,,ii #aagth ,,congress #ast ,session ,s4 #cahi ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #d1 #bjba,mr4 ,heinrich 7for himself1 ,mr4 ,wyden1 ,mr4 ,lujn1 ,mr4 ,murphy1 ,mr4 ,blumenthal1 and ,ms4 ,rosen7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xx of the ,social ,security ,act to provide a pathway to health careers through health profession opportunity grants4 #a4 ,short title ,this ,act may be cited as the ,pathways to ,health ,careers ,act4 #b4 ,pathways to ,health ,careers ,effective ,october #a1 #bjba1 title ,,xx of the ,social ,security ,act 7#db ,u4,s4,c4 #acig-acign-#ac7 is amended by adding at the end the following3 ,d ,career pathways through health profession opportunity grants #bjga4 ,career pathways through health profession opportunity grants 7a7 ,application requirements ,an eligible entity desiring a grant under this section for a project shall submit to the ,secretary an application for the grant1 that includes the following3 7#a7 ,a description of how the applicant will use a career pathways approach to train eligible individuals for health professions that will put eligible individuals on a career path to an occupation that pays well1 under the project4 7#b7 ,a description of the adult basic education and literacy activities1 work readiness activities1 training activities1 and case management and career coaching services that the applicant will use to assist eligible individuals to gain work experience1 connection to employers1 and job placement1 and a description of the plan for recruiting1 hiring1 and training staff to provide the case management1 mentoring1 and career coaching services1 under the project directly or through local governmental1 apprenticeship1 educational1 or charitable institutions4 7#c7 ,a demonstration that the applicant has experience working with low-income populations1 or a description of the plan of the applicant to work with a partner organization that has the experience4 7#d7 ,a plan for providing post-employment support and ongoing training as part of a career pathway under the project4 7#e7 ,a description of the support services that the applicant will provide under the project1 including a plan for how child care and transportation support services will be guaranteed and1 if the applicant will provide a cash stipend or wage supplement1 how the stipend or supplement would be calculated and distributed4 7#f7 ,a certification by the applicant that the project development included-- 7,a7 consultation or commitment to consult with a local workforce development board2 7,b7 consideration of registered apprenticeship and pre-apprenticeship models2 7,c7 consideration of career pathway programs in the ,state in which the project is to be conducted2 and 7,d7 a review of the ,state plan under section #ajb or #ajc of the ,workforce ,innovation and ,opportunity ,act4 7#g7 ,a description of the availability and relevance of recent labor market information and other pertinent evidence of in-demand jobs or worker shortages4 7#h7 ,a certification that the applicant will directly provide or contract for the training services described in the application4 7#i7 ,a commitment by the applicant that1 if the grant is made to the applicant1 the applicant will-- 7,a7 during the planning period for the project1 provide the ,secretary with any information needed by the ,secretary to establish adequate data reporting and administrative structure for the project2 7,b7 hire a person to direct the project not later than the end of the planning period applicable to the project2 7,c7 accept all technical assistance offered by the ,secretary with respect to the grant2 7,d7 participate in peer technical assistance conferences as are regularly scheduled by the ,secretary2 and 7,e7 provide all data required by the ,secretary under subsection 7g74 7b7 ,additional application element ,in considering applications for a grant under this section1 the ,secretary shall require qualified applicants to have at least #a of the following application elements-- 7#a7 applications submitted by applicants to whom a grant was made under this section or any predecessor to this section2 7#b7 applications submitted by applicants who have business and community partners in each of the following categories3 7,a7 ,state and local government agencies and social service providers1 including a ,state or local entity that administers a ,state program funded under part ,a of this title2 7,b7 institutions of higher education1 apprenticeship programs1 and local workforce development boards2 and 7,c7 health care employers1 health care industry or sector partnerships1 labor unions1 and labor-management partnerships2 7#c7 applications that include opportunities for mentoring or peer support1 and make career coaching available1 as part of the case management plan2 7#d7 applications which describe a project that will serve a rural area in which-- 7,a7 the community in which the individuals to be enrolled in the project reside is located2 7,b7 the project will be conducted2 or 7,c7 an employer partnership that has committed to hiring individuals who successfully complete all activities under the project is located2 7#e7 applications that include a commitment to providing project participants with a cash stipend or wage supplement2 and 7#f7 applications which have an emergency cash fund to assist project participants financially in emergency situations4 7c7 ,grants 7#a7 ,competitive grants 7,a7 ,grant authority 7i7 ,in general ,the ,secretary shall make a grant in accordance with this paragraph to an eligible entity whose application for the grant is approved by the ,secretary1 to conduct a project designed to train low-income individuals for allied health professions1 health information technology1 physician assistants1 nursing assistants1 registered nurse1 advanced practice nurse1 and other professions considered part of a health care career pathway model4 7ii7 ,guarantee of grantees in each state and the district of columbia ,for each grant cycle1 the ,secretary shall award a grant under this paragraph to at least #b eligible entities in each ,state that is not a territory1 to the extent there are a sufficient number of applications that have a high likelihood of success and that are submitted by the entities that meet the requirements applicable with respect to such a grant4 ,if1 for a grant cycle1 there are fewer than #b such eligible entities in a ,state that have submitted applications with a high likelihood of success1 the ,secretary shall identify qualified eligible applicants located elsewhere1 that are otherwise approved but un-funded1 and issue a ,substitution of ,grant and tailored technical assistance4 ,in the preceding sentence1 the term issue a ,substitution of ,grant means1 in a case in which an approved grantee does not complete its full project period1 or in which there are fewer than #b qualified grantees per ,state with a high likelihood of success1 substitute an applicant located in another ,state that was approved but un-funded during the competition for the award for the award recipient4 7,b7 ,guarantee of grants for indian populations ,the ,secretary shall award a grant under this paragraph to at least #aj eligible entities that are an ,indian tribe1 a tribal organization1 or a tribal college or university1 to the extent there are a sufficient number of applications submitted by the entities that meet the requirements applicable with respect to such a grant4 7,c7 ,guarantee of grantees in the territories ,the ,secretary shall award a grant under this paragraph to at least #b eligible entities that are located in a territory1 to the extent there are a sufficient number of applications submitted by the entities that meet the requirements applicable with respect to such a grant4 7#b7 ,grant cycle ,the grant cycle under this section shall be not less than #e years1 with a planning period of not more than the first #ab months of the grant cycle4 ,during the planning period1 the amount of the grant shall be in such lesser amount as the ,secretary determines appropriate4 7d7 ,use of grant 7#a7 ,in general ,an entity to which a grant is made under this section shall use the grant in accordance with the approved application for the grant4 7#b7 ,support to be provided 7,a7 ,required support ,a project for which a grant is made under this section shall include the following3 7i7 ,an assessment for adult basic skill competency1 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-secondary training1 through means including the following3 7,i7 ,establishing a network of partners that offer pre-training activities for project participants who need to improve basic academic skills or ,english language proficiency before entering a health occupational training career pathway program4 7,,ii7 ,offering resources to enable project participants to continue advancing adult basic skill proficiency while enrolled in a career pathway program4 7,,iii7 ,embedding adult basic skill maintenance as part of ongoing post-graduation career coaching and mentoring4 7ii7 ,a guarantee that child care is an available and affordable support service for project participants through means such as the following3 7,i7 ,referral to1 and assistance with1 enrollment in a subsidized child care program4 7,,ii7 ,direct payment to a child care provider if a slot in a subsidized child care program is not available or reasonably accessible4 7,,iii7 ,payment of co-payments or associated fees for child care4 7iii7 ,case management plans that include career coaching 7with the option to offer appropriate peer support and mentoring opportunities to help develop soft skills and social capital71 which may be offered on an ongoing basis before1 during1 and after initial training as part of a career pathway model4 7iv7 ,a plan to provide project participants with transportation through means such as the following3 7,i7 ,referral to1 and assistance with enrollment in1 a subsidized transportation program4 7,,ii7 ,if a subsidized transportation program is not reasonably available1 direct payments to subsidize transportation costs4 ,for purposes of this clause1 the term transportation includes public transit1 or gasoline for a personal vehicle if public transit is not reasonably accessible or available4 7,b7 ,allowed support ,the goods and services provided under a project for which a grant is made under this section may include the following3 7i7 ,a cash stipend4 7ii7 ,a reserve fund for financial assistance to project participants in emergency situations4 7iii7 ,tuition1 certification exam fees1 and training materials such as books1 software1 uniforms1 shoes1 connection to the internet1 hair nets1 and personal protective equipment4 7iv7 ,in-kind resource donations such as interview clothing and conference attendance fees4 7v7 ,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 goals4 7vi7 ,assistance with programs and activities1 including legal assistance1 deemed necessary to address arrest or conviction records as an employment barrier4 7vii7 ,other support services as deemed necessary for family well-being1 success in the project1 and progress toward career goals4 7#c7 ,training ,the number of hours of training provided to an eligible individual under a project for which a grant is made under this section1 for a recognized postsecondary credential 7including an industry-recognized credential1 and a certificate awarded by a local workforce development board71 which is awarded in recognition of attainment of measurable technical or occupational skills necessary to gain employment or advance within an occupation1 shall be-- 7,a7 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 conducted2 or 7,b7 if there is no such requirement1 such number of hours of training as the ,secretary finds is necessary to achieve that skill level4 7#d7 ,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 program funded under part ,a of title ,,iv1 at least #aj percent of the eligible individuals to whom support is provided under the project shall meet the income eligibility requirements under that ,state program1 without regard to whether the individuals receive benefits or services directly under that ,state program4 7#e7 ,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 individual4 7#f7 ,prohibition ,an entity to which a grant is made under this section shall not use the grant for purposes of entertainment1 except that case management and career coaching services may include celebrations of specific career-based milestones such as completing a semester1 graduation1 or job placement4 7e7 ,technical assistance 7#a7 ,in general ,the ,secretary shall provide technical assistance-- 7,a7 to assist eligible entities in applying for grants under this section2 7,b7 that is tailored to meet the needs of grantees at each stage of the administration of projects for which grants are made under this section2 7,c7 that is tailored to meet the specific needs of ,indian tribes1 tribal organizations1 and tribal colleges and universities2 7,d7 that is tailored to meet the specific needs of the territories2 7,e7 that is tailored to meet the specific needs of applicants1 eligible entities1 and grantees1 in carrying out dedicated career pathway projects pursuant to subsections 7h7 and 7i72 and 7,f7 to facilitate the exchange of information among eligible entities regarding best practices and promising practices used in the projects4 7#b7 ,continuation of peer technical assistance 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 section4 ,the preceding sentence shall not be interpreted to require any such conference to be held in person4 7f7 ,evaluation of dedicated career pathways 7#a7 ,in general ,the ,secretary shall1 by grant1 contract1 or interagency agreement1 conduct rigorous and well-designed evaluations of the dedicated career pathway projects carried out pursuant to subsections 7h7 and 7i74 7#b7 ,requirement applicable to second chance career pathway ,in the case of a project of the type described in subsection 7i71 the evaluation shall include identification of successful activities for creating opportunities for developing and sustaining1 particularly with respect to low-income individuals with arrest or conviction records1 a health professions workforce that has accessible entry points1 that meets high standards for education1 training1 certification1 and professional development1 and that provides increased wages and affordable benefits1 including health care coverage1 that are responsive to the needs of the workforce4 7#c7 ,requirement applicable to maternal mortality career pathway ,in the case of a project of the type described in subsection 7h71 the evaluation shall include identification of successful activities for creating opportunities for developing and sustaining1 particularly with respect to low-income individuals and other entry-level workers1 a career pathway that has accessible entry points1 that meets high standards for education1 training1 certification1 and professional development1 and that provides increased wages and affordable benefits1 including health care coverage1 that are responsive to the needs of the birth1 pregnancy1 and post-partum workforce4 7g7 ,reports ,as a condition of funding1 an eligible entity awarded a grant to conduct a project under this section shall submit interim reports to the ,secretary on the activities carried out under the project1 and1 on the conclusion of the project1 a final report on the activities4 7h7 ,maternal mortality career pathway 7#a7 ,grant authority ,the ,secretary shall award grants in accordance with this subsection to eligible entities to conduct career pathway projects for the purpose of providing education for professions such as doulas1 lactation consultants1 childbirth educators1 infant massage therapists1 newborn care specialists1 midwives1 and other community health worker professions1 for individuals to enter and follow a dedicated career pathway in the field of pregnancy1 childbirth1 or post-partum services in a ,state that recognizes doulas or midwives as health care providers and that provides payment for services provided by doulas or midwives1 as the case may be1 under the ,state plan approved under title ,,xix4 7#b7 ,duration ,a grant awarded under this subsection shall have the same grant cycle as is provided in subsection 7c77#b71 and as a condition of funding the grantee shall comply with all data reporting requirements associated with the grant cycle4 7#c7 ,application requirements ,an entity seeking a grant under this subsection for a project shall submit to the ,secretary an application for the grant1 that includes the following3 7,a7 ,a description of the partnerships1 strategic staff hiring decisions1 tailored program activities1 or other programmatic elements of the project that are designed to support a strong career pathway in pregnancy1 birth1 or post-partum services4 7,b7 ,a demonstration that the ,state in which the project is to be conducted recognizes and permits doulas and midwives to practice in the ,state4 7,c7 ,a demonstration that the applicant has experience working with low-income populations1 or a description of the plan of the applicant to work with a partner that has the experience4 7#d7 ,support to be provided ,the recipient of a grant under this subsection for a project shall provide required supportive services described in subsection 7d77#b77;,a7 to project participants who need the services1 and may expend the funding on eligible supportive services described in subsection 7d77#b77;,b74 7i7 ,second chance career pathway 7#a7 ,grant authority ,the ,secretary shall award grants in accordance with this subsection to eligible entities to conduct career pathway projects for the purpose of providing education and training for eligible individuals with arrest or conviction records to enter and follow a career pathway in the health professions through occupations that are expected to experience a labor shortage or be in high demand4 7#b7 ,duration ,a grant awarded under this subsection shall have the same grant cycle as is provided in subsection 7c77#b71 and as a condition of funding the grantee shall comply with all data reporting requirements associated with the grant cycle4 7#c7 ,application requirements ,an entity seeking a grant under this subsection for a project shall submit to the ,secretary an application for the grant1 that includes the following3 7,a7 ,a demonstration that the ,state in which the project is to be conducted 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 7which policies or laws shall include appeals processes and other opportunities to demonstrate rehabilitation to obtain licensure and approval to work in the proposed health careers71 and a plan described in the application which will use a legally permitted career pathway to train people with such a record to be trained and employed in such a career4 7,b7 ,a discussion of how the project or future strategic hiring decisions will demonstrate the experience and expertise of the project in working with job seekers who have arrest or conviction records or employers with experience working with people with arrest or conviction records4 7,c7 ,a demonstration that the applicant has experience working with low-income populations1 or a description of the plan of the applicant to work with a partner that has the experience4 7,d7 ,an identification of promising innovations or best practices that can be used to provide the training4 7,e7 ,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 criminal records can be hired4 7,f7 ,a plan for recruiting students who are eligible individuals into the project4 7,g7 ,a plan for providing post-employment support and ongoing training as part of a career pathway under the project4 7#d7 ,support to be provided 7,a7 ,required support ,a recipient of a grant under this subsection for a project shall provide-- 7i7 access to legal assistance for project participants for the purpose of addressing arrest or conviction records and associated workforce barriers2 7ii7 assistance with programs and activities deemed necessary to address arrest or conviction records as an employment barrier2 and 7iii7 required supportive services described in subsection 7d77#b77;,a7 to participants who need the services1 and may expend funds on eligible supportive services described in subsection 7d77#b77;,b74 7j7 ,definitions ,in this section3 7#a7 ,allied health profession ,the term allied health profession has the meaning given in section #gii;,b7#e7 of the ,public ,health ,service ,act4 7#b7 ,career pathway ,the term career pathway has the meaning given that term in section #c7g7 of the ,workforce ,innovation and ,opportunity ,act4 7#c7 ,doula ,the term doula means an individual who-- 7,a7 is certified by an organization that has been established for not less than #e years and that requires the completion of continuing education to maintain the certification1 to provide non-medical advice1 information1 emotional support1 and physical comfort to an individual during the individual's pregnancy1 childbirth1 and post-partum period2 and 7,b7 maintains the certification by completing the required continuing education4 7#d7 ,eligible entity ,the term eligible entity means any of the following entities that demonstrates in an application submitted under this section that the entity has the capacity to fully develop and administer the project described in the application3 7,a7 ,a local workforce development board established under section #ajg of the ,workforce ,innovation and ,opportunity ,act4 7,b7 ,a ,state or territory1 a political subdivision of a ,state or territory1 or an agency of a ,state1 territory1 or such a political subdivision1 including a ,state or local entity that administers a ,state program funded under part ,a of this title4 7,c7 ,an ,indian tribe1 a tribal organization1 or a tribal college or university4 7,d7 ,an institution of higher education 7as defined in the ,higher ,education ,act of #aife74 7,e7 ,a hospital 7as defined in section #ahfa7;e774 7,f7 ,a high-quality skilled nursing facility4 7,g7 ,a ,federally qualified health center 7as defined in section #ahfa7;aa77#d774 7,h7 ,a nonprofit organization described in section #eja7;c77#c7 of the ,internal ,revenue ,code of #aihf1 a labor organization1 or an entity with shared labor-management oversight1 that has a demonstrated history of providing health profession training to eligible individuals4 7,i7 ,in the case of a project of the type provided for in subsection 7h7 of this section1 an entity recognized by a ,state1 ,indian tribe1 or tribal organization as qualified to train doulas or midwives1 if midwives or doulas1 as the case may be1 are permitted to practice in the ,state involved4 7,j7 ,an opioid treatment program 7as defined in section #ahfa7;jjj77#b771 and other high quality comprehensive addiction care providers4 7#e7 ,eligible individual ,the term eligible individual means an individual whose family income does not exceed #bjj percent of the ,federal poverty level4 7#f7 ,federal poverty level ,the term ,federal poverty level means the poverty line 7as defined in section #fgc7b7 of the ,omnibus ,budget ,reconciliation ,act of #aiha1 including any revision required by such section applicable to a family of the size involved74 7#g7 ,indian tribe2 tribal organization ,the terms ,indian tribe and tribal organization have the meaning given the terms in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #dej;b74 7#h7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja or #ajb7;a77#a77;,b7 of the ,higher ,education ,act of #aife4 7#i7 ,territory ,the term territory means the ,commonwealth of ,puerto ,rico1 the ,united ,states ,virgin ,islands1 ,guam1 the ,northern ,mariana ,islands1 and ,american ,samoa4 7#aj7 ,tribal college or university ,the term tribal college or university has the meaning given the term in section #caf7;b7 of the ,higher ,education ,act of #aife4 7k7 ,funding ,in addition to amounts otherwise available1 there is appropriated to the ,secretary-- 7#a7 #cah1gej1jjj for grants under subsection 7c77#a77;,a7 for each of fiscal years #bjbb through #bjbf2 7#b7 #ag1jjj1jjj for grants under subsection 7c77#a77;,b7 for each of fiscal years #bjbb through #bjbf2 7#c7 #ba1bej1jjj for grants under subsection 7c77#a77;,c7 for each of fiscal years #bjbb through #bjbf2 7#d7 #be1ejj1jjj for projects conducted under subsections 7h7 and 7i7 for each of fiscal years #bjbc through #bjbf2 7#e7 #be1ejj1jjj1 plus all amounts referred to in paragraphs 7#a7 through 7#d7 of this subsection that remain unused after all grant awards are made for the fiscal year1 for each of fiscal years #bjbb through #bjbf1 for the provision of technical assistance and administration2 and 7#f7 #ag1jjj1jjj for each of fiscal years #bjbb through #bjbf for studying the effects of the projects for which a grant is made under this section1 and for administration1 for the purpose of supporting the rigorous evaluation of the projects1 and supporting the continued study of the short-1 medium-1 and long-term effects of all such projects1 including the effectiveness of new or added elements of the projects4 4