,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #cggh  ,,in ,,the ,,house ,,of  
,,representatives  ,september #ad1      
#bjag,mr4 ,scott of ,virginia 7for      
himself and ,mrs4 ,davis of ,california7
 introduced the following bill2 which   
was referred to the ,committee on       
,education and the ,workforce1 and in   
addition to the ,committee on ,energy   
and ,commerce1 for a period to be       
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to award grants for the     
recruitment1 retention1 and advancement 
of direct care workers4  #a4 ,short     
title ,this ,act may be cited as the    
,direct ,creation1 ,advancement1 and    
,retention of ,employment ,opportunity  
,act or the ,direct ,,care ,opportunity 
,act4  #b4 ,findings ,congress finds the
 following3  7#a7 ,millions of seniors  
and persons with disabilities in the    
,united ,states require assistance with 

activities of daily living in order to  
live independently and participate in   
their communities4  7#b7 ,the assistance
 of direct care workers allows seniors  
and persons with disabilities to live   
with dignity1 safety and independence in
 their own homes and communities and in 
the most integrated settings appropriate
 to their needs and preferences4  7#c7  
,the ,institute of ,medicine has found  
that direct care workers provide the    
bulk of services for older adults in    
nursing homes1 assisted living          
facilities1 and individuals' homes4     
7#d7 ,the ,bureau of ,labor ,statistics 
projects that personal care aides and   
home health aides will be two of the    
occupations with the most new jobs      
created in the country by #bjbd4  7#e7  
,many direct care workers lack access to
 a career ladder or advanced training   
opportunities and1 according to ,,phi1  
more than half of home care workers have
 completed no formal education beyond   
high school1 making quality1            

transferable training essential to      
success on the job4  7#f7 ,according to 
,,phi1 direct care workers earn a median
 wage of just over #aj an hour and      
frequently are not provided the         
workplace-based benefits that would     
allow them to care for themselves and   
their families4  7#g7 ,according to     
,national ,women's ,law ,center's       
analysis of ,census ,bureau data1 the   
vast majority of direct care workers are
 women1 and women of color represent    
nearly half of the direct care          
workforce4  7#h7 ,according to the      
,federal ,commission on ,long-,term     
,care1 there is high turnover and       
workforce shortages in direct care      
occupations1 which can contribute to    
reduced care quality4  7#i7 ,the        
,institute of ,medicine found that to   
ensure that the ,united ,states is      
prepared to meet the health care needs  
of older ,americans during the #bast    
century1 it is essential that the       
capacity of the direct care workforce be

 enhanced in both size and ability to   
meet their health care and quality of   
life needs4  #c4 ,grants for            
recruitment1 retention1 and advancement 
of direct care workers  7a7 ,authority  
,to award grants ,not later than #ab    
months after the date of enactment of   
this section1 the ,secretary of ,labor1 
in consultation with the ,secretary of  
,health and ,human ,services1 shall     
award grants to not more than #ae       
eligible entities to conduct projects   
for purposes of recruiting1 retaining1  
or providing advancement opportunities  
to direct care workers4  7b7 ,duration  
7#a7 ,grant period ,a grant under this  
section shall be for not less than #e   
years4  7#b7 ,length of project ,a      
project assisted with a grant awarded   
under this section shall be conducted   
for not less than #c years4  7c7        
,project plans  7#a7 ,in general ,to    
receive a grant under this section1 an  
eligible entity shall submit to the     
,secretary a project plan at such time  

and in such manner as the ,secretary may
 determine1 which shall contain the     
information described in paragraph 7#b74
  7#b7 ,contents ,each project plan     
submitted by an eligible entity under   
paragraph 7#a7 shall include a          
description of the following3  7,a7     
,current or projected workforce         
vacancies and supply of direct care     
workers in the ,state or region to be   
served by the eligible entity1 and the  
geographic scope of the workforce to be 
served4  7,b7 ,specific efforts and     
strategies that the project will        
undertake to reduce barriers to         
recruitment1 retention1 and advancement 
of direct care workers1 including       
whether such efforts will include--  7i7
 assessment of the wages or other       
compensation or benefits necessary to   
recruit and retain direct care workers1 
conducted in consultation with          
individuals employed as direct care     
workers1 representatives of such        
workers1 individuals assisted by such   

workers1 and the families of such       
individuals2  7ii7 analysis of reliable 
data that has previously been collected 
with respect to such wages or other     
compensation or benefits2  7iii7        
validation and implementation of        
successful training models1 standards1  
and curricula 7such as the models1      
standards1 and curricula used in the    
grants awarded under section #bjjh7;b7  
of the ,social ,security ,act for       
developing training competencies and    
certification programs for direct care  
workers 7#db ,u4,s4,c4 #acig;g77 or     
through work-based learning strategies1 
career pathways1 supervision1 or        
mentoring2 or  7iv7 any other supportive
 services or benefits provided to create
 or sustain employment for direct care  
workers4  7,c7 ,the models1 standards1  
and curricula the eligible entity will  
carry out under subparagraph 7,b74  7,d7
 ,any other supportive services provided
 to assist in the goals of the project1 
if applicable4  7,e7 ,identification of 

advancement opportunities and strategies
 to expand career pathways for direct   
care workers in the ,state or region to 
be served by the eligible entity1 if    
applicable4  7,f7 ,how the eligible     
entity will collect and submit to the   
,secretary workforce data and outcomes  
of the project to be assisted with the  
grant under this section4  7,g7 ,how the
 eligible entity will consult on the    
implementation of the project1 or       
coordinate the project with1 each of the
 following entities1 to the extent that 
each such entity is not a part of the   
eligible entity3  7i7 ,the ,state agency
 responsible for administering the      
,state plan under title ,,xix of the    
,social ,security ,act 7or waiver of the
 plan74  7ii7 ,local boards and ,state  
boards for the ,state or region to be   
served by the eligible entity4  7iii7   
,nonprofit organizations with           
demonstrated experience in the          
recruitment1 training1 employment1 or   
career consultation of direct care      

workers or the development of curricula 
or coursework to be used in the training
 under the project4  7iv7 ,nonprofit    
organizations that foster the           
professional development and collective 
engagement of direct care workers1      
including labor organizations4  7v7     
,nonprofit organizations with an        
expertise in identifying and addressing 
the care needs of local seniors and     
people with disabilities and their      
caregivers 7including area agencies on  
aging1 centers for independent living1  
and aging and disability resource       
centers74  7vi7 ,nonprofit ,state       
provider associations that represent    
providers who employ direct care        
workers1 where such associations exist4 
7,h7 ,how the eligible entity will      
consult with individuals employed as    
direct care workers1 representatives of 
such workers1 individuals assisted by   
such workers1 and the families of such  
individuals throughout the project4     
7,i7 ,outreach efforts to individuals   

for participation in such project1      
including targeted outreach to          
recipients of assistance under a ,state 
program funded under part ,a of title   
,,iv of the ,social ,security ,act or   
individuals who are eligible for such   
assistance4  7#c7 ,evaluation ,in       
selecting eligible entities to receive a
 grant under this section1 the          
,secretary shall-- 7,a7 ensure--  7i7   
geographic and demographic diversity1   
including rural and urban areas2 and    
7ii7 that selected eligible entities    
will serve areas where direct care1 or  
related occupations1 is considered an   
in-demand industry sector or occupation2
 and  7,b7 evaluate the efficacy of each
 project plan submitted under paragraph 
7#b7-- 7i7 for recruiting1 retaining1   
and providing advancement opportunities 
for direct care workers2 and  7ii7 on   
the methods used to recruit1 retain1 and
 provide advancement opportunities to   
direct care workers4  7d7 ,consultation 
,the ,secretary shall encourage each    

eligible entity receiving a grant under 
this section-- 7#a7 in developing and   
carrying out a project under this       
section1 to consult with--  7,a7        
institutions of higher education2  7,b7 
entities that employ direct care        
workers2  7,c7 the ,state               
,apprenticeship ,agency recognized under
 the ,act of ,august #af1 #aicg         
7commonly known as the ,national        
,apprenticeship ,act71 for the ,state or
 region to be served by the eligible    
entity or1 if no such agency has been   
recognized in the ,state or region1 the 
,office of ,apprenticeship of the       
,department of ,labor2 and  7,d7        
one-stop centers2 and  7#b7 in carrying 
out a project under this section1 to    
coordinate1 to the extent practicable1  
activities under the project with       
activities under the grants awarded     
under section #bjjh of the ,social      
,security ,act 7#db ,u4,s4,c4 #acig;g74 
7e7 ,uses of funds ,each eligible entity
 receiving a grant under this section   

shall use such funds to carry out a     
project or to continue a project        
commenced prior to receipt of such grant
 that develops and implements a strategy
 for the recruitment1 retention1 or     
advancement of direct care workers1     
which includes the activities described 
in subsection 7c77#b71 and that provides
 compensation to each eligible direct   
care worker for any training received   
under the project4  7f7 ,supplement1 not
 supplant ,an eligible entity receiving 
a grant under this ,act shall use such  
grant only to supplement1 and not       
supplant1 the amount of funds that1 in  
the absence of such grant1 would be     
available to address the recruitment1   
retention1 and advancement of direct    
care workers in the ,state or region    
served by the eligible entity4  7g7     
,reports  7#a7 ,eligible entities  7,a7 
,in general ,not later #f months after  
the completion of each project assisted 
with a grant under this section1 the    
eligible entity that received such grant

 shall submit to the ,secretary of      
,labor and the ,secretary of ,health and
 ,human ,services a report on the       
progress and outcomes of the project1   
which data shall be disaggregated in the
 manner described in subparagraph 7,b71 
and shall include the following3  7i7   
,the number of individuals served by the
 project1 including-- 7,i7 the number of
 individuals recruited to be employed as
 an direct care worker2 and  7,,ii7 the 
number of individuals who attained      
employment as an direct care worker4    
7ii7 ,the percentage of individuals     
described in clause 7i77,,ii7 employed  
as an direct care worker in the manner  
described in subclause 7,i7 of section  
#aaf7;b77#b77;,a77i7 of the ,workforce  
,innovation and ,opportunity ,act 7#bi  
,u4,s4,c4 #cada7;b77#b77;,a77i774  7iii7
 ,the percentage of individuals         
described in clause 7i77,,ii7 employed  
in the manner described in subclause    
7,,ii7 of section #aaf7;b77#b77;,a77i7  
of such ,act 7#bi ,u4,s4,c4             

#cada7;b77#b77;,a77i774  7iv7 ,the      
number of individuals or families       
assisted by direct care workers4  7v7   
,the number of direct care workers who  
received and completed the following    
training or education in the field of   
direct care1 if applicable3  7,i7       
,entry-level training4  7,,ii7          
,advanced-level training4  7,,iii7      
,continuing education4  7,,iv7          
,professional development1 mentoring1 or
 supervision4  7vi7 ,the median earnings
 of individuals completing each type    
training or education described in      
clause 7v71 as determined in accordance 
with section #aaf7;b77#b77;,a77i77,,iii7
 of the ,workforce ,innovation and      
,opportunity ,act 7#bi ,u4,s4,c4        
#cada7;b77#b77;,a77i77,,iii774  7vii7   
,how the project assessed satisfaction  
with respect to-- 7,i7 direct care      
workers assisted by the project2  7,,ii7
 individuals receiving services         
delivered by such workers1 including any
 impact on the health care outcomes of  

such individuals2 and  7,,iii7 employers
 of such workers1 as determined in      
accordance with section                 
#aaf7;b77#b77;,a77i77,,vi7 of the       
,workforce ,innovation and ,opportunity 
,act 7#bi ,u4,s4,c4                     
#cada7;b77#b77;,a77i77,,vi774  7viii7   
,other services1 benefits1 or supports  
7other than the services1 benefits1 or  
supports described in clause 7v77       
provided to assist in the recruitment1  
retention1 and advancement of direct    
care workers1 the number of individuals 
who accessed such services1 benefits1 or
 supports1 and the impact of such       
services1 benefits1 or supports4  7,b7  
,disaggregation ,the data collected     
under clauses 7i7 through 7vi7 of       
subparagraph 7,a7 shall be disaggregated
 by race1 ethnicity1 sex1 and age in    
accordance with section                 
#aaf7;d77#b77;,b7 of the ,workforce     
,innovation and ,opportunity ,act 7#bi  
,u4,s4,c4 #cada7;d77#b774  7,c7         
,supplemental outcomes information      

,eligible entities shall submit         
supplemental information detailing the  
outcomes of the project1 including      
explanations of the information provided
 in accordance with 7,a74  7#b7         
,secretaries ,not later than #a year    
after the completion of each project    
assisted with a grant under this        
section1 the ,secretary of ,labor1 in   
consultation with the ,secretary of     
,health and ,human ,services1 shall     
prepare and submit to ,congress a report
 containing--  7,a7 the progress and    
outcomes of the project submitted by the
 eligible entity under paragraph 7#a72  
7,b7 an analysis of the workforce       
supply1 current and projected shortages1
 and distribution of direct care workers
 at a national1 regional1 and ,state    
level2 and  7,c7 recommendations for    
such legislative or administrative      
action as the ,secretaries determine    
appropriate4  7#c7 ,,gao report ,not    
later than #a year after the completion 
of each project assisted with a grant   

under this section1 the ,comptroller    
,general of the ,united ,states shall   
conduct a study and submit to ,congress 
a report including--  7,a7 an assessment
 of how the project assisted in the     
recruitment1 retention1 and advancement 
of direct care workers2 and  7,b7 such  
recommendations for legislative or      
administrative changes as the           
,comptroller ,general determines are    
appropriate4  7h7 ,technical assistance 
,not later than #f months after the date
 of enactment of this ,act1 the         
,secretary of ,labor shall provide      
technical assistance to eligible        
entities1 for purposes of compliance    
with subsection 7g77#a7 of this section1
 on--  7#a7 the disaggregation          
requirements of section                 
#aaf7;d77#b77;,b7 of the ,workforce     
,innovation and ,opportunity ,act 7#bi  
,u4,s4,c4 #cada7;d77#b772 and  7#b7 the 
data collection requirements of section 
#aaf7;b77#b77;,a77i7 of such ,act 7#bi  
,u4,s4,c4 #cada7;b77#b77;,a77i774  7i7  

,authorization of appropriations ,there 
are authorized to be appropriated such  
funds as may be necessary to carry out  
this section for each of fiscal years   
#bjah through #bjbb4  7j7 ,definitions  
,in this ,act3 7#a7 ,career pathway ,the
 term career pathway has the meaning    
given the term in section #c of the     
,workforce ,innovation and ,opportunity 
,act 7#bi ,u4,s4,c4 #cajb74  7#b7       
,direct care worker ,the term direct    
care worker has the meaning given the   
term in section #gii;,b of the ,public  
,health ,service ,act 7#db ,u4,s4,c4    
#biep74  7#c7 ,eligible entity ,the term
 eligible entity means--  7,a7 a ,state2
  7,b7 a nonprofit organization1 labor  
organization1 or an entity with shared  
labor-management oversight--  7i7 with  
an established record of recruiting or  
providing training to direct care       
workers2 or  7ii7 that established a    
training program in consultation with an
 organization with an established record
 of providing training to direct care   

workers2  7,c7 a local board2  7,d7 a   
nonprofit entity carrying out a         
registered apprenticeship program2  7,e7
 ,indian tribe or tribal organization2  
or  7,f7 a consortium of entities listed
 in subparagraph 7,a71 7,b71 7,c71 7,d71
 or 7,e7 which may include an           
institution of higher education4  7#d7  
,employ2 employer ,the terms employ and 
employer have the meanings given the    
terms in section #c of the ,fair ,labor 
,standards ,act 7#bi ,u4,s4,c4 #bjc et  
seq474  7#e7 ,indian tribe2 tribal      
organization ,the terms ,indian tribe   
and tribal organization have the        
meanings given such terms in section #d 
of the ,indian ,self-,determination and 
,education ,assistance ,act 7#be        
,u4,s4,c4 #ecjd74  7#f7 ,institution of 
higher education ,the term institution  
of higher education has the meaning     
given the term in section #aja7;a7 of   
the ,higher ,education ,act of #aife    
7#bj ,u4,s4,c4 #ajja7;a774  7#g7 ,local 
board ,the term local board has the     

meaning given the term in section #c of 
the ,workforce ,innovation and          
,opportunity ,act 7#bi ,u4,s4,c4 #cajb74
  7#h7 ,in-demand industry sector or    
occupation ,the term in-demand industry 
sector or occupation has the meaning    
given the term in section #c of the     
,workforce ,innovation and ,opportunity 
,act 7#bi ,u4,s4,c4 #cajb74  7#i7       
,one-stop center ,the term one-stop     
center has the meaning given the term in
 section #c of the ,workforce           
,innovation and ,opportunity ,act 7#bi  
,u4,s4,c4 #cajb74  7#aj7 ,region ,the   
term region has the meaning given the   
term in section #c of the ,workforce    
,innovation and ,opportunity ,act 7#bi  
,u4,s4,c4 #cajb74  7#aa7 ,registered    
apprenticeship program ,the term        
registered apprenticeship program has   
the meaning given the term in section   
#aga7;b7 of the ,workforce ,innovation  
and ,opportunity ,act 7#bi ,u4,s4,c4    
#cbbf7;b774  7#ab7 ,secretary ,the term 
,secretary means the ,secretary of      

,labor4  7#ac7 ,state ,the term ,state  
means any ,state of the ,united ,states 
or the ,district of ,columbia ,district 
of ,columbia1 and any commonwealth1     
possession1 or other territory of the   
,united ,states4  7#ad7 ,state board    
,the term ,state board has the meaning  
given the term in section #c of the     
,workforce ,innovation and ,opportunity 
,act 7#bi ,u4,s4,c4 #cajb74  7#ae7      
,work-based learning strategy ,the term 
work-based learning strategy means a    
strategy 7which may be a registered     
apprenticeship7 that provides workers   
with paid work experience and           
corresponding classroom instruction1 as 
appropriate1 delivered in an employment 
relationship that both the employer and 
worker intend to be permanent4