[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4720 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 4720
To direct the Secretary of Labor to award grants for the recruitment,
retention, and advancement of direct care workers.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 18, 2023
Mr. Scott of Virginia (for himself, Ms. Wild, Ms. Lee of Nevada, Mr.
DeSaulnier, and Ms. Bonamici) introduced the following bill; which was
referred to the Committee on Education and the Workforce, 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 committee
concerned
_______________________________________________________________________
A BILL
To direct the Secretary of Labor to award grants for the recruitment,
retention, and advancement of direct care workers.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Direct Creation, Advancement, and
Retention of Employment Opportunity Act of 2023'' or the ``Direct CARE
Opportunity Act of 2023''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Nearly 25,000,000 adults in the United States require
assistance completing self-care and other daily tasks due to
physical, cognitive, developmental, or behavioral conditions.
This number includes approximately 22,700,000 individuals
living in the community, 1,300,000 residing in nursing homes,
and 900,000 in residential care.
(2) According to the PHI, direct care workers provide most
of the paid, hands-on care for older individuals and
individuals with disabilities.
(3) The assistance of direct care workers allows older
individuals and individuals with disabilities to live with
dignity and safety, and to exercise their right to live
independently in their own homes and communities, in keeping
with what is most appropriate for their needs and preferences.
Older individuals and individuals with disabilities may also
participate in the direct care workforce, further supporting
their ability to live independently.
(4) The direct care workforce is diverse. Almost 9 in 10
direct care workers are women, and 61 percent are people of
color, with women of color growing as a share of the workforce
across every long-term care setting between 2009 and 2019.
(5) From 2021 to 2031, home care occupations are projected
to create nearly a million new jobs. Home care is also among
the fastest-growing occupations, and with the projected growth
in the population over age 65, this may underestimate the
number of home care workers that will be needed to provide care
for this growing population.
(6) Due to transitions to other occupations or exits from
the labor force, there will be an estimated 7,900,000 total job
openings in direct care from 2020 to 2030.
(7) Many direct care workers lack access to a career
pathway or advanced training opportunities. This limits their
ability to build competency and expertise in their field that,
when gained, may lead to an increase in their earning capacity.
According to PHI, more than half of home care workers have
completed no formal education beyond high school, making high-
quality, transferable training essential to success on the job.
(8) The median wage for direct care workers is $14.27 per
hour, and wages and earnings for home care workers are even
lower in rural areas. Because of low wages, variable work
hours, and the inability to access workplace-based benefits, 40
percent of direct care workers live in low-income households,
and 14 percent of the workers from such households live below
the poverty line. Nearly half of direct care workers rely on
some form of public assistance to support themselves and their
families.
(9) Direct care workers face high injury rates, as they are
up to three or more times likelier to experience workplace
injuries than the typical worker in the United States.
(10) The poor quality of these jobs contribute to high
turnover, low job satisfaction, and workforce shortages. This
impacts the quality of care and availability of supports for
older individuals and individuals with disabilities.
(11) The Institute of Medicine found that to ensure that
the United States is prepared to meet the health care needs of
older individuals during the 21st century, it is essential that
the capacity of the direct care workforce be enhanced in both
the number of workers available and their ability to meet their
own health care and quality of life needs.
(12) Training has been shown to reduce worker turnover,
reduce rates of injury, and lead to increased job satisfaction.
(13) Wraparound services, such as career navigation
support, mentoring, and vouchers for child care or
transportation, have been shown to have a positive effect on
program completion and employment outcomes, like increased
wages.
(14) Career pathways are an evidence-based approach to
workforce development that aligns secondary and postsecondary
education to labor market needs. It involves articulated steps
of education, training, and employment within an industry
sector or occupation that leads to the progressive attainment
of skills and wages.
SEC. 3. DEFINITIONS.
In this Act:
(1) Apprenticeship program.--The term ``apprenticeship
program'' means an apprenticeship program registered under the
Act of August 16, 1937 (commonly known as the ``National
Apprenticeship Act''; 50 Stat. 664, chapter 663; 29 U.S.C. 50
et seq.).
(2) Direct care worker.--The term ``direct care worker''
means--
(A) a direct support professional;
(B) a worker providing direct care services, which
may include palliative care, in a home or community-
based setting;
(C) a respite care provider who provides short-term
support and care to an individual in order to provide
relief to a family caregiver;
(D) a direct care worker, as defined in section
799B of the Public Health Service Act (42 U.S.C. 295p);
or
(E) an individual in any other position or job
related to those described in subparagraphs (A) through
(D), as determined by the Secretary of Labor, in
consultation with the Secretary of Health and Human
Services.
(3) Direct support professional.--The term ``direct support
professional'' means a worker who provides services, in a home
or community-based setting, to individuals with disabilities
that promote their independence, well-being, and community
inclusion, including--
(A) providing services related to coaching and
career development, employment assistance, or the
pursuit of personal goals;
(B) aiding activities of daily living;
(C) supporting communication; or
(D) providing habilitation services or other
supports.
(4) Eligible entity.--The term ``eligible entity'' means an
entity that is--
(A) a State;
(B) a labor organization or a joint labor-
management organization;
(C) a nonprofit organization with experience in
aging, disability, supporting the rights and interests
of direct care workers, or training or educating direct
care workers;
(D) an Indian Tribe or Tribal organization;
(E) an urban Indian organization;
(F) a State board or local board;
(G) a nonprofit or governmental organization--
(i) with expertise in identifying and
addressing the care needs of older individuals
and individuals with disabilities and their
caregivers; and
(ii) which may include one or more of the
following--
(I) an area agency on aging (as
defined in section 102 of the Older
Americans Act of 1965 (42 U.S.C.
3002));
(II) a center for independent
living (as described in part C of title
VII of the Rehabilitation Act of 1973
(29 U.S.C. 796f et seq.)); or
(III) an Aging and Disability
Resource Center (as defined in section
102 of the Older Americans Act of 1965
(42 U.S.C. 3002));
(H) a partnership between or among--
(i)(I) an institution of higher education;
or
(II) an area career and technical
education school; and
(ii)(I) an entity described in any of
subparagraphs (A) through (G); or
(II) a consortium described in subparagraph
(I); or
(I) a consortium of entities listed in any of
subparagraphs (A) through (G).
(5) Employ; employer.--The terms ``employ'' and
``employer'' have the meanings given the terms in section 3 of
the Fair Labor Standards Act (29 U.S.C. 203 et seq.).
(6) Indian tribe; tribal organization.--The terms ``Indian
tribe'' and ``tribal organization'' have the meanings given
such terms in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 5304).
(7) Individual with a significant disability.--The term
``individual with a significant disability'' has the meaning
given the term in section 7 of the Rehabilitation Act of 1973
(29 U.S.C. 705).
(8) Institution of higher education.--The term
``institution of higher education'' has the meaning given the
term in section 101 of the Higher Education Act of 1965 (20
U.S.C. 1001) or section 102(a)(1)(B) of such Act (20 U.S.C.
1002(a)(1)(B)).
(9) Secretary; secretary of labor.--The terms ``Secretary''
and ``Secretary of Labor'' means the Secretary of Labor, acting
through the Assistant Secretary for Employment and Training.
(10) Secretary of health and human services.--The term
``Secretary of Health and Human Services'' means the Secretary
of Health and Human Services, acting through the Administrator
for the Administration for Community Living.
(11) State.--The term ``State'' has the meaning given the
term in section 3 of the Carl D. Perkins Career and Technical
Education Act of 2006 (20 U.S.C. 2302).
(12) Supportive services.--The term ``supportive services''
means services such as transportation, child care, dependent
care, food, housing, and needs-related payments, that are
necessary to enable an individual to participate in a strategy
to be funded with a grant under this Act.
(13) Workforce innovation and opportunity act terms.--The
terms ``area career and technical education school'', ``career
pathway'', ``career planning'', ``eligible youth'', ``in-demand
industry sector or occupation'', ``individual with a barrier to
employment'', ``individual with a disability'', ``local
board'', ``older individual'', ``one-stop center'', ``on-the-
job training'', ``recognized postsecondary credential'',
``region'', and ``State board'' have the meanings given such
terms in section 3 of the Workforce Innovation and Opportunity
Act (29 U.S.C. 3102).
(14) Work-based learning.--The term ``work-based learning''
has the meaning given the term in section 3 of the Carl D.
Perkins Career and Technical Education Act of 2006 (20 U.S.C.
2302).
SEC. 4. AUTHORITY TO AWARD GRANTS; DURATION.
(a) Authority To Award Grants.--Not later than 12 months after the
date of enactment of this Act, from the amounts appropriated under
section 10(a) (and not reserved under paragraph (2) of such section),
the Secretary of Labor in consultation with the Secretary of Health and
Human Services, shall award grants to eligible entities to assist such
entities in developing and implementing strategies for the recruitment,
retention, or advancement of direct care workers.
(b) Interagency Cooperation.--
(1) In general.--To receive assistance from the Secretary
of Health and Human Services in administering or awarding
grants, or providing technical assistance under this Act, the
Secretary of Labor may--
(A) enter into an agreement with the Secretary of
Health and Human Services;
(B) transfer to the Secretary of Health and Human
Services a portion of the amounts appropriated under
section 10(a); or
(C) receive from the Secretary of Health and Human
Services a portion of the amounts appropriated under
section 10(b).
(2) Procedures and criteria.--An agreement entered into
under paragraph (1)--
(A) shall specify whether the procedures of the
Secretary of Labor or the Secretary of Health and Human
Services, or whether a single set of criteria developed
by both Secretaries, shall be used to administer or
award grants, or provide technical assistance, under
this Act; and
(B) may require that applicants for a grant under
this Act submit a single application for joint review
by the Secretary of Labor and the Secretary of Health
and Human Services.
(c) Duration.--A grant under this Act shall be for not less than 5
years.
SEC. 5. APPLICATIONS; CONSULTATION.
(a) Applications.--
(1) In general.--An eligible entity seeking a grant under
this Act shall submit to the Secretary an application at such
time, in such manner, and containing such information as the
Secretary, in consultation with the Secretary of Health and
Human Services, may require, which shall include the
information listed in paragraph (2).
(2) Contents.--An application submitted under paragraph (1)
by an eligible entity seeking a grant under this Act shall
include each of the following:
(A) Information with respect to the State or
geographic area to be served by such grant, including
the following:
(i) Demographic information regarding the
population, including a description of the
populations likely to need direct care
services, such as the aging population and
individuals with significant disabilities.
(ii) Projections of unmet need for direct
care services, which may include, enrollment on
waiting lists under home and community-based
waivers under section 1115 of the Social
Security Act (42 U.S.C. 1315) or section
1915(c) of such Act (42 U.S.C. 1396n(c)),
demand for long-term care provided through the
Department of Veterans Affairs, demand for
services provided under title III of the Older
Americans Act of 1965 (42 U.S.C. 3021 et seq.),
and other relevant data to the extent
practicable.
(iii) Current and projected job openings
for direct care workers and relevant labor
market information related to such workers, and
the geographic scope of the workforce to be
served.
(B) A description of each specific strategy that
the eligible entity will develop and implement using
the grant to reduce barriers to recruitment, retention,
or advancement of direct care workers, including--
(i) a description of how the eligible
entity will consult and coordinate with the
entities described in subsection (b) on the
development and implementation of the strategy;
and
(ii) an assurance that the eligible entity
will implement the strategy in consultation
with--
(I) individuals receiving direct
care services, including the aging
population and individuals with
disabilities; and
(II) individuals performing direct
care services, which may include family
caregivers.
(C) In the case in which a strategy described in
subparagraph (B) will include the provision of wages
(or other compensation or benefits) to direct care
workers (or individuals training to become such
workers) participating in activities carried out under
the strategy--
(i) an assurance that the provision of such
wages will result in a wage for such workers
that is not less than the greater of--
(I) the minimum wage required under
section 6(a) of the Fair Labor
Standards Act of 1938 (29 U.S.C.