S 245 ISCommentsClose CommentsPermalink

To expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States.CommentsClose CommentsPermalink

January 14, 2009CommentsClose CommentsPermalink

Mr. KOHL (for himself, Mrs. LINCOLN, and Mr. CASEY) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and PensionsCommentsClose CommentsPermalink

To expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the ‘Retooling the Health Care Workforce for an Aging America Act of 2009’.CommentsClose CommentsPermalink





(b) Table of Contents- The table of contents of this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title; table of contents.CommentsClose CommentsPermalink





Sec. 2. Findings.CommentsClose CommentsPermalink

TITLE I--AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT

Subtitle A--Health Professions Education Related to Geriatrics

Sec. 101. Geriatric education centers.CommentsClose CommentsPermalink





Sec. 102. Improving geriatric training for physicians, dentists, and behavior and mental health professionals.CommentsClose CommentsPermalink





Sec. 103. Geriatric academic career awards.CommentsClose CommentsPermalink





Sec. 104. Geriatric Career Incentive Awards.CommentsClose CommentsPermalink





Sec. 105. National Center for Health Workforce Analysis.CommentsClose CommentsPermalink

Subtitle B--Improved Nursing Services

Sec. 121. Comprehensive geriatric education nursing grant program.CommentsClose CommentsPermalink

TITLE II--AMENDMENTS TO THE WORKFORCE INVESTMENT ACT OF 1998

Sec. 201. Core services.CommentsClose CommentsPermalink





Sec. 202. Individual training accounts.CommentsClose CommentsPermalink





Sec. 203. Collaboration between State boards and the veterans agencies of the States.CommentsClose CommentsPermalink





Sec. 204. Collaboration between Department of Labor and Department of Veterans Affairs.CommentsClose CommentsPermalink





Sec. 205. Training opportunities for direct care workers.CommentsClose CommentsPermalink

TITLE III--AMENDMENTS TO THE OLDER AMERICANS ACT OF 1965

Sec. 301. Family caregiver training.CommentsClose CommentsPermalink





Sec. 302. Redesignations in provisions for multigenerational and civic engagement activities.CommentsClose CommentsPermalink





Sec. 303. National Resource Center on Volunteers, Students, and Seniors.CommentsClose CommentsPermalink

TITLE IV--AMENDMENTS TO THE SOCIAL SECURITY ACT

Sec. 401. Demonstration program for personal or home care aides, nurse aides, and home health aides in long-term care settings.CommentsClose CommentsPermalink





Sec. 402. Medicare family caregiver information and referral.CommentsClose CommentsPermalink





Sec. 403. Medicaid assessment of family caregiver support needs.CommentsClose CommentsPermalink

TITLE V--STUDIES AND REPORTS

Sec. 501. Studies and reports.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

Congress finds the following:CommentsClose CommentsPermalink





(1) The United States will not be able to meet near-term demands for chronic, geriatric, and long-term care without a workforce that is prepared for the job.CommentsClose CommentsPermalink





(2) Between 2005 and 2030, it is estimated that the number of adults aged 65 and older will almost double from 37,000,000 to over 70,000,000, increasing from 12 percent of the population of the United States to almost 20 percent of the population.CommentsClose CommentsPermalink





(3) Because the overall size of the population of older adults in the United States will increase rapidly, the number of older adults in the United States who are disabled will soar in the coming decades. Between 2000 and 2040 the number of older adults who are disabled will more than double, increasing from an estimated 10,000,000 to an estimated 21,000,000.CommentsClose CommentsPermalink





(4) A 2008 report by the Institute of Medicine of the National Academies, entitled, ‘Retooling for an Aging America’ concludes that the health care workforce will lack the capacity, in both size and ability, to meet the needs of older patients in the future unless action is taken immediately.CommentsClose CommentsPermalink





(5) Inadequate training in geriatrics, gerontology, chronic care management, and long-term care is known to result in misdiagnoses, medication errors, and inadequate coordination of services and treatments that result in poor care and is costly for the health care system as a whole.CommentsClose CommentsPermalink





(6) Currently, only 1 percent of all physicians (approximately 7,000) in the United States are certified geriatricians, even as the population of older adults is on track to double by 2030.CommentsClose CommentsPermalink





(7) Inadequate amounts of time devoted to geriatric training are reported by 1/4 of graduating medical students, and close to 1/2 of graduating medical students say they are unprepared to care for residents in nursing homes.CommentsClose CommentsPermalink





(8) Less than 1 percent of all nurses are certified gerontological nurses. Absent any change, by the year 2020, the total supply of nurses in the United States is projected to fall 29 percent below requirements, resulting in a severe shortage of nursing expertise relative to the demand for care of medically complex, frail older adults.CommentsClose CommentsPermalink





(9) Estimates suggest that there are currently only 700 practicing geropsychologists in the United States, falling far short of the current need for 5,000 to 7,500 geropsychologists.CommentsClose CommentsPermalink





(10) The Bureau of Labor Statistics of the Department of Labor predicts that personal or home care aides and home health aides will represent the second and third fastest-growing occupations between 2006 and 2016. Yet personal or home care aides are not subject to any Federal requirements related to training or education, and States have very different requirements for personal or home care aides.CommentsClose CommentsPermalink





(11) Research shows that inadequate training is a major contributor to high turnover rates among direct care workers and more training is correlated with better staff recruitment and retention rates.CommentsClose CommentsPermalink





(12) An estimated 44,000,000 family caregivers are being asked to provide increasingly complex medical services to frail and elderly loved ones wishing to live at home. Multiple surveys have documented that basic training and access to other targeted services are necessary for family caregivers to provide consistent quality care on an ongoing basis.CommentsClose CommentsPermalink

TITLE I--AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACTCommentsClose CommentsPermalink

Subtitle A--Health Professions Education Related to GeriatricsCommentsClose CommentsPermalink

SEC. 101. GERIATRIC EDUCATION CENTERS.

Section 753 of the Public Health Service Act (42 U.S.C. 294) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(d) Grants To Expand and Improve Geriatric Education Centers-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall award grants or contracts under this subsection to entities that operate a geriatric education center pursuant to subsection (a)(1).CommentsClose CommentsPermalink





‘(2) APPLICATION- To be eligible for an award under paragraph (1), an entity described in such paragraph shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





‘(3) USE OF FUNDS- Amounts awarded under a grant or contract under paragraph (1) shall be used to--CommentsClose CommentsPermalink





‘(A) carry out the fellowship program described in paragraph (4); andCommentsClose CommentsPermalink





‘(B) carry out 2 of the 3 activities described in paragraph (5).CommentsClose CommentsPermalink





‘(4) FELLOWSHIP PROGRAM-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Pursuant to paragraph (3), a geriatric education center that receives an award under this subsection shall use such funds to offer short-term intensive courses (referred to in this subsection as a ‘fellowship’) that focus on geriatrics, chronic care management, and long-term care that provide supplemental training for faculty members in medical schools and other health professions schools with programs in psychology, pharmacy, nursing, social work, dentistry, public health, or other health disciplines, as approved by the Secretary. Such a fellowship shall be open to current faculty, and appropriately credentialed volunteer faculty and practitioners, who do not have formal training in geriatrics, to upgrade their knowledge and clinical skills for the care of older adults and adults with functional limitations and to enhance their interdisciplinary teaching skills.CommentsClose CommentsPermalink





‘(B) LOCATION- A fellowship shall be offered either at the geriatric education center that is sponsoring the course, in collaboration with other geriatric education centers, or at medical schools, schools of nursing, schools of pharmacy, schools of social work, graduate programs in psychology, or other health professions schools approved by the Secretary with which the geriatric education centers are affiliated.CommentsClose CommentsPermalink





‘(C) CME CREDIT- Participation in a fellowship under this paragraph shall be accepted with respect to complying with continuing medical education requirements. As a condition of such acceptance, the recipient shall agree to subsequently provide a minimum of 18 hours of voluntary instructional support through a geriatric education center that is providing clinical training to students or trainees in long-term care settings.CommentsClose CommentsPermalink





‘(5) ADDITIONAL REQUIRED ACTIVITIES DESCRIBED- Pursuant to paragraph (3), a geriatric education center that receives an award under this subsection shall use such funds to carry out 2 of the 3 activities:CommentsClose CommentsPermalink





‘(A) FAMILY CAREGIVER TRAINING- A geriatric education center that receives an award under this subsection shall offer at least 2 courses each year, at no charge or nominal cost, to family caregivers that are designed to provide practical training for supporting frail elders and individuals with disabilities. The Secretary shall require such Centers to work with appropriate community partners, including family caregivers and family caregiver organizations, to develop training program content and to publicize the availability of training courses in their service areas. All family caregiver training programs shall include instruction on the management of psychological and behavioral aspects of dementia, communication techniques for working with individuals who have dementia, and the appropriate, safe, and effective use of medications for older adults.CommentsClose CommentsPermalink





‘(B) DIRECT CARE WORKING TRAINING- A geriatric education center that receives an award under this subsection shall offer at least 2 courses each year to certified nurse aides, home health aides, personal or home care aides and other types of direct care workers on ‘best practices’ for working with frail elders and individuals with disabilities, including individuals with dementia, urinary incontinence, and problems with balance or mobility, and raising awareness of medication issues for older adults.CommentsClose CommentsPermalink





‘(C) INCORPORATION OF BEST PRACTICES- A geriatric education center that receives an award under this subsection shall develop and include material on depression and other mental disorders common among older adults, medication safety issues for older adults, and management of the psychological and behavioral aspects of dementia and communication techniques with individuals who have dementia in all training courses, where appropriate.CommentsClose CommentsPermalink





‘(6) TARGETS- A geriatric education center that receives an award under this subsection shall meet targets approved by the Secretary for providing geriatric training to a certain number of faculty or practitioners during the term of the grant, as well as other parameters established by the Secretary, including guidelines for the content of the fellowships.CommentsClose CommentsPermalink





‘(7) AMOUNT OF AWARD- An award under this subsection shall be in an amount of $150,000. Not more than 24 geriatric education centers may receive an award under this subsection.CommentsClose CommentsPermalink





‘(8) MAINTENANCE OF EFFORT- A geriatric education center that receives an award under this subsection shall provide assurances to the Secretary that funds provided to the geriatric education center under this subsection will be used only to supplement, not to supplant, the amount of Federal, State, and local funds otherwise expended by the geriatric education center.CommentsClose CommentsPermalink





‘(9) AUTHORIZATION OF APPROPRIATIONS- In addition to any other funding available to carry out this section, there is authorized to be appropriated to carry out this subsection, $10,800,000 for the period of fiscal year 2011 through 2013.’.CommentsClose CommentsPermalink

SEC. 102. IMPROVING GERIATRIC TRAINING FOR PHYSICIANS, DENTISTS, AND BEHAVIOR AND MENTAL HEALTH PROFESSIONALS.

Section 753 of the Public Health Service Act (42 U.S.C. 294), as amended by section 101, is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(e) Geriatric Training for Physicians, Dentists, and Behavior and Mental Health Professionals- An accredited school of medicine or osteopathic medicine, an accredited psychology program, a teaching hospital, or a graduate medical education program that receives an award under subsection (c) may use the funds under such award to carry out a program to train individuals for either 1 year, 2 years, or both, who are seeking a certificate of added qualification or specialization in geriatrics for either 1 year, 2 years, or both. Such a program may be located in a medical school or academic health center that offers programs in 2 of the 3 disciplines described in subsection (c)(5). Such program may fund the training of psychologists, psychiatric nurse practitioners, and clinical social workers as part of the behavior and mental health training programs.’.CommentsClose CommentsPermalink

SEC. 103. GERIATRIC ACADEMIC CAREER AWARDS.

(a) Expansion of Eligibility for Geriatric Academic Career Awards; Payment to Institution- Section 753(c) of the Public Health Service Act (42 U.S.C. 294(c)) is amended--CommentsClose CommentsPermalink





(1) by striking paragraph (2) through paragraph (3) and inserting the following:CommentsClose CommentsPermalink





‘(2) ELIGIBLE INDIVIDUALS- To be eligible to receive an Award under paragraph (1), an individual shall--CommentsClose CommentsPermalink





‘(A) be board certified or board eligible in internal medicine, family practice, or psychiatry or have completed any required training in a discipline and employed in an accredited health professions school that is approved by the Secretary, including dentistry, pharmacy, nursing, social work, and psychology;CommentsClose CommentsPermalink





‘(B) have completed an approved fellowship program in geriatrics; andCommentsClose CommentsPermalink





‘(C) have a junior (non-tenured) faculty appointment at an accredited (as determined by the Secretary) school of medicine, osteopathic medicine, nursing, social work, psychology, dentistry, pharmacy, or other allied health disciplines in an accredited health professions school that is approved by the Secretary.CommentsClose CommentsPermalink





‘(3) LIMITATIONS- No Award under paragraph (1) may be made to an eligible individual unless the individual--CommentsClose CommentsPermalink





‘(A) has submitted to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require, and the Secretary has approved such application;CommentsClose CommentsPermalink





‘(B) provides, in such form and manner as the Secretary may require, assurances that the individual will meet the service requirement described in paragraph (5); andCommentsClose CommentsPermalink





‘(C) provides, in such form and manner as the Secretary may require, assurances that the individual has a full-time faculty appointment in a health professions institution and documented commitment from such institution to spend 75 percent of the total time of such individual on teaching and developing skills in interdisciplinary education in geriatrics.CommentsClose CommentsPermalink





‘(4) MAINTENANCE OF EFFORT- An eligible individual that receives an Award under paragraph (1) shall provide assurances to the Secretary that funds provided to the eligible individual under this subsection will be used only to supplement, not to supplant, the amount of Federal, State, and local funds otherwise expended by the eligible individual.’; andCommentsClose CommentsPermalink





(2) in paragraph (4)--CommentsClose CommentsPermalink





(A) in subparagraph (A)--CommentsClose CommentsPermalink





(i) by inserting ‘for individuals who are physicians’ after ‘this section’; andCommentsClose CommentsPermalink





(ii) by inserting after the period at the end the following: ‘The Secretary shall determine the amount of an Award under this section for individuals who are not physicians.’; andCommentsClose CommentsPermalink





(B) by adding at the end the following:CommentsClose CommentsPermalink





‘(C) PAYMENT TO INSTITUTION- The Secretary shall transfer funds awarded to an individual under this section to the institution where such individual will carry out the award, in order to facilitate financial management of the reward pursuant to guidelines of the Health Resources and Services Administration.’.CommentsClose CommentsPermalink





(b) Authorization of Appropriations- There are authorized to be appropriated to carry out the amendments made by this section $6,000,000 for each of fiscal years 2011, 2012, and 2013.CommentsClose CommentsPermalink

SEC. 104. GERIATRIC CAREER INCENTIVE AWARDS.

Section 753 of the Public Health Service Act (42 U.S.C. 294), as amended by section 102, is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(f) Geriatric Career Incentive Awards-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall award grants or contracts under this section to individuals described in paragraph (2) to foster greater interest among a variety of health professionals in entering the field of geriatrics, long-term care, and chronic care management.CommentsClose CommentsPermalink





‘(2) ELIGIBLE INDIVIDUALS- To be eligible to received an award under paragraph (1), an individual shall--CommentsClose CommentsPermalink





‘(A) be an advanced practice nurse (such as a clinical nurse specialist or nurse practitioner), a clinical social worker, a pharmacist, or student of psychology who is pursuing a doctorate or other advanced degree approved by the Secretary in geriatrics, long-term care, geropsychology, or chronic care management in an accredited health professions school that is approved by the Secretary; andCommentsClose CommentsPermalink





‘(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





‘(3) CONDITION OF AWARD- As a condition of receiving an award under this subsection, an individual shall agree that, following completion of the award period, the individual will teach or practice in the field of geriatrics, long-term care, or chronic care management for a minimum of 5 years under guidelines set by the Secretary.CommentsClose CommentsPermalink





‘(4) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated to carry out this subsection, $10,000,000 for the period of fiscal years 2011 through 2013.’.CommentsClose CommentsPermalink

SEC. 105. NATIONAL CENTER FOR HEALTH WORKFORCE ANALYSIS.

Part E of Title VII of the Public Health Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘Subpart 3--National Center for Health Workforce Analysis

‘SEC. 774. ACTIVITIES OF THE NATIONAL CENTER FOR HEALTH WORKFORCE ANALYSIS.

‘In addition to any activities being carried out at the National Center for Health Workforce Analysis of the Health Resources and Services Administration as of the day before the date of enactment of the Retooling the Health Care Workforce for an Aging America Act of 2009, the head of such Center shall analyze--CommentsClose CommentsPermalink





‘(1) current and projected needs for health and long-term care workforce demand and supply, and training and education needs specific to older adults and adults with functional limitations;CommentsClose CommentsPermalink





‘(2) turnover and retention for professionals and paraprofessionals in these fields, including administrators, medical directors and direct care staff of nursing homes, assisted living facilities and home and community-based settings, or any other setting or provider the Secretary determines appropriate; andCommentsClose CommentsPermalink





‘(3) diversity of racial and ethnic minority groups represented by professionals and paraprofessionals in these fields.CommentsClose CommentsPermalink

‘SEC. 775. AUTHORIZATION OF APPROPRIATIONS.

‘There is authorized to be appropriated to the National Center for Workforce Analysis to carry out this subpart $6,000,000 for the period of fiscal years 2011 through 2013.’.CommentsClose CommentsPermalink

Subtitle B--Improved Nursing ServicesCommentsClose CommentsPermalink

SEC. 121. COMPREHENSIVE GERIATRIC EDUCATION NURSING GRANT PROGRAM.

Section 855 of the Public Health Service Act (42 U.S.C. 298) is amended--CommentsClose CommentsPermalink





(1) in subsection (b)--CommentsClose CommentsPermalink





(A) in paragraph (3), by striking ‘or’;CommentsClose CommentsPermalink





(B) in paragraph (4), by striking the period and inserting ‘; or’; andCommentsClose CommentsPermalink





(C) by inserting after paragraph (4) the following:CommentsClose CommentsPermalink





‘(5) establish Federal traineeships to individuals who are preparing for advanced degrees in geriatric nursing, long-term care, and gero-psychiatric nursing.’; andCommentsClose CommentsPermalink





(2) in subsection (e), by inserting before the period the following: ‘, $12,000,000 for each of fiscal years 2011 through 2013 to provide assistance under this section to support additional training for nurses who care for the elderly and individuals with disabilities and for the development and dissemination of curricula relating to geriatric nursing care, the training of nursing faculty in geriatrics, and the provision of continuing education for nurses practicing in geriatrics, and $25,000,000 for each of fiscal years 2011 through 2013 to provide assistance under this section to support the Federal traineeships established under subsection (b)(5)’.CommentsClose CommentsPermalink

TITLE II--AMENDMENTS TO THE WORKFORCE INVESTMENT ACT OF 1998CommentsClose CommentsPermalink

SEC. 201. CORE SERVICES.

Section 134(d)(2)(E)(iii) of the Workforce Investment Act of 1998 (29 U.S.C. 2864(d)(2)(E)(iii)) is amended to read as follows:CommentsClose CommentsPermalink





‘(iii) information relating to local occupations in demand, including health care and long-term care occupations, and the earnings and skill requirements for such local occupations;’.CommentsClose CommentsPermalink

SEC. 202. INDIVIDUAL TRAINING ACCOUNTS.

Section 134(d)(4)(G)(iii) of the Workforce Investment Act of 1998 (29 U.S.C. 2864(d)(4)(G)(iii)) is amended to read as follows:CommentsClose CommentsPermalink





‘(iii) LINKAGE TO OCCUPATIONS IN DEMAND- Training services provided under this paragraph shall be directly linked to occupations, including health care and long-term care occupations, that are in demand in the local area, or in another area to which an adult or dislocated worker receiving such services is willing to relocate, except that a local board may approve training services for occupations determined by the local board to be in sectors of the economy that have a high potential for sustained demand or growth in the local area. In making determinations of demand or potential demand or growth under this clause, a local board shall consult local and State health agencies, employers, and other organizations that the local board determines to be appropriate.’.CommentsClose CommentsPermalink

SEC. 203. COLLABORATION BETWEEN STATE BOARDS AND THE VETERANS AGENCIES OF THE STATES.

Section 112(b) of the Workforce Investment Act of 1998 (29 U.S.C. 2822(b)) is amended--CommentsClose CommentsPermalink





(1) in paragraph (17), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(2) in paragraph (18), by striking the period and inserting ‘; and’; andCommentsClose CommentsPermalink





(3) by adding at the end the following new paragraph:CommentsClose CommentsPermalink





‘(19) a description of how the State board will collaborate with the veterans agency of the State, including entering into a memorandum of understanding with the veterans agency of the State specifying--CommentsClose CommentsPermalink





‘(A) the manner in which the State board and the veterans agency of the State will provide information on health care workforce employment and training opportunities available to individuals, including veterans who are receiving core services described in section 134(d)(2) at a one-stop center and are receiving assistance from the Veterans’ Employment and Training Service of the Department of Labor; andCommentsClose CommentsPermalink





‘(B) the manner in which the State board and the veterans agency of the State will obtain and provide information to one-stop operators in the State, for distribution through one-stop centers, about training, internship, and employment opportunities in geriatrics, gerontology, and long-term care, including, as available, opportunities at geriatric research, education and clinical centers operated by the Department of Veterans Affairs.’.CommentsClose CommentsPermalink

SEC. 204. COLLABORATION BETWEEN DEPARTMENT OF LABOR AND DEPARTMENT OF VETERANS AFFAIRS.

The Secretary of Labor, acting through the Assistant Secretary for Veterans’ Employment and Training, and the Secretary of Veterans Affairs, shall develop memoranda of understanding outlining how veterans seeking employment information through the Local Veterans’ Employment Representative Program and the Transition Assistance Program will be provided with information about training, internship, and employment opportunities in geriatrics, gerontology, and long-term care, including opportunities at geriatric research, education and clinical centers operated by the Department of Veterans Affairs.CommentsClose CommentsPermalink

SEC. 205. TRAINING OPPORTUNITIES FOR DIRECT CARE WORKERS.

(a) In General- Section 171 of the Workforce Investment Act of 1998 (29 U.S.C. 2916) is amended by adding at the end the following new subsection:CommentsClose CommentsPermalink





‘(f) Training Opportunities for Direct Care Workers-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall award grants to eligible entities to enable such entities to provide new training opportunities for direct care workers (including certified nursing assistants, home health aides, and personal or home care aides) who are employed in long-term care settings such as nursing homes (as defined in section 1908(e)(1) of the Social Security Act (42 U.S.C. 1396g(e)(1)), assisted living facilities, home care settings, and any other setting the Secretary determines to be appropriate.CommentsClose CommentsPermalink





‘(2) ELIGIBILITY- To be eligible to receive a grant under paragraph (1), an entity shall--CommentsClose CommentsPermalink





‘(A) be an institution of higher education (as defined in section 102 of the Higher Education Act of 1965 (20 U.S.C. 1002)) that--CommentsClose CommentsPermalink





‘(i) is accredited by a nationally recognized accrediting agency or association listed under section 101(c) of the Higher Education Act of 1965 (20 U.S.C. 1001(c)); andCommentsClose CommentsPermalink





‘(ii) has established a public-private educational partnership with a nursing home, home health agency, or other long-term care provider; andCommentsClose CommentsPermalink





‘(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





‘(3) PRIORITY- In making grants to eligible entities, the Secretary shall give priority to entities that demonstrate that the entities will coordinate activities with one-stop operators and one-stop partners at local one-stop centers referred to in section 134(c).CommentsClose CommentsPermalink





‘(4) USE OF FUNDS- An eligible entity shall use amounts awarded under a grant under paragraph (1) to provide assistance to eligible individuals to offset the cost of tuition and required fees for enrollment in academic programs provided by such entity, including--CommentsClose CommentsPermalink





‘(A) the provision of stipends to such individuals for a period of not to exceed 2 years;CommentsClose CommentsPermalink





‘(B) the lowering of fees assessed with respect to eligible individuals who are enrolled in programs leading to a licensed practical nursing degree, a registered nursing degree, or any other advanced nursing degree; andCommentsClose CommentsPermalink





‘(C) the lowering of fees assessed with respect to eligible individuals who are enrolled in courses aimed at improving direct care skills for the treatment of specialized conditions that are common in the long-term care sector, such as wound care, brain trauma, immobility, incontinence, functional impairment, and dementia.CommentsClose CommentsPermalink





‘(5) ELIGIBLE INDIVIDUAL-CommentsClose CommentsPermalink





‘(A) ELIGIBILITY- To be eligible for assistance under paragraph (4), an individual shall be enrolled in courses provided by a grantee under this subsection and maintain satisfactory academic progress in such courses.CommentsClose CommentsPermalink





‘(B) CONDITION OF ASSISTANCE- As a condition of receiving assistance under paragraph (4), an individual shall agree that, following completion of the assistance period, the individual will work in the field of geriatrics, long-term care, or chronic care management for a minimum of 2 years under guidelines set by the Secretary.CommentsClose CommentsPermalink





‘(6) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated to carry out this subsection, $10,000,000 for the period of fiscal years 2011 through 2013.’.CommentsClose CommentsPermalink





(b) Conforming Amendments-CommentsClose CommentsPermalink





(1) Section 174(b)(1) of the Workforce Investment Act of 1998 (29 U.S.C. 2919(b)(1)) is amended by inserting ‘and except as provided in section 171(f),’ after ‘paragraph (2),’.CommentsClose CommentsPermalink





(2) Section 174(b)(2)(B)(ii) of the Workforce Investment Act (29 U.S.C. (b)(2)(B)(ii)) is amended to read as follows:CommentsClose CommentsPermalink





‘(ii) except as provided in section 171(f), for each of the fiscal years 2000 through 2003, reserve not less than 45 percent for carrying out section 171;’.CommentsClose CommentsPermalink

TITLE III--AMENDMENTS TO THE OLDER AMERICANS ACT OF 1965CommentsClose CommentsPermalink

SEC. 301. FAMILY CAREGIVER TRAINING.

(a) In General- Part E of title III of the Older Americans Act of 1965 (42 U.S.C. 3030s et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 375. FAMILY CAREGIVER TRAINING.

‘(a) Development of Materials-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Assistant Secretary shall, directly or by contract, develop family caregiver training materials, working with an advisory committee, comprised of experts on matters related to family caregivers, including researchers, clinicians, representatives of nursing homes and State Long-Term Care Ombudsman programs, representatives of community colleges and vocational schools, family caregivers, and representatives of organizations for family caregivers. The materials shall be suitable to provide online training for family caregivers, and grandparents or older individuals who are relative caregivers, in providing personal care to care recipients.CommentsClose CommentsPermalink





‘(2) CONTENT- The materials shall include written materials and videos, designed to be easily downloaded, that demonstrate techniques for key personal care activities. The materials shall demonstrate ways of safely lifting and transferring individuals with disabilities, means of preventing falls, and other means of providing assistance with activities of daily living, and instrumental activities of daily living such as medication management. The materials shall provide information on behavioral management and communication techniques for care recipients that are individuals with Alzheimer’s disease or a related disorder with neurological and organic brain dysfunction.CommentsClose CommentsPermalink





‘(b) Distribution of Materials- The Assistant Secretary shall make the training described in subsection (a)(1) available online, free of cost to users.CommentsClose CommentsPermalink





‘(c) Definitions- In this section:CommentsClose CommentsPermalink





‘(1) CARE RECIPIENT- The term ‘care recipient’--CommentsClose CommentsPermalink





‘(A) used with respect to a family caregiver, means an older individual or an individual with Alzheimer’s disease or a related disorder with neurological and organic brain dysfunction; andCommentsClose CommentsPermalink





‘(B) used with respect to a grandparent or older individual who is a relative caregiver, means an individual with a disability.CommentsClose CommentsPermalink





‘(2) COMMUNITY COLLEGE- The term ‘community college’ means an institution of higher education (as defined in section 101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a))) that offers a 2-year program of study.CommentsClose CommentsPermalink





‘(3) INDIVIDUAL WITH A DISABILITY- The term ‘individual with a disability’ means an individual with a disability, within the meaning of section 372(a)(1).CommentsClose CommentsPermalink





‘(4) VOCATIONAL SCHOOL- The term ‘vocational school’ means an area career and technical education school, as defined in section 3 of the Carl D. Perkins Career and Technical Education Act of 2006 (20 U.S.C. 2302).’.CommentsClose CommentsPermalink





(b) Authorization of Appropriations- Section 303(e) of the Older Americans Act of 1965 (42 U.S.C. 3023(e)) is amended--CommentsClose CommentsPermalink





(1) in paragraph (2), by inserting ‘, other than section 375’ after ‘part E’; andCommentsClose CommentsPermalink





(2) by adding at the end the following:CommentsClose CommentsPermalink





‘(4) There is authorized to be appropriated to carry out section 375, $5,000,000 for the period of fiscal years 2011 through 2013.’.CommentsClose CommentsPermalink

SEC. 302. REDESIGNATIONS IN PROVISIONS FOR MULTIGENERATIONAL AND CIVIC ENGAGEMENT ACTIVITIES.

(a) Redesignations- Section 417 of the Older Americans Act of 1965 is amended--CommentsClose CommentsPermalink





(1) in subsection (a)--CommentsClose CommentsPermalink





(A) in paragraph (1), by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and indenting accordingly;CommentsClose CommentsPermalink





(B) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(C) by inserting all that precedes ‘The Assistant Secretary’ and inserting the following:CommentsClose CommentsPermalink





‘(a) Demonstration, Support, and Research Projects-CommentsClose CommentsPermalink





‘(1) GRANTS AND CONTRACTS- ’;CommentsClose CommentsPermalink





(2) in subsection (b)--CommentsClose CommentsPermalink





(A) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(B) by inserting all that precedes ‘An eligible’ and inserting the following:CommentsClose CommentsPermalink





‘(2) USE OF FUNDS- ’;CommentsClose CommentsPermalink





(3) in subsection (c)--CommentsClose CommentsPermalink





(A) by redesignating paragraphs (1) through (4) as subparagraphs (A) through (D), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(B) by striking all that precedes ‘In awarding’ and inserting the following:CommentsClose CommentsPermalink





‘(3) PREFERENCE- ’;CommentsClose CommentsPermalink





(4) in subsection (d), by striking all that precedes ‘To be’ and inserting the following:CommentsClose CommentsPermalink





‘(4) APPLICATION- ’;CommentsClose CommentsPermalink





(5) in subsection (e)--CommentsClose CommentsPermalink





(A) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(B) by inserting all that precedes ‘Organizations’ and inserting the following:CommentsClose CommentsPermalink





‘(5) ELIGIBLE ORGANIZATIONS- ’;CommentsClose CommentsPermalink





(6) in subsection (f)--CommentsClose CommentsPermalink





(A) in paragraph (1), by redesignating subparagraphs (A), (B), and (C) as clauses (i), (ii), and (iii), respectively, and indenting accordingly;CommentsClose CommentsPermalink





(B) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(C) by inserting all that precedes subparagraph (A) (as redesignated by subparagraph (B) of this paragraph) and inserting the following:CommentsClose CommentsPermalink





‘(6) LOCAL EVALUATION AND REPORT- ’;CommentsClose CommentsPermalink





(7) in subsection (g)--CommentsClose CommentsPermalink





(A) by redesignating paragraphs (1) through (8) as subparagraphs (A) through (H), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(B) by inserting all that precedes ‘Not later’ and inserting the following:CommentsClose CommentsPermalink





‘(7) REPORT TO CONGRESS- ’; andCommentsClose CommentsPermalink





(8) in subsection (h)--CommentsClose CommentsPermalink





(A) in paragraph (2)--CommentsClose CommentsPermalink





(i) in subparagraph (B), by redesignating clauses (i) and (ii) as subclauses (I) and (II), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(ii) by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and indenting accordingly;CommentsClose CommentsPermalink





(B) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and indenting accordingly; andCommentsClose CommentsPermalink





(C) by inserting all that precedes ‘As used’ and inserting the following:CommentsClose CommentsPermalink





‘(8) DEFINITIONS- ’.CommentsClose CommentsPermalink





(b) Conforming Amendments- Section 417 of the Older Americans Act of 1965 is amended--CommentsClose CommentsPermalink





(1) by striking ‘this section’ each place it appears and inserting ‘this subsection’;CommentsClose CommentsPermalink





(2) by striking ‘subsection (a)(1)’ each place it appears and inserting ‘paragraph (1)(A)’;CommentsClose CommentsPermalink





(3) by striking ‘subsection (a)(2)’ each place it appears and inserting ‘paragraph (1)(B)’;CommentsClose CommentsPermalink





(4) except as provided in paragraphs (2) and (3), by striking ‘subsection (a)’ each place it appears and inserting ‘paragraph (1)’; andCommentsClose CommentsPermalink





(5) in subsection (a) (as redesignated by subsection (a) of this section)--CommentsClose CommentsPermalink





(A) in paragraph (2)(B), by striking ‘subsection (f)’ and inserting ‘paragraph (6)’; andCommentsClose CommentsPermalink





(B) in paragraph (7)--CommentsClose CommentsPermalink





(i) in the matter preceding subparagraph (A), by striking ‘subsection (f)(2)’ and inserting ‘paragraph (6)(B)’; andCommentsClose CommentsPermalink





(ii) in subparagraph (G), by striking ‘paragraph (1)’ and inserting ‘subparagraph (A)’.CommentsClose CommentsPermalink

SEC. 303. NATIONAL RESOURCE CENTER ON VOLUNTEERS, STUDENTS, AND SENIORS.

Section 417 of the Older Americans Act of 1965 (42 U.S.C. 3032f), as amended by section 302, is further amended by adding at the end the following:CommentsClose CommentsPermalink





‘(b) National Resource Center on Volunteers, Students, and Seniors-CommentsClose CommentsPermalink





‘(1) IN GENERAL-CommentsClose CommentsPermalink





‘(A) GRANT- The Assistant Secretary shall award a grant for the establishment and operation of a National Resource Center on Volunteers, Students, and Seniors (referred to in this subsection as the ‘Center’). The Center shall--CommentsClose CommentsPermalink





‘(i) promote partnerships between entities in the aging network, and institutions of higher education and secondary schools, in order to expand the capacity of individuals to serve in, and in order to attract new leaders for and professionals into, the aging network; andCommentsClose CommentsPermalink





‘(ii) encourage projects that involve underserved communities, including rural communities and racial and ethnic minority communities.CommentsClose CommentsPermalink





‘(B) PARTNERSHIPS- Such partnerships may involve--CommentsClose CommentsPermalink





‘(i) State agencies, area agencies on aging, or other local government agencies, Aging and Disability Resource Centers, tribal organizations, nonprofit health or social service organizations, community clinics, adult day care centers, senior housing providers, and other providers that provide direct services to older individuals and that are determined to be appropriate by the Assistant Secretary; andCommentsClose CommentsPermalink





‘(ii) local institutions of higher education and secondary schools.CommentsClose CommentsPermalink





‘(2) CENTER- The Center shall use the funds made available through the grant to--CommentsClose CommentsPermalink





‘(A) identify and disseminate information (including information about best practices) concerning how entities described in paragraph (1)(B) can establish partnerships in a manner that provides volunteers and students in nursing, social work, gerontology, psychology, dental hygiene, music and recreational therapy, nutrition, and other disciplines identified by the Assistant Secretary with opportunities, approved by the Assistant Secretary, to gain experience working with older individuals, including older individuals with dementia or cognitive impairment, receiving services under this Act;CommentsClose CommentsPermalink





‘(B) develop and implement a model demonstration grant program to--CommentsClose CommentsPermalink





‘(i) promote new partnerships between the entities described in paragraph (1)(B) and incorporate activities of the partnerships into established curricula of institutions of higher education and secondary schools; andCommentsClose CommentsPermalink





‘(ii) promote and sponsor internship programs, career development seminars, and continuing education and lifelong learning programs; andCommentsClose CommentsPermalink





‘(C) develop and implement a model career ladder program that will disseminate information on best practices designed to enable mid-level professionals to advance in the field of aging.CommentsClose CommentsPermalink





‘(3) DEFINITION- In this subsection, the term ‘secondary school’ has the meaning given the term in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 8801).CommentsClose CommentsPermalink





‘(4) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be appropriated to carry out this subsection $3,000,000 for fiscal year 2011, $3,500,000 for fiscal year 2012, and $4,000,000 for fiscal year 2013.’.CommentsClose CommentsPermalink

TITLE IV--AMENDMENTS TO THE SOCIAL SECURITY ACTCommentsClose CommentsPermalink

SEC. 401. DEMONSTRATION PROGRAM FOR PERSONAL OR HOME CARE AIDES, NURSE AIDES, AND HOME HEALTH AIDES IN LONG-TERM CARE SETTINGS.

(a) Establishment-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary shall establish a demonstration program (in this section referred to as the ‘program’) to make grants to participating States to develop core training competencies for eligible personal or home care aides and additional training content for nurse aides and home health aides to supplement training for nurse aides and home health aides that is required under Federal law or regulation, and to evaluate the effectiveness of such competencies and additional training content. Such program shall evaluate the efficacy of--CommentsClose CommentsPermalink





(A) the core training competencies developed under subsection (b)(2)(A);CommentsClose CommentsPermalink





(B) the additional training content developed under subsection (b)(2)(B); andCommentsClose CommentsPermalink





(C) the method of implementation of such core training competencies and additional training content against a ‘control’ group being trained under a participating State’s existing training protocols.CommentsClose CommentsPermalink





(2) DURATION- The program shall be conducted for not less than 4 years.CommentsClose CommentsPermalink





(b) Establishment of Expert Panel-CommentsClose CommentsPermalink





(1) IN GENERAL- Not later than 120 days after the date of enactment of this Act, the Secretary shall establish a panel of long-term care workforce experts (in this section referred to as the ‘expert panel’).CommentsClose CommentsPermalink





(2) DUTIES- The expert panel shall carry out the following duties:CommentsClose CommentsPermalink





(A)(i) Subject to clause (ii), developing core training competencies for personal or home care aides, including such competencies with respect to the following areas:CommentsClose CommentsPermalink





(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).CommentsClose CommentsPermalink





(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).CommentsClose CommentsPermalink





(III) Communication, cultural and linguistic competence and sensitivity, problem solving, behavior management, and relationship skills.CommentsClose CommentsPermalink





(IV) Personal care skills.CommentsClose CommentsPermalink





(V) Health care support.CommentsClose CommentsPermalink





(VI) Nutritional support.CommentsClose CommentsPermalink





(VII) Infection control.CommentsClose CommentsPermalink





(VIII) Safety and emergency training.CommentsClose CommentsPermalink





(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).CommentsClose CommentsPermalink





(X) Self-Care.CommentsClose CommentsPermalink





(ii) For purposes of the program, the core training competencies developed under clause (i) shall only apply with respect to newly hired personal or home care aides.CommentsClose CommentsPermalink





(B)(i) Subject to clause (ii), developing additional training content for home health aides and nurse aides which is not required under Federal law as of the date of enactment of this Act, including such content with respect to the following areas:CommentsClose CommentsPermalink





(I) Culturally and linguistically competent practice.CommentsClose CommentsPermalink





(II) Standardized direct care worker communication protocols (such as Situation, Background, Assessment, and Recommendation communication tools).CommentsClose CommentsPermalink





(III) Palliative and end-of-life care.CommentsClose CommentsPermalink





(IV) Injury prevention.CommentsClose CommentsPermalink





(V) Wound and decubitus care.CommentsClose CommentsPermalink





(VI) Medication management, adherence, and safe disposal.CommentsClose CommentsPermalink





(VII) Mental and behavioral health.CommentsClose CommentsPermalink





(VIII) Additional aspects of dementia care training (such as understanding dementia and Alzheimer’s disease, dealing with challenging behavior, developing communication skills, working with family caregivers, and ensuring physical health and safety).CommentsClose CommentsPermalink





(IX) Prevention and reporting of abuse and caregiver burnout.CommentsClose CommentsPermalink





(ii) For purposes of the program, the additional training content developed under clause (i) shall only apply with respect to newly hired home health aides and nurse aides.CommentsClose CommentsPermalink





(C)(i) Subject to clause (ii), making recommendations regarding how training shall be provided under the program, including recommendations with respect to the following:CommentsClose CommentsPermalink





(I) The length of the training.CommentsClose CommentsPermalink





(II) The appropriate trainer to student ratio.CommentsClose CommentsPermalink





(III) The amount of instruction time spent in the classroom as compared to on-site in the home or a facility.CommentsClose CommentsPermalink





(IV) Trainer qualifications.CommentsClose CommentsPermalink





(V) Content for a ‘hands-on’ and written certification exam.CommentsClose CommentsPermalink





(VI) Continuing education requirements.CommentsClose CommentsPermalink





(VII) Ways to integrate the core training competencies developed for personal and home care aides under subparagraph (A) with the additional training content developed for home health aides and nurse aides under subparagraph (B).CommentsClose CommentsPermalink





(ii) The recommendations under clause (i) shall ensure that the number of hours of training provided under the program are not less than the number of hours of training required under any applicable State or Federal law or regulation.CommentsClose CommentsPermalink





(3) MEMBERSHIP-CommentsClose CommentsPermalink





(A) IN GENERAL- Subject to subparagraph (B), the expert panel shall be composed of 11 members appointed by the Secretary from among leading experts in the long-term care field, including representatives of--CommentsClose CommentsPermalink





(i) personal or home care agencies;CommentsClose CommentsPermalink





(ii) home health care agencies;CommentsClose CommentsPermalink





(iii) nursing homes and residential care facilities;CommentsClose CommentsPermalink





(iv) the disability community (including the mental retardation and developmental disability communities);CommentsClose CommentsPermalink





(v) the nursing community;CommentsClose CommentsPermalink





(vi) national advocacy organizations and unions that represent direct care workers;CommentsClose CommentsPermalink





(vii) older individuals and family caregivers;CommentsClose CommentsPermalink





(viii) State Medicaid waiver program officials;CommentsClose CommentsPermalink





(ix) curriculum developers with expertise in adult learning;CommentsClose CommentsPermalink





(x) researchers on direct care workers and the long-term care workforce; andCommentsClose CommentsPermalink





(xi) geriatric pharmacists.CommentsClose CommentsPermalink





(B) INCLUSION OF REPRESENTATIVES OF CERTAIN INDIVIDUALS- Not less than 2 of the 11 members appointed by the Secretary under subparagraph (A) shall represent the interests of individuals who rely on long-term care services, including the interests of those individuals described in clause (vii) of such subparagraph.CommentsClose CommentsPermalink





(4) REPORT- Not later than 1 year after the date of enactment of this Act, the expert panel shall submit to the Secretary a report containing--CommentsClose CommentsPermalink





(A) the core training competencies developed under paragraph (2)(A);CommentsClose CommentsPermalink





(B) the additional training content developed under paragraph (2)(B);CommentsClose CommentsPermalink





(C) any recommendations of the expert panel under paragraph (2)(C); andCommentsClose CommentsPermalink





(D) recommendations for such legislation or administrative action as the expert panel determines appropriate.CommentsClose CommentsPermalink





(5) TERMINATION- The expert panel shall terminate 180 days after it submits the report under paragraph (4).CommentsClose CommentsPermalink





(c) Application and Selection Criteria-CommentsClose CommentsPermalink





(1) IN GENERAL-CommentsClose CommentsPermalink





(A) SOLICITATION- Not later than 2 years after the date of enactment of this Act, the Secretary shall issue a proposal soliciting States to voluntarily participate in the program.CommentsClose CommentsPermalink





(B) AGREEMENTS- The Secretary shall enter into agreements with not more than 4 States to conduct the program in such States.CommentsClose CommentsPermalink





(C) REQUIREMENTS FOR STATES- An agreement entered into under subparagraph (B) shall require that a participating State--CommentsClose CommentsPermalink





(i) use grant funds made available to the State under the program to recruit eligible health and long-term care providers to--CommentsClose CommentsPermalink





(I) participate in the program; andCommentsClose CommentsPermalink





(II) implement the core training competencies developed under subsection (b)(2)(A) and the additional training content developed under subsection (b)(2)(B); andCommentsClose CommentsPermalink





(ii) develop written materials and protocols for such core training competencies and such additional training content, including the development of a certification test for personal or home care aides who have completed such training competencies and, if applicable, additional training content.CommentsClose CommentsPermalink





(D) 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 program, which may include consideration of such colleges as partners in such implementation.CommentsClose CommentsPermalink





(2) APPLICATION AND ELIGIBILITY- A State seeking to participate in the program shall--CommentsClose CommentsPermalink





(A) submit an application to the Secretary containing such information and at such time as the Secretary may specify;CommentsClose CommentsPermalink





(B) meet the selection criteria established under paragraph (3); andCommentsClose CommentsPermalink





(C) meet such additional criteria as the Secretary may specify.CommentsClose CommentsPermalink





(3) SELECTION CRITERIA- In selecting States to participate in the program, the Secretary shall establish criteria to ensure--CommentsClose CommentsPermalink





(A) geographic and demographic diversity;CommentsClose CommentsPermalink





(B) that participating States offer medical assistance for personal care services under the State Medicaid plan;CommentsClose CommentsPermalink





(C) that the existing training standards for personal or home care aides, home health aides, and nurse aides in each participating State--CommentsClose CommentsPermalink





(i) are different from such standards in the other participating States; andCommentsClose CommentsPermalink





(ii) are different from the core training competencies developed under subsection (b)(2)(A) and the additional training content developed under subsection (b)(2)(B);CommentsClose CommentsPermalink





(D) 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 program; andCommentsClose CommentsPermalink





(E) that States recruit a minimum number of eligible health and long-term care providers to participate in the program.CommentsClose CommentsPermalink





(4) TECHNICAL ASSISTANCE- The Secretary shall provide technical assistance to States in developing written materials and protocols for such core training competencies and such additional training content under paragraph (1)(C)(ii).CommentsClose CommentsPermalink





(d) Evaluation and Report-CommentsClose CommentsPermalink





(1) 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--CommentsClose CommentsPermalink





(A) the impact of core training competencies developed under subsection (b)(2)(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 established under subsection (b);CommentsClose CommentsPermalink





(B) the impact of incorporating the additional training content developed under subsection (b)(2)(B) into existing training standards for home health aides and certified nurse aides within each participating State;CommentsClose CommentsPermalink





(C) the impact of providing such core training competencies and additional training content on the existing training infrastructure and resources of States;CommentsClose CommentsPermalink





(D) whether the minimum number of hours of initial training required for nurse aides under sections 1819(f)(2)(A)(i)(II) and 1919(f)(2)(A)(i)(II) of the Social Security Act (42 U.S.C. 1395i-3(f)(2)(A)(i)(II); 1396r(f)(2)(A)(i)(II)) should be increased; andCommentsClose CommentsPermalink





(E) 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.CommentsClose CommentsPermalink





(2) REPORT- Not later than 1 year after the completion of the program, the Secretary shall submit to Congress a report containing the results of the evaluations conducted under paragraph (1), together with such recommendations for legislation or administrative action as the Secretary determines appropriate.CommentsClose CommentsPermalink





(e) Funding- Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out the program under this section for the period of fiscal years 2011 through 2016, $14,000,000.CommentsClose CommentsPermalink





(f) Definitions- In this section:CommentsClose CommentsPermalink





(1) 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)) of the Social Security Act (42 U.S.C. 1395x(o)), or any other health care provider the Secretary determines appropriate which--CommentsClose CommentsPermalink





(A) is licensed or authorized to provide services in a participating State; andCommentsClose CommentsPermalink





(B) receives payment for services under title XVIII or XIX of the Social Security Act.CommentsClose CommentsPermalink





(2) HOME HEALTH AIDE- The term ‘home health aide’ has the meaning given such term in section 1891(a)(3)(E) of the Social Security Act (42 U.S.C. 1395bbb(a)(3)(E)).CommentsClose CommentsPermalink





(3) NURSE AIDE- The term ‘nurse aide’ has the meaning given such term in section 1819(b)(5)(F) of the Social Security Act (42 U.S.C. 1395i-3(b)(5)(F)).CommentsClose CommentsPermalink





(4) PERSONAL CARE SERVICES- The term ‘personal care services’ has the meaning given such term for purposes of title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).CommentsClose CommentsPermalink





(5) 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.CommentsClose CommentsPermalink





(6) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink

SEC. 402. MEDICARE FAMILY CAREGIVER INFORMATION AND REFERRAL.

State health insurance assistance programs, the Administrator of the Centers for Medicare & Medicaid Services, and the Assistant Secretary of the Administration on Aging shall, in collaboration with each other, directly or by contract, develop practical, easy-to-understand information and referral protocols for health care providers, social workers, and other appropriate individuals to provide to family caregivers of Medicare beneficiaries either on admission to or discharge from a hospital (including a discharge from a hospital emergency room or a hospital outpatient department which has furnished a surgical service) or a post-acute care setting (including a skilled nursing facility (as defined in section 1819(a) of the Social Security Act (42 U.S.C. 1395i-3(a)), a comprehensive rehabilitation facility (as defined in section 1861(cc)(2) of such Act (42 U.S.C. 1395x(cc)(2)) or a rehabilitation agency, a provider of long-term care services, and a home health agency (as defined in section 1861(o) of such Act (42 U.S.C. 1395x(o)). Information developed under the preceding sentence shall--CommentsClose CommentsPermalink





(1) include information on national, State, and community-based resources for seniors, individuals with disabilities and their caregivers, which shall be updated on a semi-annual basis (or as frequently as practicable);CommentsClose CommentsPermalink





(2) be disseminated by health care providers, social workers, and other appropriate individuals as printed materials (including materials in Spanish and other languages (other than English) as appropriate); andCommentsClose CommentsPermalink





(3) be made available on the Internet websites of State health insurance assistance programs, the Centers for Medicare & Medicaid Services, and the Administration on Aging.CommentsClose CommentsPermalink

SEC. 403. MEDICAID ASSESSMENT OF FAMILY CAREGIVER SUPPORT NEEDS.

(a) In General- Section 1915 of the Social Security Act (42 U.S.C. 1396n) is amended--CommentsClose CommentsPermalink





(1) in subsection (c)(2)--CommentsClose CommentsPermalink





(A) in subparagraph (D), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(B) in subparagraph (E), by striking the period at the end and inserting ‘; and’; andCommentsClose CommentsPermalink





(C) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink





‘(F) under such waiver the State may provide for an assessment of family caregiver support needs (in accordance with subsection (k)).’;CommentsClose CommentsPermalink





(2) in subsection (d)(2)--CommentsClose CommentsPermalink





(A) in subparagraph (B), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(B) in subparagraph (C), by striking the period at the end and inserting ‘; and’; andCommentsClose CommentsPermalink





(C) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink





‘(D) under such waiver the State may provide for an assessment of family caregiver support needs (in accordance with subsection (k)).’;CommentsClose CommentsPermalink





(3) in subsection (i)(1)(F), by adding at the end the following new clause:CommentsClose CommentsPermalink





‘(vii) Where appropriate, an assessment of family caregiver support needs (in accordance with subsection (k)).’; andCommentsClose CommentsPermalink





(4) by adding at the end the following new subsection:CommentsClose CommentsPermalink





‘(k) Assessment of Family Caregiver Support Needs-CommentsClose CommentsPermalink





‘(1) IN GENERAL- In the case of an individual who is determined to be eligible for home and community-based services under a waiver under subsection (c) or (d) or under section 1115, under a State plan amendment under subsection (i), under an MFP demonstration project established under section 6071 of the Deficit Reduction Act of 2005, or as part of self-directed personal assistance services provided pursuant to a written plan of care in accordance with the requirements of subsection (j), and who is dependent upon the assistance of a family caregiver, the State may provide for an assessment of the family caregiver support needs of the individual. Such assessment shall, to the extent feasible, be conducted at the same time as, or closely coordinated with, the determination of the eligibility of the individual for such services.CommentsClose CommentsPermalink





‘(2) QUESTIONNAIRE-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Such assessment shall include asking the family caregiver of the individual questions in order to determine whether they would benefit from targeted support services (such as those services described in paragraph (3)).CommentsClose CommentsPermalink





‘(B) COMPLETION ON A VOLUNTARY BASIS- The answering of questions under subparagraph (A) by a family caregiver shall be on a voluntary basis.CommentsClose CommentsPermalink





‘(3) TARGETED SUPPORT SERVICES DESCRIBED- The following targeted support services are described in this paragraph:CommentsClose CommentsPermalink





‘(A) Respite care and emergency back-up services (including short-term help for the individual that gives the family caregiver a break from providing such care).CommentsClose CommentsPermalink





‘(B) Individual counseling (including advice and consultation sessions to bolster emotional support for the family caregiver to make well-informed decisions about how to cope with the strain of supporting the individual).CommentsClose CommentsPermalink





‘(C) Support groups, including groups which provide help for family caregivers to--CommentsClose CommentsPermalink





‘(i) locate a support group either locally or online to share experiences and reduce isolation;CommentsClose CommentsPermalink





‘(ii) make well-informed decisions about caring for the individual; andCommentsClose CommentsPermalink





‘(iii) reduce isolation.CommentsClose CommentsPermalink





‘(D) Information and assistance (including brochures and online resources for researching a disease or disability or learning and managing a regular caregiving role, new technologies that can assist family caregivers, and practical assistance for locating services).CommentsClose CommentsPermalink





‘(E) Chore services (such as house cleaning).CommentsClose CommentsPermalink





‘(F) Personal care (including outside help).CommentsClose CommentsPermalink





‘(G) Education and training (including workshops and other resources available with information about stress management, self-care to maintain good physical and mental health, understanding and communicating with individuals with dementia, medication management, normal aging processes, change in disease and disability, the role of assistive technologies, and other relevant topics).CommentsClose CommentsPermalink





‘(H) Legal and financial planning and consultation (including advice and counseling regarding long-term care planning, estate planning, powers of attorney, community property laws, tax advice, employment leave advice, advance directives, and end-of-life care).CommentsClose CommentsPermalink





‘(I) Transportation (including transportation to medical appointments).CommentsClose CommentsPermalink





‘(J) Other targeted support services the Secretary or the State determines appropriate.CommentsClose CommentsPermalink





‘(4) REFERRALS- In the case where a questionnaire completed by a family caregiver under paragraph (2) indicates that the family caregiver would benefit from 1 or more of the targeted support services described in paragraph (3), the State shall provide referrals to the family caregiver for local, State, and private-sector family caregiver programs and other resources that provide such targeted support services.’.CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by subsection (a) shall apply to medical assistance for home and community-based services that is provided on or after the date of enactment of this Act.CommentsClose CommentsPermalink

TITLE V--STUDIES AND REPORTSCommentsClose CommentsPermalink

SEC. 501. STUDIES AND REPORTS.

(a) IOM Study and Report on Mental Health Workforce Needs-CommentsClose CommentsPermalink





(1) STUDY- Not later than 90 days after the date of enactment of this Act, the Secretary of Health and Human Services shall enter into a contract with the Institute of Medicine of the National Academies (in this section referred to as the ‘Institute’) under which the Institute shall conduct a study on the specific policy, workforce, economic, and implementation issues relevant to the mental health workforce that need to be addressed to meet the current needs of older individuals and the future needs of the aging boomer generation.CommentsClose CommentsPermalink





(2) REPORT- Not later than 24 months after the effective date of the contract under paragraph (1), the Institute, as part of such contract, shall submit a report to the Secretary of Health and Human Services and the appropriate committees of jurisdiction of Congress containing the results of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Institute determines appropriate.CommentsClose CommentsPermalink





(3) AUTHORIZATION- There is authorized to be appropriated to carry out this subsection, $1,200,000 for the period of fiscal years 2011 through 2012.CommentsClose CommentsPermalink





(b) GAO Study and Report on the Needs of the Aging Network-CommentsClose CommentsPermalink





(1) STUDY- The Comptroller General of the United States (in this section referred to as the ‘Comptroller General’) shall conduct a study on the aging network, focusing on State agencies and area agencies on aging (as defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002)) to determine the current capacity of such network and to identify challenges in providing services to older adults, including older adults who are low-income and older adults with functional disabilities, during the 10-year period beginning on the date of enactment of this Act.CommentsClose CommentsPermalink





(2) REPORT- Not later than 18 months after the date of enactment of this Act, the Comptroller General shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations--CommentsClose CommentsPermalink





(A) on the workforce supply and capitol resources needed by the aging network in order to meet the demand for services by older adults during such 10-year period; andCommentsClose CommentsPermalink





(B) for such legislation and administrative action as the Comptroller General determines appropriate.CommentsClose CommentsPermalink





(c) GAO Study and Report on the Direct Case Workforce in Long-Term Care Settings-CommentsClose CommentsPermalink





(1) STUDY- The Comptroller General shall conduct a study on the use of practices to reduce turnover and improve retention and tenure of nurse aides and home health aides in nursing homes, assisted living facilities, and home health agencies (as defined in section 1861(o) of the Social Security Act (42 U.S.C. 1395x(o)). Such study shall include an analysis of the reasons for the success of such practices and how such practices could be replicated in other facilities.CommentsClose CommentsPermalink





(2) REPORT- Not later than 18 months after the date of enactment of this Act, the Comptroller General shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.CommentsClose CommentsPermalink





(3) DEFINITIONS- In this subsection:CommentsClose CommentsPermalink





(A) HOME HEALTH AIDE- The term ‘home health aide’ has the meaning given such term in section 1891(a)(3)(E) of the Social Security Act (42 U.S.C. 1395bbb(a)(3)(E)).CommentsClose CommentsPermalink





(B) NURSE AIDE- The term ‘nurse aide’ has the meaning given such term in section 1819(b)(5)(F) of the Social Security Act (42 U.S.C. 1395i-3(b)(5)(F)).CommentsClose CommentsPermalink





(d) GAO Study and Report on NIH Spending and Grants-CommentsClose CommentsPermalink





(1) STUDY- The Comptroller General shall conduct a study on spending by the National Institutes of Health, including the number of grants made by the National Institutes of Health, on conditions and illnesses that disproportionately impact the physical and mental health of older individuals. Such study shall include an analysis of the number of older individuals who are included in clinical trials, including clinical trials assessing the prevalence and impact of medication-related problems for older adults, that are supported by the National Institutes of Health.CommentsClose CommentsPermalink





(2) REPORT- Not later than 18 months after the date of enactment of this Act, the Comptroller General shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.CommentsClose CommentsPermalink