42 U.S.C. § 1397g — Demonstration projects to address health professions workforce needs

(a) Demonstration projects for education, training, and career advancement addressing health-professions workforce needs. (1) The Secretary, consulting the Secretary of Labor, must award grants to eligible entities for projects giving eligible people opportunities for education and training for well-paying health-care occupations expected to have labor shortages or high demand. (2) Requirements. (A) (i) When appropriate, a grantee must provide participating eligible people financial aid, child care, case management, and other support. (ii) Aid, services, and incentives given to an eligible beneficiary do not count as income and cannot affect eligibility for, or the amount of, benefits under a means-tested program. (B) An applicant must show that it consulted and will coordinate with the State TANF agency, the local workforce investment board where the project will occur unless the applicant is that board, the State workforce development board under section 3111 of title 29, and the recognized State Apprenticeship Agency under the National Apprenticeship Act, or the Labor Department’s Office of Apprenticeship if no State agency is recognized. (C) At least three grants must go to an Indian tribe, tribal organization, or Tribal College or University. (3) Reports and evaluation. (A) A grantee must send interim reports and a final report when its participation ends. The reports must assess how effectively the activities improve participating eligible people’s outcomes and address health-profession workforce needs in the project areas. (B) The Secretary must evaluate the projects by grant, contract, or interagency agreement. The evaluation must identify successful activities for creating and sustaining a health-professions workforce, especially for low-income people and entry-level workers, with accessible entry points, high education, training, certification, and professional-development standards, higher wages, and affordable benefits including health coverage responsive to workers’ needs. (C) The Secretary must send Congress interim reports and a final report based on the evaluation. (4) Definitions. (A) “Eligible entity” means a State; Indian tribe or tribal organization; institution of higher education; local workforce development board under section 3122 of title 29; National Apprenticeship Act registered apprenticeship sponsor; or community-based organization. (B) “Eligible individual” means (i) one individual receiving State TANF assistance and (ii) possibly other low-income people described in the applicant’s grant application. (C) “Indian tribe” and “tribal organization” have the meanings in section 5304 of title 25. (D) “Institution of higher education” has the meaning in section 1001 of title 20. (E) “State” means the 50 States, District of Columbia, Puerto Rico, United States Virgin Islands, Guam, and American Samoa. (F) “State TANF program” means the temporary assistance for needy families program funded under part A of subchapter IV. (G) “Tribal College or University” has the meaning in section 1059c(b) of title 20. (b) Demonstration projects for personal or home care aide training and certification. (1) No later than 18 months after March 23, 2010, the Secretary must award grants to eligible State entities to develop core training competencies and certification programs. The Secretary must (A) evaluate those competencies for newly hired aides and the States’ implementation methods using the issues in (3)(B), and (B) ensure that State training hours are at least the hours required by applicable State or Federal law or regulation. (2) Each project must last at least three years. (3) Core competencies. (A) They include: (i) the aide’s role, including agency employment versus direct employment by the consumer or an independent provider; (ii) consumer rights, ethics, confidentiality, and proxy decision-makers for consumers with impaired decision-making; (iii) communication, cultural and linguistic competence and sensitivity, problem-solving, behavior management, and relationship skills; (iv) personal care; (v) health-care support; (vi) nutrition; (vii) infection control; (viii) safety and emergencies; (ix) training for an individual consumer’s needs, including older people, younger people with disabilities, people with developmental disabilities or dementia, and people with mental or behavioral health needs; and (x) self-care. (B) Implementation issues include training length; trainer-to-student ratio; classroom versus home or facility instruction time; trainer qualifications; hands-on and written certification-exam content; and continuing-education requirements. (4) Applications and selection. (A) (i) The Secretary may make agreements with no more than six States. (ii) Each agreement must require the State to implement (3)(A) and develop written materials and protocols, including a certification test for aides completing the competencies. (iii) The Secretary should encourage States to consult community and vocational colleges about curricula and consider them as implementation partners. (B) A State applicant must submit the required information on the Secretary’s schedule, meet (C)’s selection criteria, and meet any additional criteria the Secretary specifies. (C) The Secretary must establish criteria, when applicable, to ensure geographic and demographic diversity; that participating States cover personal-care services under Medicaid; that each State’s existing aide-training standards differ from those of the other participating States and from (3)(A); that a State does not reduce required training hours after selection; and that each State recruits a minimum number of eligible health and long-term-care providers. (D) The Secretary must give States technical help in developing the written materials and protocols. (5) Evaluation and reports. (A) The Secretary must develop an experimental or control-group testing protocol with an independent evaluation contractor. The contractor must evaluate: (i) the effect in each State of the core competencies and implementing curricula on job satisfaction, mastery of job skills, beneficiary and family-caregiver satisfaction, and additional measures set by the Secretary with the expert panel; (ii) the effect on State training infrastructure and resources; and (iii) whether an initial minimum training-hour requirement is needed and, if so, its length. (B) (i) Within two years after March 23, 2010, the Secretary must report to Congress on initial implementation, available evaluation results, and recommended legislative or administrative action. (ii) Within one year after the project ends, the Secretary must report the evaluation results and such recommendations. (6) Definitions. (A) “Eligible health and long-term-care provider” means a personal or home-care agency, including a public authority; nursing home; home health agency as defined in section 1395x(o); or another provider the Secretary approves, if licensed or authorized in a participating State and paid under subchapter XIX. (B) “Personal care services” has the meaning used for subchapter XIX. (C) “Personal or home care aide” means someone who helps an elderly, disabled, ill, or mentally disabled person, including someone with Alzheimer’s disease or other dementia, live at home or in a residential-care facility such as a nursing home or assisted-living facility, by providing routine personal care and other appropriate services. (D) “State” has the meaning used for subchapter XIX. (c) Funding. (1) Subject to (2), the Treasury appropriates $85,000,000 for each fiscal year 2010 through 2019 to the Secretary for subsections (a) and (b). (2) For fiscal years 2010 through 2012, the Secretary must use $5,000,000 each year of that appropriation for subsection (b). No paragraph (1) funds may support subsection (b) projects after fiscal year 2012. (d) Nonapplication. (1) Except as (2) provides, the preceding sections of this division do not apply to grants under this section. (2) Section 1397d(a), except paragraph (6), applies to a grant under this section to the same extent and in the same way it applies to payments to States under this division.