I 118th CONGRESS 2d Session H. R. 9812 IN THE HOUSE OF REPRESENTATIVES September 25, 2024 Mr. Comer (for himself and Mr. McGarvey ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To direct the Secretary of Health and Human Services to award grants to States to establish, increase the availability of, and improve access to, qualified health care programs to increase and strengthen the health care workforce in such States.

1. Short title This Act may be cited as the Health Care Workforce Investment Act . 2. Sense of Congress It is the sense of Congress to address the Nation’s shortage of a broad spectrum of health care professionals, including direct support professionals, nurses, mental health professionals, nurse aides, and emergency medical services professionals by incentivizing collaboration between health care programs, health care industry partners, and States to grow and strengthen the education and training pipeline of health care professionals within the Nation to better serve patients and families by: (1) Improving the ability of a broad variety of health care programs to meet the workforce demands and capacity of the States, including the workforce demands of historically underserved areas. (2) Raising awareness of an interest in a broad variety of health care occupations and reducing the barriers of access to the health care programs necessary to pursue these occupations, including financial barriers. (3) Improving pathways between high school career and technical programs and other health care programs. (4) Developing strategies for health care organizations and educational and training programs to support career growth and development for their employees and for students. 3. Health care workforce improvement plans (a) In general Not later than 12 months after the date of enactment of this Act, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall award grants to States to establish and implement a State Health Care Workforce Improvement Plan (in this section referred to as the Workforce Plan ) to increase and strengthen the health care workforce in such States. (b) Workforce plans (1) In general A State seeking a grant under this section shall submit to the Secretary, at such time and in such manner as specified by the Secretary, a Workforce Plan containing the following information: (A) A description of the State Health Care Workforce Council (in accordance with subsection (c)(1)(A)) designated by such State to administer such Workforce Plan. (B) The means by which such Council will incentivize and establish public-private partnerships with program partners (as defined in subsection (e)(3)) to provide education and training that will— (i) raise awareness of, and interest in, careers in health care; (ii) improve pathways between high school career, technical programs, and other qualified health care programs (as defined in subsection (c)(2)(A)(i)); (iii) increase the availability of, and improve access to, such qualified health care programs; (iv) reduce barriers to accessing such qualified health care programs, including financial barriers to enrolling in such programs; and (v) assist employers in the health care industry in supporting career growth and development for employees. (C) The method by which such qualified health care programs will be evaluated, including— (i) the benchmarks and improvement activities used to identify and reduce disparities in access to, and the utilization of, such programs; and (ii) adequate safeguards to ensure that such programs are invested in the continuing excellence of such programs, including the education, recruitment, and training of health care program faculty and staff, and the maintenance and acquisition of medical equipment utilized by such program. (D) The State’s plan (if any) to implement an income tax credit (or other tax credit) for program partners. (2) Publication of approved workforce plans The Secretary shall make publicly available on an internet website of the Department of Health and Human Services each approved Workforce Plan. (c) Administration of workforce plans (1) Administration and funding (A) State health care workforce council Each State shall establish (or appoint as existing body to serve as) a State Health Care Workforce Council (in this section referred to as the Council ) to administer the Workforce Plan. Such Council shall— (i) establish and maintain the State Health Care Workforce Investment Fund (as described in subparagraph (B)); (ii) provide for education and training opportunities through qualified health care programs (as described in paragraph (2)(A)); (iii) evaluate such programs and provide incentives to successful programs; and (iv) provide scholarships to eligible individuals to reduce financial barriers to accessing such programs (in accordance with the requirements under paragraph (2)(B)). (B) Health care workforce investment fund Each Council shall establish a State Health Care Workforce Investment Fund (in this section referred to as the Fund ) for the purpose of funding the activities described in the Workforce Plan, including— (i) providing funding for new or established qualified health care programs; (ii) establishing and supporting scholarships for eligible individuals seeking to enroll in such qualified health care programs to reduce financial barriers for such individuals; (iii) providing incentives to reward successful qualified health care programs (in accordance with paragraph (2)(A)(iii)); (iv) supporting related administrative research, consulting, planning, and analysis of the health care workforce needs within such State; and (v) encouraging investment in the Fund from private, financial, and philanthropic organizations to implement the work described in the Workforce Plan. (2) Workforce plan components (A) Qualified health care program (i) Qualified health care program defined In this section, the term qualified health care program means an educational or training program, including a high school health care vocational program, that is required to obtain or maintain employment or a professional credential or license for a career in a hospital or other health care setting. (ii) Criteria In order to receive funding from a Council, a qualified health care program must— (I) target the specific needs of historically underserved areas (as defined in subsection (e)(2)); (II) demonstrate how such program will benefit the workforce demands and capacity in underserved areas; and (III) assist eligible individuals in meeting some or all of the requirements for a certificate, training, or license in health care issued by a State. (iii) Incentives for successful programs A Council may award additional financial incentives to eligible individuals for programs that demonstrate an increase or other improvement in— (I) the number of such individuals completing such program; (II) the passage rate, particularly the first-time passage rate, on any State, health care, credential, examination by graduates of such program; (III) the ability of such qualified health care programs to meet the workforce demands of the communities such programs serve; and (IV) any other objective factors as determined by such Council. (B) Scholarships (i) In general The Council, in accordance with clause (ii), may award scholarships to eligible individuals for purposes of enrolling in a qualified health care program. (ii) Conditions for award In awarding scholarships under the Workforce Plan, the Council shall— (I) award not more than two 1-year scholarships to an eligible individual; and (II) require that such eligible individual— (aa) submit written proof of enrollment in a qualified health care program to the Council prior to receipt of such scholarship funds; (bb) upon completion of such program, work as a trained, licensed, or certified health care provider (in accordance with State law) in the State in which such program was conducted, for a period of not less than 1 year for each academic year for which a scholarship was provided; and (cc) sign a promissory note agreeing to repay the amount of the scholarship awarded upon failure to complete the requirement under item (bb). (d) Reporting requirements (1) Council report Not later than December 31, 2024, and annually thereafter, each Council shall submit to the Secretary a report on the activities undertaken in accordance with the Workforce Plan, including— (A) a detailed accounting of all monies raised and expended by the Fund, including the sources and recipients of such monies; (B) the amount of funds spent to conduct each activity under such Workforce Plan; (C) data and descriptive information related to the scholarships awarded pursuant to subsection (c)(2)(B), including— (i) the criteria used to award such scholarships; (ii) the number of scholarships awarded and the amount of each such scholarship; and (iii) the State and county of residence (or equivalent) of each scholarship recipient; (D) data and descriptive information with respect to each qualified health care program receiving funds under this section, including— (i) which such programs have received incentives pursuant to subsection (c)(2)(A)(iii); (ii) the overall graduation, workforce participation, and retention rates for each such program; and (iii) the graduation, workforce participation, and retention rates for eligible individuals enrolled in each such program, disaggregated by those eligible individuals who received a scholarship pursuant to subsection (c)(2)(B) and those who did not; (E) the number of eligible individuals practicing or employed in the health care field in a respective State, including the training, licensure, or credential of such individual; and (F) any other data demonstrating the need for professionals with such training, licensures, or credentials in such State. (2) Report to Congress Not later than June 1, 2025, and annually thereafter, the Secretary shall submit to Congress a report, including— (A) the information submitted by each Council under paragraph (1); and (B) any other information as determined by the Secretary, including information ensuring compliance with this section and accountability with respect to any Federal funds disbursed under a Workforce Plan. (e) Other definitions In this Act: (1) Eligible individual The term eligible individual means an individual enrolling in a qualified health care program to pursue or advance a career in health care. (2) Historically underserved county or region The term historically underserved county or region means a county or a region of a State in which, for the 5 years immediately preceding such State’s application under subsection (b)— (A) objective data with the respect to the health care workforce in such State demonstrates the needs and demands of a State’s health care workforce that exceed the average for such State during such years; and (B) unemployment among health care providers as calculated by the Department of Labor of a State demonstrating a countywide or regional rate of unemployment which exceeds statewide unemployment in such State. (3) Program partner The term program partner means an individual or an entity that gifts, grants, or donates monies to a State’s Fund, and that is— (A) a health care provider (as defined in accordance with State law); (B) a licensed health care facility operating in such State; or (C) a business, corporation, or health care association doing business in, and incorporated under, the laws of such State. (f) Funding (1) In general Amounts in the Medicare Improvement Fund established under section 1898 of the Social Security Act ( 42 U.S.C. 1395iii(a) ) shall be available, as provided in advance in appropriation Acts, to carry out this section. (2) State limitation A State with an approved Workforce Plan under this section shall be eligible to receive an amount not to exceed 50 percent of the amount of the State appropriated match to the State Fund established under this section. (3) Overall limitation In no case shall the aggregate amount made available under paragraph (1) exceed 25 percent of the amount of the combined annual appropriations of the Nurse Corps Scholarship Program and the Nurse Corps Loan Repayment Program authorized pursuant to section 846 of the Public Health Service Act ( 42 U.S.C. 297n ).