Supporting Our Direct Care Workforce and Family Caregivers Act

II 118TH CONGRESS 1ST SESSION S. 1298 To award grants for the creation, recruitment, training and education, reten- tion, and advancement of the direct care workforce and to award grants to support family caregivers. IN THE SENATE OF THE UNITED STATES APRIL 26, 2023 Mr. KAINE (for himself, Mr. CASEY, Mr. REED, Ms. SMITH, Ms. HASSAN, Mr. WHITEHOUSE, Mrs. GILLIBRAND, and Mr. WYDEN) introduced the fol- lowing bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants to support family care- givers. 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 ‘‘Supporting Our Direct 4 Care Workforce and Family Caregivers Act’’. 5 SEC. 2. DEFINITIONS. 6 In this Act: 7 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1298 IS (1) APPRENTICESHIP PROGRAM.—The term 1 ‘‘apprenticeship program’’ means an apprenticeship 2 program registered under the Act of August 16, 3 1937 (commonly known as the ‘‘National Appren- 4 ticeship Act’’; 50 Stat. 664, chapter 663; 29 U.S.C. 5 50 et seq.), including any requirement, standard, or 6 rule promulgated under such Act. 7 (2) COMMUNITY COLLEGE.—The term ‘‘commu- 8 nity college’’ means a public institution of higher 9 education at which the highest degree that is pre- 10 dominantly awarded to students is an associate’s de- 11 gree, including Tribal Colleges or Universities receiv- 12 ing grants under section 316 of the Higher Edu- 13 cation Act of 1965 (20 U.S.C. 1059c) that offer a 14 2-year program for completion of such degree and 15 State public institutions of higher education that 16 offer such a 2-year program. 17 (3) DIRECT CARE PROFESSIONAL.—The term 18 ‘‘direct care professional’’— 19 (A) means an individual who, in exchange 20 for compensation, provides services to a person 21 with a disability or an older individual that pro- 22 motes the independence of such person or indi- 23 vidual, including— 24 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1298 IS (i) services that enhance the inde- 1 pendence and community inclusion for 2 such person or individual, including trav- 3 eling with such person or individual or at- 4 tending and assisting such person or indi- 5 vidual while visiting friends and family, 6 shopping, or socializing; 7 (ii) services such as coaching and sup- 8 porting such person or individual in com- 9 municating needs, achieving self-expres- 10 sion, pursuing personal goals, living inde- 11 pendently, and participating actively in em- 12 ployment or voluntary roles in the commu- 13 nity; 14 (iii) services such as providing assist- 15 ance with activities of daily living (such as 16 feeding, bathing, toileting, and ambulation) 17 and with tasks such as meal preparation, 18 shopping, light housekeeping, and laundry; 19 (iv) services that support such person 20 or individual at home, work, school, or in 21 any other community setting; or 22 (v) services that promote health and 23 wellness, including scheduling and taking 24 such person or individual to health care 25 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1298 IS appointments, communicating with health 1 and allied health professionals admin- 2 istering medications, implementing health 3 and behavioral health interventions and 4 treatment plans, monitoring and recording 5 health status and progress; and 6 (B) may include— 7 (i) a direct support professional sup- 8 porting people with intellectual and devel- 9 opmental disabilities; 10 (ii) a home and community-based 11 services manager or direct support profes- 12 sional manager; 13 (iii) a self-directed care worker; 14 (iv) a personal care service worker; 15 (v) a direct care worker, as defined in 16 section 799B of the Public Health Service 17 Act (42 U.S.C. 295p); or 18 (vi) any other position or job related 19 to the home care or direct care workforce, 20 such as positions or jobs in respite care or 21 palliative care, as determined by the Sec- 22 retary, in consultation with the Center for 23 Medicare & Medicaid Services and the Sec- 24 retary of Labor. 25 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1298 IS (4) DIRECT CARE WORKFORCE.—The term ‘‘di- 1 rect care workforce’’ means the broad workforce of 2 direct care professionals. 3 (5) FAMILY CAREGIVER.—The term ‘‘family 4 caregiver’’ has the meaning given such term in sec- 5 tion 2 of the RAISE Family Caregivers Act (42 6 U.S.C. 3030s note; Public Law 115–119) and in- 7 cludes paid and unpaid family caregivers. 8 (6) ELIGIBLE ENTITY.—The term ‘‘eligible enti- 9 ty’’ means an entity— 10 (A) that is— 11 (i) a State; 12 (ii) a labor organization, joint labor- 13 management organization, or employer of 14 direct care professionals; 15 (iii) a nonprofit entity with experience 16 in aging, disability, or supporting the 17 rights and interests of, training of, or edu- 18 cating direct care professionals or family 19 caregivers; 20 (iv) an Indian Tribe, Tribal organiza- 21 tion, or Urban Indian organization; 22 (v) a community college or other insti- 23 tution of higher education; or 24 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1298 IS (vi) a consortium of entities listed in 1 any of clauses (i) through (v); 2 (B) that agrees to include, as applicable 3 with respect to the type of grant the entity is 4 seeking under this Act and the activities sup- 5 ported through such grant, older individuals, 6 people with disabilities, direct care profes- 7 sionals, and family caregivers, as advisors and 8 trainers in such activities; and 9 (C) that agrees to consult with the State 10 Medicaid agency of the State (or each State) 11 served by the grant on the grant activities, to 12 the extent that such agency (or each such agen- 13 cy) is not the eligible entity. 14 (7) EMPLOYER.—The terms ‘‘employ’’ and 15 ‘‘employer’’ have the meanings given the terms in 16 section 3 of the Fair Labor Standards Act of 1938 17 (29 U.S.C. 203 et seq.). 18 (8) INDIAN TRIBE; TRIBAL ORGANIZATION.— 19 The terms ‘‘Indian Tribe’’ and ‘‘Tribal organiza- 20 tion’’ have the meanings given such terms in section 21 4 of the Indian Self-Determination and Education 22 Assistance Act (25 U.S.C. 5304). 23 (9) INSTITUTION OF HIGHER EDUCATION.—The 24 term ‘‘institution of higher education’’ means— 25 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1298 IS (A) an institution of higher education de- 1 fined in section 101 of the Higher Education 2 Act of 1965 (20 U.S.C. 1001); or 3 (B) an institution of higher education de- 4 fined in section 102(a)(1)(B) of such Act (20 5 U.S.C. 1002(a)(1)(B)). 6 (10) OLDER INDIVIDUAL.—The term ‘‘older in- 7 dividual’’ means an individual who is 60 years of age 8 or older. 9 (11) PERSON WITH A DISABILITY.—The term 10 ‘‘person with disability’’ means an individual with a 11 disability, as defined in section 3 of the Americans 12 with Disabilities Act of 1990 (42 U.S.C. 12102). 13 (12) PROJECT PARTICIPANT.—The term 14 ‘‘project participant’’ means an individual partici- 15 pating in a project or activity assisted with a grant 16 under this Act, including (as applicable for the cat- 17 egory of the grant) a direct care professional, or an 18 individual training to be such a professional, or a 19 family caregiver. 20 (13) SECRETARY.—The term ‘‘Secretary’’ 21 means the Secretary of Health and Human Services, 22 acting through the Administrator for Community 23 Living. 24 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1298 IS (14) SELF-DIRECTED CARE PROFESSIONAL.— 1 The term ‘‘self-directed care professional’’ means a 2 direct care professional who is employed by an indi- 3 vidual who is an older individual, a person with a 4 disability, or a representative of such older indi- 5 vidual or person with a disability, and such older in- 6 dividual or person with a disability has the decision- 7 making authority over certain supports and services 8 provided by the direct care professional and takes di- 9 rect responsibility to manage those supports and 10 services. 11 (15) SUPPORTIVE SERVICES.—The term ‘‘sup- 12 portive services’’ means services that are necessary 13 to enable an individual to participate in activities as- 14 sisted with a grant under this Act, such as transpor- 15 tation, child care, dependent care, housing, work- 16 place accommodations, employee benefits such as 17 paid sick leave and child care, workplace health and 18 safety protections, wages and overtime pay, and 19 needs-related payments. 20 (16) URBAN INDIAN ORGANIZATION.—The term 21 ‘‘urban Indian organization’’ has the meaning given 22 the term in section 4 of the Indian Health Care Im- 23 provement Act (25 U.S.C. 1603). 24 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1298 IS (17) WORKFORCE INNOVATION AND OPPOR- 1 TUNITY ACT TERMS.—The terms ‘‘career pathway’’, 2 ‘‘career planning’’, ‘‘in-demand industry sector or 3 occupation’’, ‘‘individual with a barrier to employ- 4 ment’’, ‘‘local board’’, ‘‘on-the-job training’’, ‘‘recog- 5 nized postsecondary credential’’, ‘‘region’’, and 6 ‘‘State board’’ have the meanings given such terms 7 in section 3 of the Workforce Innovation and Oppor- 8 tunity Act (29 U.S.C. 3102). 9 (18) WORK-BASED LEARNING.—The term 10 ‘‘work-based learning’’ has the meaning given the 11 term in section 3 of the Carl D. Perkins Career and 12 Technical Education Act of 2006 (20 U.S.C. 2302). 13 SEC. 3. AUTHORITY TO ESTABLISH A TECHNICAL ASSIST- 14 ANCE CENTER FOR BUILDING THE DIRECT 15 CARE WORKFORCE. 16 (a) PROGRAM AUTHORIZED.—The Secretary shall es- 17 tablish a national technical assistance center (referred to 18 in this section as the ‘‘Center’’) for, in consultation with 19 the Secretary of Labor, the Secretary of Education, the 20 Administrator of the Centers for Medicare & Medicaid 21 Services, and the heads of other entities as necessary— 22 (1) supporting direct care workforce creation, 23 training and education, recruitment, retention, and 24 advancement; and 25 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1298 IS (2) supporting family caregivers and activities 1 of family caregivers as a critical part of the support 2 team for older individuals or people with disabilities. 3 (b) ADVISORY COUNCIL.—The Secretary shall con- 4 vene an advisory council to provide recommendations to 5 the Center with respect to the duties of the Center under 6 this section and may engage individuals and entities de- 7 scribed in paragraphs (3)(B), and (12), of section 5(b) 8 (without regard to a specific project described in such 9 paragraphs) for service on the advisory council. 10 (c) ACTIVITIES.—The Center may— 11 (1) develop recommendations for training and 12 education curricula for direct care professionals, 13 which such recommendations may include rec- 14 ommendations for curricula for higher education, 15 postsecondary credentials, and programs with com- 16 munity colleges; 17 (2) develop learning and dissemination strate- 18 gies to— 19 (A) engage States and other entities in ac- 20 tivities supported under this Act and best prac- 21 tices; and 22 (B) distribute findings from activities sup- 23 ported by grants under this Act; 24 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1298 IS (3) develop recommendations for training and 1 education curricula and other strategies for sup- 2 porting family caregivers; 3 (4) explore the national data gaps, workforce 4 shortage areas, and data collection strategies for di- 5 rect care professionals and make recommendations 6 to the Director of the Office of Management and 7 Budget for an occupation category in the Standard 8 Occupational Classification system for direct support 9 professionals as a healthcare support occupation; 10 (5) recommend career development and ad- 11 vancement opportunities for direct care profes- 12 sionals, which may include occupational frameworks, 13 national standards, recruitment campaigns, pre-ap- 14 prenticeship and on-the-job training opportunities, 15 apprenticeship programs, career ladders or path- 16 ways, specializations or certifications, or other activi- 17 ties; and 18 (6) develop strategies for assisting with report- 19 ing and evaluation of grant activities under section 20 7. 21 SEC. 4. AUTHORITY TO AWARD GRANTS. 22 (a) GRANTS.— 23 (1) IN GENERAL.—Not later than 12 months 24 after the date of enactment of this Act, the Sec- 25 VerDate Sep 11 2014 04:43 May 03, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1298.IS S1298 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1298 IS retary, in consultation with the Center for Medicare 1 & Medicaid Services, the Secretary of Labor, and the 2 Secretary of Education, shall award grants described 3 in paragraph (2) to eligible entities. A grant award- 4 ed under this section may be in more than 1 cat- 5 egory described in such paragraph. 6 (2) CATEGORIES OF GRANTS.—The categories 7 of grants described in this paragraph are each of the 8 following: 9 (A) DIRECT CARE PROFESSIONAL 10 GRANTS.—Grants to eligible entities to create 11 and carry out projects for the purposes of re- 12 cruiting, retaining, or providing advancement 13 opportunities for direct care professionals who 14 are not described in subparagraph (B) or (C), 15 including through education or training pro- 16 grams for such professionals or individuals 17 seeking to become such professionals. 18 (B) DIRECT CARE PROFESSIONAL MAN- 19 AGERS GRANTS.—Grants to eligible entities to 20 create and carry out projects for the purposes 21 of recruiting, [Text truncated for display. Full text available on Congress.gov.]