Direct CARE Opportunity Act

II 116TH CONGRESS 1ST SESSION S. 2521 To award grants for the recruitment, retention, and advancement of direct care workers. IN THE SENATE OF THE UNITED STATES SEPTEMBER 19, 2019 Mr. KAINE (for himself and Ms. HASSAN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To award grants for the recruitment, retention, and advancement of direct care workers. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Direct Creation, Ad- 4 vancement, and Retention of Employment Opportunity 5 Act’’ or the ‘‘Direct CARE Opportunity Act’’. 6 SEC. 2. FINDINGS. 7 Congress finds the following: 8 (1) Millions of older individuals and individuals 9 with disabilities in the United States require assist- 10 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 2521 IS ance with activities of daily living to live independ- 1 ently and participate in their communities to their 2 fullest extent. The Bureau of the Census projects 3 that by 2060 the population of individuals age 65 or 4 older will double from 49,200,000 in 2016 to 5 94,700,000. According to the Centers for Disease 6 Control and Prevention, 1 in 4 (or 60,000,000) 7 adults in the United States are living with a dis- 8 ability. 9 (2) The assistance of direct care workers allows 10 older individuals and individuals with disabilities to 11 live with dignity and safety, and to exercise their 12 right to live independently in their own homes and 13 communities, in keeping with what is most appro- 14 priate for their needs and preferences. Older individ- 15 uals and individuals with disabilities may also par- 16 ticipate in the direct care workforce, further sup- 17 porting their ability to live independently. 18 (3) According to PHI, direct care workers pro- 19 vide most of the paid, hands-on care for older indi- 20 viduals and individuals with disabilities. 21 (4) According to PHI, 4,500,000 direct care 22 workers provide care across home and community- 23 based settings, nursing facilities, assisted living fa- 24 cilities, group homes, intermediate care facilities, 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 2521 IS and hospitals to care for the growing population of 1 older individuals and individuals with disabilities. 2 (5) PHI projects that by 2024, 5,200,000 di- 3 rect care workers will be needed across all care set- 4 tings to care for the growing population of older in- 5 dividuals and individuals with disabilities. 6 (6) Many direct care workers lack access to a 7 career pathway or advanced training opportunities. 8 This limits their ability to build competency and ex- 9 pertise in their field that, when gained, may lead to 10 an increase in their earning capacity. According to 11 PHI, more than half of home care workers have 12 completed no formal education beyond high school, 13 making high-quality, transferable training essential 14 to success on the job. 15 (7) As of 2015, the median wage for direct care 16 workers is approximately $11 an hour; wages and 17 earnings for home care workers are even lower in 18 rural areas. Because of low wages, variable work 19 hours, and the inability to access workplace-based 20 benefits, 19 percent of home care workers live below 21 the Federal poverty level as compared to 9 percent 22 of the general United States workforce. Nearly half 23 of direct care workers rely on some form of public 24 assistance to support themselves and their families. 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 2521 IS (8) According to PHI, approximately 9 in 10 1 direct care workers are women, more than half are 2 women of color, and one quarter of direct care work- 3 ers are immigrants. 4 (9) The direct care workforce is plagued with 5 high turnover, low job satisfaction, and workforce 6 shortages. These conditions can contribute to re- 7 duced quality of care and threaten the availability of 8 supports for older individuals and individuals with 9 disabilities. 10 (10) Because of the nature of the work, direct 11 care workers suffer from disproportionately high 12 rates of injury. In 2016, the injury rate for nursing 13 assistants was 337 per 10,000 as compared to 100 14 per 10,000 for other occupations. 15 (11) Training has been shown to reduce worker 16 turnover, reduce rates of injury, and lead to in- 17 creased job satisfaction. 18 (12) The Institute of Medicine found that to 19 ensure that the United States is prepared to meet 20 the health care needs of older individuals during the 21 21st century, it is essential that the capacity of the 22 direct care workforce be enhanced in both the num- 23 ber of workers available and their ability to meet 24 their own health care and quality of life needs. 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 2521 IS SEC. 3. DEFINITIONS. 1 In this Act: 2 (1) APPRENTICESHIP PROGRAM.—The term 3 ‘‘apprenticeship program’’ means an apprenticeship 4 program registered under the Act of August 16, 5 1937 (commonly known as the ‘‘National Appren- 6 ticeship Act’’; 50 Stat. 664, chapter 663; 29 U.S.C. 7 50 et seq.). 8 (2) DIRECT CARE WORKER.—The term ‘‘direct 9 care worker’’ has the meaning given the term in sec- 10 tion 799B of the Public Health Service Act (42 11 U.S.C. 295p). 12 (3) ELIGIBLE ENTITY.—The term ‘‘eligible enti- 13 ty’’ means— 14 (A) a State; 15 (B) a nonprofit organization, a labor orga- 16 nization, or an entity with shared labor-man- 17 agement oversight— 18 (i) with an established record of re- 19 cruiting or providing training to direct care 20 workers; or 21 (ii) that establishes a training pro- 22 gram in consultation with an organization 23 with an established record of providing 24 training to direct care workers; 25 (C) a local board; 26 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 2521 IS (D) a nonprofit entity carrying out an ap- 1 prenticeship program; 2 (E) an Indian tribe or tribal organization; 3 or 4 (F) a consortium of entities listed in sub- 5 paragraph (A), (B), (C), (D), or (E) that may 6 also include an institution of higher education. 7 (4) EMPLOY; EMPLOYER.—The terms ‘‘employ’’ 8 and ‘‘employer’’ have the meanings given the terms 9 in section 3 of the Fair Labor Standards Act (29 10 U.S.C. 203 et seq.). 11 (5) INDIAN TRIBE; TRIBAL ORGANIZATION.— 12 The terms ‘‘Indian tribe’’ and ‘‘tribal organization’’ 13 have the meanings given such terms in section 4 of 14 the Indian Self-Determination and Education Assist- 15 ance Act (25 U.S.C. 5304). 16 (6) INSTITUTION OF HIGHER EDUCATION.—The 17 term ‘‘institution of higher education’’ has the 18 meaning given the term in section 101 of the Higher 19 Education Act of 1965 (20 U.S.C. 1001). 20 (7) SECRETARY.—The term ‘‘Secretary’’ means 21 the Secretary of Labor, except as otherwise specified 22 in this Act. 23 (8) STATE.—The term ‘‘State’’ has the mean- 24 ing given the term in section 3 of the Carl D. Per- 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 2521 IS kins Career and Technical Education Act of 2006 1 (20 U.S.C. 2302). 2 (9) WORKFORCE INNOVATION AND OPPOR- 3 TUNITY ACT TERMS.—The terms ‘‘career pathway’’, 4 ‘‘career planning’’, ‘‘in-demand industry sector or 5 occupation’’, ‘‘individual with a barrier to employ- 6 ment’’, ‘‘individual with a disability’’, ‘‘local board’’, 7 ‘‘older individual’’, ‘‘one-stop center’’, ‘‘on-the-job 8 training’’, ‘‘recognized postsecondary credential’’, 9 ‘‘region’’, ‘‘State board’’, and ‘‘supportive services’’ 10 have the meanings given such terms in section 3 of 11 the Workforce Innovation and Opportunity Act (29 12 U.S.C. 3102). 13 (10) WORK-BASED LEARNING.—The term 14 ‘‘work-based learning’’ has the meaning given the 15 term in section 3 of the Carl D. Perkins Career and 16 Technical Education Act of 2006 (20 U.S.C. 2302). 17 SEC. 4. AUTHORITY TO AWARD GRANTS; DURATION. 18 (a) AUTHORITY TO AWARD GRANTS.—Not later than 19 12 months after the date of enactment of this Act, the 20 Secretary, in consultation with the Secretary of Health 21 and Human Services, shall award grants— 22 (1) to not fewer than 15 eligible entities to de- 23 velop and carry out projects for purposes of recruit- 24 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 2521 IS ing, retaining, or providing advancement opportuni- 1 ties to direct care workers; and 2 (2) 5 of which shall be awarded for projects 3 that focus on providing such advancement opportu- 4 nities. 5 (b) TREATMENT OF CONTINUATION ACTIVITIES.— 6 An eligible entity that carries out activities for purposes 7 of recruiting, retaining, or providing advancement oppor- 8 tunities to direct care workers prior to receipt of a grant 9 under this Act may use such grant to continue carrying 10 out such activities, and shall be treated as an eligible enti- 11 ty carrying out a project described in subsection (a)(1). 12 (c) DURATION.— 13 (1) GRANT PERIOD.—A grant under this Act 14 shall be for not less than 5 years. 15 (2) LENGTH OF PROJECT.—A project assisted 16 with a grant awarded under this Act shall be carried 17 out for not less than 3 years. 18 SEC. 5. PROJECT PLANS; CONSULTATION. 19 (a) PROJECT PLANS.— 20 (1) IN GENERAL.—To receive a grant under 21 this Act, an eligible entity shall submit to the Sec- 22 retary a project plan for each project to be developed 23 and carried out (or for activities to be continued) 24 with the grant at such time and in such manner as 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 2521 IS the Secretary may determine, and which shall con- 1 tain the information described in paragraph (2). 2 (2) CONTENTS.—A project plan submitted by 3 an eligible entity under paragraph (1) shall include 4 a description of each of the following: 5 (A) Current or projected job openings for, 6 or relevant labor market information related to, 7 direct care workers in the State or region to be 8 served by the project, and the geographic scope 9 of the workforce to be served by the project. 10 (B) Specific efforts and strategies that the 11 project will undertake to reduce barriers to re- 12 cruitment, retention, or advancement of direct 13 care workers, including an assurance that such 14 efforts will include— 15 (i) an assessment of the wages or 16 other compensation or benefits necessary 17 to recruit and retain direct care workers; 18 and 19 (ii) a description of the project’s pro- 20 jected wages and other compensation or 21 benefits for direct care workers at the 22 State or local level, including a comparison 23 of such projected wages to regional and 24 national wages. 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 2521 IS (C) In the case of a project offering an 1 education and training program, a description 2 of such program (including any curricula, mod- 3 els, and standards used under the program, and 4 any associated recognized postsecondary creden- 5 tials for which the program provides prepara- 6 tion, as applicable), which shall include an as- 7 surance that such program will provide— 8 (i) an apprenticeship program, work- 9 based learning, or on-the-job training op- 10 portunities; 11 (ii) supervision or mentoring; and 12 (iii) a progressively increasing, clearly 13 defined schedule of wages to be paid to the 14 direct care worker that— 15 (I) is consistent with skill gains 16 or attainment of a recognized postsec- 17 ondary credential; and 18 (II) ensures the entry wage is not 19 less than the greater of— 20 (aa) the minimum wage re- 21 quired under section 6(a) of the 22 Fair Labor Standards Act of 23 1938 (29 U.S.C. 206(a)); or 24 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 2521 IS (bb) the applicable wage re- 1 quired by other applicable Fed- 2 eral or State law, or a collective 3 bargaining agreement. 4 (D) If applicable, any other innovative 5 models or processes the eligible entity will im- 6 plement to support the retention of direct care 7 workers. 8 (E) The supportive services and benefits to 9 be provided to direct care workers to support 10 the retention of employment of direct care 11 workers. 12 (F) How the eligible entity will make use 13 of career planning to support the identification 14 of advancement opportunities and career path- 15 ways for direct care workers in the State or re- 16 gion to be served by the project. 17 (G) How the eligible entity will collect and 18 submit to the Secretary workforce data and 19 outcomes of the project. 20 (H) How the project will— 21 (i) provide adequate and safe equip- 22 ment, and facilities for training and super- 23 vision, including a safe work environment 24 free from discrimination; 25 VerDate Sep 11 2014 20:34 Sep 23, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2521.IS S2521 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 2521 IS (ii) provide safety training for direct 1 care workers as part of the education and 2 training program described in subpara- 3 graph (C), as applicable; and 4 (iii) provide adequate training for 5 mentors and qualified instructors to ensure 6 compliance with clause (i) and, as applica- 7 ble, clause (ii). 8 (I) How the eligible entity will consult on 9 the implementation of the project, or coordinate 10 the project with, each of the following entities, 11 to the extent that each such entity is not a part 12 of the eligible entity: 13 (i) The State agency responsible for 14 administering the State plan under title 15 XIX of the Social Security Act (42 U.S.C. 16 1396 et seq.) (or waiver of the plan), or 17 the State agency with primary responsi- 18 bility for providing services and supports 19 for individuals with int [Text truncated for display. Full text available on Congress.gov.]