANTATION.—A State to which 
an amount is paid under this section shall not use 
the amount to supplant the expenditure of any State 
funds for recruiting or retaining employees in an eli-
gible setting. 
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‘‘(5) OBLIGATION DEADLINE.—A State, Indian 
tribe, or tribal organization shall remit to the Sec-
retary for reallotment under this section any amount 
paid under this section for a fiscal year that is not 
obligated within 2 years after the end of the fiscal 
year. 
‘‘(c) ADMINISTRATION.—A State to which a grant is 
made under this section shall reserve not more than 10 
percent of the grant to— 
‘‘(1) administer subgrants in accordance with 
this section; 
‘‘(2) provide technical assistance and support 
for applying for and accessing such a subgrant op-
portunity; 
‘‘(3) publicize the availability of the subgrants; 
‘‘(4) carry out activities to increase the supply 
of eligible individuals; and 
‘‘(5) provide technical assistance to help sub-
grantees find and train individuals to provide the 
services for which they are contracted. 
‘‘(d) REPORTS.— 
‘‘(1) STATE
REPORTS.—Not less frequently 
than annually, each State to which a grant has been 
made under this section shall transmit to the Sec-
retary a written report describing the activities un-
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‘‘(2) REPORT TO THE CONGRESS.—Not later 
than 3 years after the date of the enactment of this 
section, and every 4 years thereafter, the Secretary 
shall submit to the Congress a written report out-
lining how the States have used the grants made 
under this section during the period covered by the 
report, which shall include— 
‘‘(A) the total amount expended in each 
State for each type of use described in para-
graph (1) or (2) of subsection (b); 
‘‘(B) the total number of non-State organi-
zations in each State to which grant funds were 
provided, and the amount so provided to each 
such organization; 
‘‘(C) the change in the number of individ-
uals working in each job category described in 
subsection (f)(2) in an eligible setting; 
‘‘(D) the average duration of employment 
for each such job category, by State; 
‘‘(E) the average annual wage of workers 
in each job category described in subsection 
(f)(2) in an eligible setting; 
‘‘(F) the average amount of paid time off 
to which a worker in each job category de-
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scribed in subsection (f)(2) in an eligible setting 
is entitled by their contract; and 
‘‘(G) such other data elements as the Sec-
retary deems relevant. 
‘‘(e) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to the Secretary $400,000,000 for each of fiscal 
years 2025 through 2028 to carry out this section, of 
which 2 percent shall be reserved for grants to Indian 
tribes and tribal organizations. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) AVAILABLE AMOUNT.—The term ‘available 
amount’ means, with respect to a fiscal year, the 
amount specified in subsection (e) that remains after 
the reservation required by such subsection for the 
fiscal year, plus all amounts remitted to the Sec-
retary under subsection (b)(5) that have not been 
reallotted under subsection (a)(1)(B)(iii). 
‘‘(2) ELIGIBLE INDIVIDUAL.—The term ‘eligible 
individual’ means an individual who— 
‘‘(A)(i) is a qualified home health aide, as 
defined in section 484.80(a) of title 42, Code of 
Federal Regulations; 
‘‘(ii) is a nurse aide approved by the State 
as meeting the requirements of sections 
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483.150 through 483.154 of such title, and is 
listed in good standing on the State nurse aide 
registry; 
‘‘(iii) is a personal care aide approved by 
the State, and furnishes personal care services, 
as defined in section 440.167 of such title; 
‘‘(iv) is a qualified hospice aide, as defined 
in section 418.76 of such title; 
‘‘(v) is a licensed practical nurse or a li-
censed or certified social worker; or 
‘‘(vi) is receiving training to be certified or 
licensed as such an aide, nurse, or social work-
er; and 
‘‘(B) provides (or, in the case of a trainee, 
intends to provide) services as such an aide, 
nurse, or social worker in an eligible setting. 
‘‘(3) ELIGIBLE
SETTING.—The term ‘eligible 
setting’ means— 
‘‘(A) a skilled nursing facility, as defined 
in section 1819; 
‘‘(B) a nursing facility, as defined in sec-
tion 1919; 
‘‘(C) a home health agency, as defined in 
section 1891; 
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‘‘(D) a facility approved to deliver home or 
community-based services authorized under 
State options described in subsection (c) or (i) 
of section 1915 or, as relevant, demonstration 
projects authorized under section 1115; 
‘‘(E) a hospice, as defined in section 1814; 
or 
‘‘(F) a tribal assisted living facility. 
‘‘(4) TRIBAL ORGANIZATION.—The term ‘tribal 
organization’ has the meaning given the term in sec-
tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act.’’. 
Æ 
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