Direct CARE Opportunity Act

I 116TH CONGRESS 1ST SESSION H. R. 4397 To award grants for the recruitment, retention, and advancement of direct care workers. IN THE HOUSE OF REPRESENTATIVES SEPTEMBER 19, 2019 Mr. SCOTT of Virginia (for himself and Mrs. LEE of Nevada) introduced the following bill; which was referred to the Committee on Education and Labor, and in addition to the Committee on Energy and Commerce, 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 com- mittee concerned 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 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 2 •HR 4397 IH (1) Millions of older individuals and individuals 1 with disabilities in the United States require assist- 2 ance with activities of daily living to live independ- 3 ently and participate in their communities to their 4 fullest extent. The Bureau of the Census projects 5 that by 2060 the population of individuals age 65 or 6 older will double from 49,200,000 in 2016 to 7 94,700,000. According to the Centers for Disease 8 Control and Prevention, 1 in 4 (or 60,000,000) 9 adults in the United States are living with a dis- 10 ability. 11 (2) The assistance of direct care workers allows 12 older individuals and individuals with disabilities to 13 live with dignity and safety, and to exercise their 14 right to live independently in their own homes and 15 communities, in keeping with what is most appro- 16 priate for their needs and preferences. Older individ- 17 uals and individuals with disabilities may also par- 18 ticipate in the direct care workforce, further sup- 19 porting their ability to live independently. 20 (3) According to PHI, direct care workers pro- 21 vide most of the paid, hands-on care for older indi- 22 viduals and individuals with disabilities. 23 (4) According to PHI, 4,500,000 direct care 24 workers provide care across home and community- 25 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 3 •HR 4397 IH based settings, nursing facilities, assisted living fa- 1 cilities, group homes, intermediate care facilities, 2 and hospitals to care for the growing population of 3 older individuals and individuals with disabilities. 4 (5) PHI projects that by 2024, 5,200,000 di- 5 rect care workers will be needed across all care set- 6 tings to care for the growing population of older in- 7 dividuals and individuals with disabilities. 8 (6) Many direct care workers lack access to a 9 career pathway or advanced training opportunities. 10 This limits their ability to build competency and ex- 11 pertise in their field that, when gained, may lead to 12 an increase in their earning capacity. According to 13 PHI, more than half of home care workers have 14 completed no formal education beyond high school, 15 making high-quality, transferable training essential 16 to success on the job. 17 (7) As of 2015, the median wage for direct care 18 workers is approximately $11 an hour; wages and 19 earnings for home care workers are even lower in 20 rural areas. Because of low wages, variable work 21 hours, and the inability to access workplace-based 22 benefits, 19 percent of home care workers live below 23 the Federal poverty level as compared to 9 percent 24 of the general United States workforce. Nearly half 25 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 4 •HR 4397 IH of direct care workers rely on some form of public 1 assistance to support themselves and their families. 2 (8) According to PHI, approximately 9 in 10 3 direct care workers are women, more than half are 4 women of color, and one quarter of direct care work- 5 ers are immigrants. 6 (9) The direct care workforce is plagued with 7 high turnover, low job satisfaction, and workforce 8 shortages. These conditions can contribute to re- 9 duced quality of care and threaten the availability of 10 supports for older individuals and individuals with 11 disabilities. 12 (10) Because of the nature of the work, direct 13 care workers suffer from disproportionately high 14 rates of injury. In 2016, the injury rate for nursing 15 assistants was 337 per 10,000 as compared to 100 16 per 10,000 for other occupations. 17 (11) Training has been shown to reduce worker 18 turnover, reduce rates of injury, and lead to in- 19 creased job satisfaction. 20 (12) The Institute of Medicine found that to 21 ensure that the United States is prepared to meet 22 the health care needs of older individuals during the 23 21st century, it is essential that the capacity of the 24 direct care workforce be enhanced in both the num- 25 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 5 •HR 4397 IH ber of workers available and their ability to meet 1 their own health care and quality of life needs. 2 SEC. 3. DEFINITIONS. 3 In this Act: 4 (1) APPRENTICESHIP PROGRAM.—The term 5 ‘‘apprenticeship program’’ means an apprenticeship 6 program registered under the Act of August 16, 7 1937 (commonly known as the ‘‘National Appren- 8 ticeship Act’’; 50 Stat. 664, chapter 663; 29 U.S.C. 9 50 et seq.). 10 (2) DIRECT CARE WORKER.—The term ‘‘direct 11 care worker’’ has the meaning given the term in sec- 12 tion 799B of the Public Health Service Act (42 13 U.S.C. 295p). 14 (3) ELIGIBLE ENTITY.—The term ‘‘eligible enti- 15 ty’’ means— 16 (A) a State; 17 (B) a nonprofit organization, a labor orga- 18 nization, or an entity with shared labor-man- 19 agement oversight— 20 (i) with an established record of re- 21 cruiting or providing training to direct care 22 workers; or 23 (ii) that establishes a training pro- 24 gram in consultation with an organization 25 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 6 •HR 4397 IH with an established record of providing 1 training to direct care workers; 2 (C) a local board; 3 (D) a nonprofit entity carrying out an ap- 4 prenticeship program; 5 (E) an Indian tribe or tribal organization; 6 or 7 (F) a consortium of entities listed in sub- 8 paragraph (A), (B), (C), (D), or (E) that may 9 also include an institution of higher education. 10 (4) EMPLOY; EMPLOYER.—The terms ‘‘employ’’ 11 and ‘‘employer’’ have the meanings given the terms 12 in section 3 of the Fair Labor Standards Act (29 13 U.S.C. 203 et seq.). 14 (5) INDIAN TRIBE; TRIBAL ORGANIZATION.— 15 The terms ‘‘Indian tribe’’ and ‘‘tribal organization’’ 16 have the meanings given such terms in section 4 of 17 the Indian Self-Determination and Education Assist- 18 ance Act (25 U.S.C. 5304). 19 (6) INSTITUTION OF HIGHER EDUCATION.—The 20 term ‘‘institution of higher education’’ has the 21 meaning given the term in section 101 of the Higher 22 Education Act of 1965 (20 U.S.C. 1001). 23 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 7 •HR 4397 IH (7) SECRETARY.—The term ‘‘Secretary’’ means 1 the Secretary of Labor, except as otherwise specified 2 in this Act. 3 (8) STATE.—The term ‘‘State’’ has the mean- 4 ing given the term in section 3 of the Carl D. Per- 5 kins Career and Technical Education Act of 2006 6 (20 U.S.C. 2302). 7 (9) WORKFORCE INNOVATION AND OPPOR- 8 TUNITY ACT TERMS.—The terms ‘‘career pathway’’, 9 ‘‘career planning’’, ‘‘in-demand industry sector or 10 occupation’’, ‘‘individual with a barrier to employ- 11 ment’’, ‘‘individual with a disability’’, ‘‘local board’’, 12 ‘‘older individual’’, ‘‘one-stop center’’, ‘‘on-the-job 13 training’’, ‘‘recognized postsecondary credential’’, 14 ‘‘region’’, ‘‘State board’’, and ‘‘supportive services’’ 15 have the meanings given such terms in section 3 of 16 the Workforce Innovation and Opportunity Act (29 17 U.S.C. 3102). 18 (10) WORK-BASED LEARNING.—The term 19 ‘‘work-based learning’’ has the meaning given the 20 term in section 3 of the Carl D. Perkins Career and 21 Technical Education Act of 2006 (20 U.S.C. 2302). 22 SEC. 4. AUTHORITY TO AWARD GRANTS; DURATION. 23 (a) AUTHORITY TO AWARD GRANTS.—Not later than 24 12 months after the date of enactment of this Act, the 25 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 8 •HR 4397 IH Secretary, in consultation with the Secretary of Health 1 and Human Services, shall award grants— 2 (1) to not fewer than 15 eligible entities to de- 3 velop and carry out projects for purposes of recruit- 4 ing, retaining, or providing advancement opportuni- 5 ties to direct care workers; and 6 (2) 5 of which shall be awarded for projects 7 that focus on providing such advancement opportu- 8 nities. 9 (b) TREATMENT OF CONTINUATION ACTIVITIES.— 10 An eligible entity that carries out activities for purposes 11 of recruiting, retaining, or providing advancement oppor- 12 tunities to direct care workers prior to receipt of a grant 13 under this Act may use such grant to continue carrying 14 out such activities, and shall be treated as an eligible enti- 15 ty carrying out a project described in subsection (a)(1). 16 (c) DURATION.— 17 (1) GRANT PERIOD.—A grant under this Act 18 shall be for not less than 5 years. 19 (2) LENGTH OF PROJECT.—A project assisted 20 with a grant awarded under this Act shall be carried 21 out for not less than 3 years. 22 SEC. 5. PROJECT PLANS; CONSULTATION. 23 (a) PROJECT PLANS.— 24 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 9 •HR 4397 IH (1) IN GENERAL.—To receive a grant under 1 this Act, an eligible entity shall submit to the Sec- 2 retary a project plan for each project to be developed 3 and carried out (or for activities to be continued) 4 with the grant at such time and in such manner as 5 the Secretary may determine, and which shall con- 6 tain the information described in paragraph (2). 7 (2) CONTENTS.—A project plan submitted by 8 an eligible entity under paragraph (1) shall include 9 a description of each of the following: 10 (A) Current or projected job openings for, 11 or relevant labor market information related to, 12 direct care workers in the State or region to be 13 served by the project, and the geographic scope 14 of the workforce to be served by the project. 15 (B) Specific efforts and strategies that the 16 project will undertake to reduce barriers to re- 17 cruitment, retention, or advancement of direct 18 care workers, including an assurance that such 19 efforts will include— 20 (i) an assessment of the wages or 21 other compensation or benefits necessary 22 to recruit and retain direct care workers; 23 and 24 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 10 •HR 4397 IH (ii) a description of the project’s pro- 1 jected wages and other compensation or 2 benefits for direct care workers at the 3 State or local level, including a comparison 4 of such projected wages to regional and 5 national wages. 6 (C) In the case of a project offering an 7 education and training program, a description 8 of such program (including any curricula, mod- 9 els, and standards used under the program, and 10 any associated recognized postsecondary creden- 11 tials for which the program provides prepara- 12 tion, as applicable), which shall include an as- 13 surance that such program will provide— 14 (i) an apprenticeship program, work- 15 based learning, or on-the-job training op- 16 portunities; 17 (ii) supervision or mentoring; and 18 (iii) a progressively increasing, clearly 19 defined schedule of wages to be paid to the 20 direct care worker that— 21 (I) is consistent with skill gains 22 or attainment of a recognized postsec- 23 ondary credential; and 24 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 11 •HR 4397 IH (II) ensures the entry wage is not 1 less than the greater of— 2 (aa) the minimum wage re- 3 quired under section 6(a) of the 4 Fair Labor Standards Act of 5 1938 (29 U.S.C. 206(a)); or 6 (bb) the applicable wage re- 7 quired by other applicable Fed- 8 eral or State law, or a collective 9 bargaining agreement. 10 (D) If applicable, any other innovative 11 models or processes the eligible entity will im- 12 plement to support the retention of direct care 13 workers. 14 (E) The supportive services and benefits to 15 be provided to direct care workers to support 16 the retention of employment of direct care 17 workers. 18 (F) How the eligible entity will make use 19 of career planning to support the identification 20 of advancement opportunities and career path- 21 ways for direct care workers in the State or re- 22 gion to be served by the project. 23 VerDate Sep 11 2014 23:36 Sep 20, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H4397.IH H4397 kjohnson on DSK79L0C42 with BILLS 12 •HR 4397 IH (G) How the eligible entity will collect and 1 submit to the Secretary workforce data and 2 outcomes of the project. 3 (H) How the project will— 4 (i) provide adequate and safe equip- 5 ment, and facilities for training and super- 6 vision, including a safe work environment 7 free from discrimination; 8 (ii) provide safety training for direct 9 care workers as part of the education and 10 training program described in subpara- 11 graph (C), as applicable; and 12 (iii) provide adequate training for 13 mentors and qualified instructors to ensure 14 compliance with clause (i) and, as applica- 15 ble, clause (ii). 16 (I) How the eligible entity will consult on 17 the implementation of the project, or coordinate 18 the project with, each of the following entities, 19 to the extent that each such entity is not a part 20 of the eligible entity: 21 (i) The State agency responsible for 22 administering the State plan under title 23 XIX of the Social Securi [Text truncated for display. 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