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Statutory Text

SEC. 5507. DEMONSTRATION PROJECTS TO ADDRESS HEALTH PROFESSIONS
WORKFORCE NEEDS; EXTENSION OF FAMILYTO-
FAMILY HEALTH INFORMATION CENTERS.
(a) AUTHORITY TO CONDUCT DEMONSTRATION PROJECTS.—Title
XX of the Social Security Act (42 U.S.C. 1397 et seq.) is amended
by adding at the end the following:
‘‘SEC. 2008 ø42 U.S.C. 1397g¿. DEMONSTRATION PROJECTS TO ADDRESS
HEALTH PROFESSIONS WORKFORCE NEEDS.
‘‘(a) DEMONSTRATION PROJECTS TO PROVIDE LOW-INCOME INDIVIDUALS
WITH OPPORTUNITIES FOR EDUCATION, TRAINING, AND CAREER
ADVANCEMENT TO ADDRESS HEALTH PROFESSIONS WORKFORCE
NEEDS.—
‘‘(1) AUTHORITY TO AWARD GRANTS.—The Secretary, in consultation
with the Secretary of Labor, shall award grants to eligible
entities to conduct demonstration projects that are designed
to provide eligible individuals with the opportunity to
obtain education and training for occupations in the health
care field that pay well and are expected to either experience
labor shortages or be in high demand.
‘‘(2) REQUIREMENTS.—
‘‘(A) AID AND SUPPORTIVE SERVICES.—
‘‘(i) IN GENERAL.—A demonstration project conducted
by an eligible entity awarded a grant under
this section shall, if appropriate, provide eligible individuals
participating in the project with financial aid,
child care, case management, and other supportive
services.
‘‘(ii) TREATMENT.—Any aid, services, or incentives
provided to an eligible beneficiary participating in a
demonstration project under this section shall not be
considered income, and shall not be taken into account
for purposes of determining the individual’s eligibility
for, or amount of, benefits under any means-tested
program.
‘‘(B) CONSULTATION AND COORDINATION.—An eligible
entity applying for a grant to carry out a demonstration
project under this section shall demonstrate in the application
that the entity has consulted with the State agency
responsible for administering the State TANF program,
the local workforce investment board in the area in which
the project is to be conducted (unless the applicant is such
board), the State workforce investment board established
under section 111 of the Workforce Investment Act of
1998, and the State Apprenticeship Agency recognized
under the Act of August 16, 1937 (commonly known as the
‘National Apprenticeship Act’) (or if no agency has been
recognized in the State, the Office of Apprenticeship of the
Department of Labor) and that the project will be carried
out in coordination with such entities.
‘‘(C) ASSURANCE OF OPPORTUNITIES FOR INDIAN POPULATIONS.—
The Secretary shall award at least 3 grants
under this subsection to an eligible entity that is an Indian
tribe, tribal organization, or Tribal College or University.
‘‘(3) REPORTS AND EVALUATION.—
‘‘(A) ELIGIBLE ENTITIES.—An eligible entity awarded a
grant to conduct a demonstration project under this subsection
shall submit interim reports to the Secretary on
the activities carried out under the project and a final report
on such activities upon the conclusion of the entities’
participation in the project. Such reports shall include assessments
of the effectiveness of such activities with respect
to improving outcomes for the eligible individuals
participating in the project and with respect to addressing
health professions workforce needs in the areas in which
the project is conducted.
‘‘(B) EVALUATION.—The Secretary shall, by grant, contract,
or interagency agreement, evaluate the demonstration
projects conducted under this subsection. Such evaluation
shall include identification of successful activities for
creating opportunities for developing and sustaining, particularly
with respect to low-income individuals and other
entry-level workers, a health professions workforce that
has accessible entry points, that meets high standards for
education, training, certification, and professional development,
and that provides increased wages and affordable
benefits, including health care coverage, that are responsive
to the workforce’s needs.
‘‘(C) REPORT TO CONGRESS.—The Secretary shall submit
interim reports and, based on the evaluation conducted
under subparagraph (B), a final report to Congress
on the demonstration projects conducted under this subsection.
‘‘(4) DEFINITIONS.—In this subsection:
‘‘(A) ELIGIBLE ENTITY.—The term ‘eligible entity’
means a State, an Indian tribe or tribal organization, an
institution of higher education, a local workforce investment
board established under section 117 of the Workforce
Investment Act of 1998, a sponsor of an apprenticeship
program registered under the National Apprenticeship Act
or a community-based organization.
‘‘(B) ELIGIBLE INDIVIDUAL.—
‘‘(i) IN GENERAL.—The term ‘eligible individual’
means a individual receiving assistance under the
State TANF program.
‘‘(ii) OTHER LOW-INCOME INDIVIDUALS.—Such term
may include other low-income individuals described by
the eligible entity in its application for a grant under
this section.
‘‘(C) INDIAN TRIBE; TRIBAL ORGANIZATION.—The terms
‘Indian tribe’ and ‘tribal organization’ have the meaning
given such terms in section 4 of the Indian Self-Determination
and Education Assistance Act (25 U.S.C. 450b).
‘‘(D) INSTITUTION OF HIGHER EDUCATION.—The term
‘institution of higher education’ has the meaning given
that term in section 101 of the Higher Education Act of
1965 (20 U.S.C. 1001).
‘‘(E) STATE.—The term ‘State’ means each of the 50
States, the District of Columbia, the Commonwealth of
Puerto Rico, the United States Virgin Islands, Guam, and
American Samoa.
‘‘(F) STATE TANF PROGRAM.—The term ‘State TANF
program’ means the temporary assistance for needy families
program funded under part A of title IV.
‘‘(G) TRIBAL COLLEGE OR UNIVERSITY.—The term ‘Tribal
College or University’ has the meaning given that term
in section 316(b) of the Higher Education Act of 1965 (20
U.S.C. 1059c(b)).
‘‘(b) DEMONSTRATION PROJECT TO DEVELOP TRAINING AND CERTIFICATION
PROGRAMS FOR PERSONAL OR HOME CARE AIDES.—
‘‘(1) AUTHORITY TO AWARD GRANTS.—Not later than 18
months after the date of enactment of this section, the Secretary
shall award grants to eligible entities that are States to
conduct demonstration projects for purposes of developing core
training competencies and certification programs for personal
or home care aides. The Secretary shall—
‘‘(A) evaluate the efficacy of the core training competencies
described in paragraph (3)(A) for newly hired
personal or home care aides and the methods used by
States to implement such core training competencies in accordance
with the issues specified in paragraph (3)(B); and
‘‘(B) ensure that the number of hours of training provided
by States under the demonstration project with respect
to such core training competencies are not less than
the number of hours of training required under any applicable
State or Federal law or regulation.
‘‘(2) DURATION.—A demonstration project shall be conducted
under this subsection for not less than 3 years.
‘‘(3) CORE TRAINING COMPETENCIES FOR PERSONAL OR HOME
CARE AIDES.—
‘‘(A) IN GENERAL.—The core training competencies for
personal or home care aides described in this subparagraph
include competencies with respect to the following
areas:
‘‘(i) The role of the personal or home care aide (including
differences between a personal or home care
aide employed by an agency and a personal or home
care aide employed directly by the health care consumer
or an independent provider).
‘‘(ii) Consumer rights, ethics, and confidentiality
(including the role of proxy decision-makers in the
case where a health care consumer has impaired decision-
making capacity).
‘‘(iii) Communication, cultural and linguistic competence
and sensitivity, problem solving, behavior
management, and relationship skills.
‘‘(iv) Personal care skills.
‘‘(v) Health care support.
‘‘(vi) Nutritional support.
‘‘(vii) Infection control.
‘‘(viii) Safety and emergency training.
‘‘(ix) Training specific to an individual consumer’s
needs (including older individuals, younger individuals
with disabilities, individuals with developmental disabilities,
individuals with dementia, and individuals
with mental and behavioral health needs).
‘‘(x) Self-Care.
‘‘(B) IMPLEMENTATION.—The implementation issues
specified in this subparagraph include the following:
‘‘(i) The length of the training.
‘‘(ii) The appropriate trainer to student ratio.
‘‘(iii) The amount of instruction time spent in the
classroom as compared to on-site in the home or a facility.
‘‘(iv) Trainer qualifications.
‘‘(v) Content for a ‘hands-on’ and written certification
exam.
‘‘(vi) Continuing education requirements.
‘‘(4) APPLICATION AND SELECTION CRITERIA.—
‘‘(A) IN GENERAL.—
‘‘(i) NUMBER OF STATES.—The Secretary shall
enter into agreements with not more than 6 States to
conduct demonstration projects under this subsection.
‘‘(ii) REQUIREMENTS FOR STATES.—An agreement
entered into under clause (i) shall require that a participating
State—
‘‘(I) implement the core training competencies
described in paragraph (3)(A); and
‘‘(II) develop written materials and protocols
for such core training competencies, including the
development of a certification test for personal or
home care aides who have completed such training
competencies.
‘‘(iii) CONSULTATION AND COLLABORATION WITH
COMMUNITY AND VOCATIONAL COLLEGES.—The Secretary
shall encourage participating States to consult
with community and vocational colleges regarding the
development of curricula to implement the project
with respect to activities, as applicable, which may include
consideration of such colleges as partners in
such implementation.
‘‘(B) APPLICATION AND ELIGIBILITY.—A State seeking to
participate in the project shall—
‘‘(i) submit an application to the Secretary containing
such information and at such time as the Secretary
may specify;
‘‘(ii) meet the selection criteria established under
subparagraph (C); and
‘‘(iii) meet such additional criteria as the Secretary
may specify.
‘‘(C) SELECTION CRITERIA.—In selecting States to participate
in the program, the Secretary shall establish criteria
to ensure (if applicable with respect to the activities
involved)—
‘‘(i) geographic and demographic diversity;
‘‘(ii) that participating States offer medical assistance
for personal care services under the State Medicaid
plan;
‘‘(iii) that the existing training standards for personal
or home care aides in each participating State—
‘‘(I) are different from such standards in the
other participating States; and
‘‘(II) are different from the core training competencies
described in paragraph (3)(A);
‘‘(iv) that participating States do not reduce the
number of hours of training required under applicable
State law or regulation after being selected to participate
in the project; and
‘‘(v) that participating States recruit a minimum
number of eligible health and long-term care providers
to participate in the project.
‘‘(D) TECHNICAL ASSISTANCE.—The Secretary shall provide
technical assistance to States in developing written
materials and protocols for such core training competencies.
‘‘(5) EVALUATION AND REPORT.—
‘‘(A) EVALUATION.—The Secretary shall develop an experimental
or control group testing protocol in consultation
with an independent evaluation contractor selected by the
Secretary. Such contractor shall evaluate—
‘‘(i) the impact of core training competencies described
in paragraph (3)(A), including curricula developed
to implement such core training competencies,
for personal or home care aides within each participating
State on job satisfaction, mastery of job skills,
beneficiary and family caregiver satisfaction with services,
and additional measures determined by the Secretary
in consultation with the expert panel;
‘‘(ii) the impact of providing such core training
competencies on the existing training infrastructure
and resources of States; and
‘‘(iii) whether a minimum number of hours of initial
training should be required for personal or home
care aides and, if so, what minimum number of hours
should be required.
‘‘(B) REPORTS.—
‘‘(i) REPORT ON INITIAL IMPLEMENTATION.—Not
later than 2 years after the date of enactment of this
section, the Secretary shall submit to Congress a report
on the initial implementation of activities conducted
under the demonstration project, including any
available results of the evaluation conducted under
subparagraph (A) with respect to such activities, together
with such recommendations for legislation or
administrative action as the Secretary determines appropriate.
‘‘(ii) FINAL REPORT.—Not later than 1 year after
the completion of the demonstration project, the Secretary
shall submit to Congress a report containing the results of the evaluation conducted under subparagraph
(A), together with such recommendations for
legislation or administrative action as the Secretary
determines appropriate.
‘‘(6) DEFINITIONS.—In this subsection:
‘‘(A) ELIGIBLE HEALTH AND LONG-TERM CARE PROVIDER.—
The term ‘eligible health and long-term care provider’
means a personal or home care agency (including
personal or home care public authorities), a nursing home,
a home health agency (as defined in section 1861(o)), or
any other health care provider the Secretary determines
appropriate which—
‘‘(i) is licensed or authorized to provide services in
a participating State; and
‘‘(ii) receives payment for services under title XIX.
‘‘(B) PERSONAL CARE SERVICES.—The term ‘personal
care services’ has the meaning given such term for purposes
of title XIX.
‘‘(C) PERSONAL OR HOME CARE AIDE.—The term ‘personal
or home care aide’ means an individual who helps individuals
who are elderly, disabled, ill, or mentally disabled
(including an individual with Alzheimer’s disease or
other dementia) to live in their own home or a residential
care facility (such as a nursing home, assisted living facility,
or any other facility the Secretary determines appropriate)
by providing routine personal care services and
other appropriate services to the individual.
‘‘(D) STATE.—The term ‘State’ has the meaning given
that term for purposes of title XIX.
‘‘(c) FUNDING.—
‘‘(1) IN GENERAL.—Subject to paragraph (2), out of any
funds in the Treasury not otherwise appropriated, there are
appropriated to the Secretary to carry out subsections (a) and
(b), $85,000,000 for each of fiscal years 2010 through 2014.
‘‘(2) TRAINING AND CERTIFICATION PROGRAMS FOR PERSONAL
AND HOME CARE AIDES.—With respect to the demonstration
projects under subsection (b), the Secretary shall use
$5,000,000 of the amount appropriated under paragraph (1) for
each of fiscal years 2010 through 2012 to carry out such
projects. No funds appropriated under paragraph (1) shall be
used to carry out demonstration projects under subsection (b)
after fiscal year 2012.
‘‘(d) NONAPPLICATION.—
‘‘(1) IN GENERAL.—Except as provided in paragraph (2), the
preceding sections of this title shall not apply to grant awarded
under this section.
‘‘(2) LIMITATIONS ON USE OF GRANTS.—Section 2005(a)
(other than paragraph (6)) shall apply to a grant awarded
under this section to the same extent and in the same manner
as such section applies to payments to States under this title.’’.
(b) EXTENSION OF FAMILY-TO-FAMILY HEALTH INFORMATION
CENTERS.—Section 501(c)(1)(A)(iii) of the Social Security Act (42
U.S.C. 701(c)(1)(A)(iii)) is amended by striking ‘‘fiscal year 2009’’
and inserting ‘‘each of fiscal years 2009 through 2012’’.