Overview
Title
To amend title XX of the Social Security Act to provide for nursing home worker training grants.
ELI5 AI
The Nursing Home Workforce Support and Expansion Act of 2024 is like giving money to help train and support people who work in nursing homes to make sure they have the skills and tools they need for taking care of older and disabled people better. This bill sets aside a special amount of money every year to help pay for things like student loans and other supports workers need to stay in their jobs and do them well.
Summary AI
The Nursing Home Workforce Support and Expansion Act of 2024, known as H. R. 7929, aims to amend title XX of the Social Security Act to fund training grants for nursing home workers. It allows each State, as well as Indian tribes and tribal organizations, to receive grants for wage subsidies, student loan repayment, and other support services for nursing home staff. The bill intends to improve recruitment and retention of qualified workers in nursing homes by providing financial support and resources. The legislation appropriates $400 million annually for fiscal years 2025 through 2028 for this purpose.
Published
Keywords AI
Sources
Bill Statistics
Size
Language
Complexity
AnalysisAI
General Summary of the Bill
The bill titled the "Nursing Home Workforce Support and Expansion Act of 2024" seeks to amend title XX of the Social Security Act by establishing a grant program to support the training of nursing home workers. The bill proposes a fixed appropriation of $400 million annually from fiscal years 2025 through 2028. These funds will be distributed to states, Indian tribes, and tribal organizations to train healthcare workers in nursing homes and similar settings. The grants are intended to cover various supports, including wage subsidies and student loan repayment, with a mandate for regular reporting to Congress on the program's outcomes.
Summary of Significant Issues
One of the main issues with the bill is the fixed allocation of $400 million per year. This amount lacks flexibility and fails to account for potential changes in needs or inflation over the specified period. Additionally, the formula for the allocation of funds to Indian tribes and tribal organizations remains undefined, which could lead to inconsistent or biased distributions. The reliance on demographic criteria for state allotments may also not accurately reflect the actual need for training resources across different regions.
The bill imposes a two-year obligation deadline for the use of funds, potentially limiting the program's effectiveness due to time constraints. Furthermore, the provision allowing the Secretary to determine "other support services" introduces ambiguity, which could lead to inconsistency in how funds are utilized across states. Finally, the reporting requirement to Congress every four years may delay the identification of issues, slowing potential improvements to the program.
Potential Impacts on the Public
Broadly, the bill aims to address the growing need for qualified workers in nursing home settings. The training grants could lead to better-prepared and more numerous nursing home staff, thereby improving care quality for the elderly and individuals with disabilities.
However, due to potential shortcomings in the allocation formula and lack of flexibility in funding, some areas may not receive the support proportional to their needs. This could result in ongoing disparities in care quality and access across different states and regions.
Potential Impacts on Specific Stakeholders
Positive Impacts
- Nursing Home Workers: They will benefit directly from increased training opportunities, wage subsidies, and student loan repayment schemes, potentially leading to better job satisfaction and retention.
- Elderly and Disabled Individuals: This population stands to gain from improved care quality through the presence of better-trained and supported staff.
- Nursing Homes and Healthcare Facilities: These organizations could find it easier to recruit and retain staff, strengthening their operational capacity and service quality.
Negative Impacts
- States with Smaller Populations: The minimum allotment rule may result in disproportionate funding relative to actual need, potentially leading to inefficiencies or misallocation of resources in some states.
- Indian Tribes and Tribal Organizations: The undefined grant formula presents a risk of unfair allocation, where some tribes might receive insufficient support compared to their actual requirements.
- State Administrators: The administrative burden imposed by the extensive reporting requirements might strain resources, particularly for smaller states or tribal organizations, complicating their participation in the program.
In conclusion, while the bill introduces potentially beneficial provisions to boost the nursing home workforce, several challenges related to funding distribution, flexibility, and administrative complexity could impact its effectiveness. Addressing these concerns could enhance the bill’s ability to meet its intended goals of improving healthcare support for vulnerable populations.
Financial Assessment
The Nursing Home Workforce Support and Expansion Act of 2024 seeks to allocate funds specifically for training grants for nursing home workers. This initiative aims to improve the recruitment and retention of nursing home staff through various financial support mechanisms.
Financial Summary
The bill proposes an appropriation of $400 million annually for fiscal years 2025 through 2028. These funds are intended to support a range of financial aids for states, Indian tribes, and tribal organizations. The main uses of the funds include:
- Wage subsidies for eligible individuals working in nursing homes.
- Student loan repayment or tuition assistance for training and certification in relevant fields.
- Support services such as affordable child care, transportation, and paid leave for workers.
Additionally, 2 percent of the appropriation is earmarked specifically for grants to Indian tribes and tribal organizations.
Relation to Identified Issues
Several issues have been identified concerning the financial aspects of this bill:
Fixed Appropriation Concerns: The fixed amount of $400 million each year may not accommodate fluctuating needs or inflation, potentially resulting in either insufficient support for some areas or inefficient resource use if the funds exceed those needs.
Allotment Formula Limitations: The method used to determine how much each state receives is based on the population of residents aged 65 or older and those with disabilities. This could lead to an imbalance, inaccurately reflecting states' specific needs for nursing home training resources.
Undefined Grant Formula for Tribes: The allocation of funds to Indian tribes and tribal organizations relies on a formula made by the Secretary of the Interior. Without clearly defined criteria, this could lead to unequal or arbitrary fund distribution.
Obligation Deadline Issues: With a deadline of two years for states and tribes to obligate the received funds, there is a risk that some funds may be returned unspent if not used efficiently, diminishing the program’s potential impact.
Ambiguities in Support Services: The broad authority given to the Secretary to decide on necessary "other support services" introduces potential inconsistencies in how states apply these funds, leading to differences in effectiveness across the country.
Reporting Frequency: The requirement for the Secretary to report to Congress every four years could delay identifying problems or inefficiencies in fund allocation and usage, potentially hindering timely improvements.
Nonsupplantation Enforcement: The bill stipulates that block grants should not replace existing state expenditures for recruiting or retaining nursing home workers. This could be challenging to monitor and enforce, risking overlap or misallocation of resources if states are not compliant.
In conclusion, while the bill sets aside substantial funds aimed at enhancing the nursing home workforce, the formulation and management of these appropriations include several potential pitfalls that could affect their efficacy and equitable distribution. Addressing these issues would enhance the program's potential to meet its objectives successfully.
Issues
The fixed appropriation of $400,000,000 for each fiscal year from 2025 through 2028 lacks flexibility to adjust for actual needs or inflation, potentially leading to inadequate funding or inefficient use of resources. (Section 2)
The allotment formula for states, which is heavily based on population demographics of those aged 65 or older and those with disabilities, may not accurately reflect the actual training needs for nursing home workers across different states, potentially leading to inefficient resource distribution. (Section 2041)
The formula for grant allocation to Indian tribes and tribal organizations is not specifically defined, relying on determination by the Secretary of the Interior without clear criteria, increasing the risk of inconsistent or biased allocations. (Section 2 & 2041)
The obligation deadline allows only two years for funds allocation, which may be insufficient for effective use and could result in returned funds, limiting the program's impact. (Section 2)
The provision permitting the Secretary to decide on 'other support services' necessary for successful recruitment and retention introduces ambiguity, allowing for broad interpretation and potential inconsistencies across states in the use of funds. (Sections 2 & 2041)
The requirement for reporting to Congress every 4 years may delay the identification and resolution of issues or inefficiencies in the program, impacting timely improvements. (Section 2, Administration, and Reports)
The requirement that grants should not supplant existing state expenditure could be difficult to enforce or monitor, possibly leading to overlap or misallocation of funds if not strictly adhered to. (Section 2 & 2041)
Sections
Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.
1. Short title Read Opens in new tab
Summary AI
The first section of the bill introduces the name of the act, which is called the "Nursing Home Workforce Support and Expansion Act of 2024."
2. Nursing home worker training grants Read Opens in new tab
Summary AI
This section of the Social Security Act details a program for providing grants to states, Indian tribes, and tribal organizations to train and support workers in nursing home and similar healthcare settings. The funds must be used for specific purposes such as wage subsidies and student loan repayment, with strict reporting requirements, and the Secretary has to report to Congress every four years on the program's progress.
Money References
- “(2) REPORT TO THE CONGRESS.—Not later than 3 years after the date of the enactment of this section, and every 4 years thereafter, the Secretary shall submit to the Congress a written report outlining how the States have used the grants made under this section during the period covered by the report, which shall include— “(A) the total amount expended in each State for each type of use described in paragraph (1) or (2) of subsection (b); “(B) the total number of non-State organizations in each State to which grant funds were provided, and the amount so provided to each such organization; “(C) the change in the number of individuals working in each job category described in subsection (f)(2) in an eligible setting; “(D) the average duration of employment for each such job category, by State; “(E) the average annual wage of workers in each job category described in subsection (f)(2) in an eligible setting; “(F) the average amount of paid time off to which a worker in each job category described in subsection (f)(2) in an eligible setting is entitled by their contract; and “(G) such other data elements as the Secretary deems relevant. “(e) Appropriation.—Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary $400,000,000 for each of fiscal years 2025 through 2028 to carry out this section, of which 2 percent shall be reserved for grants to Indian tribes and tribal organizations. “
2041. Nursing home worker training grants Read Opens in new tab
Summary AI
The section establishes a grant program for states, Indian tribes, and tribal organizations to train nursing home workers. It describes the allocation of funds, permissible uses for the grants, administrative details, required reports, and definitions of key terms involved, with a specific budget reserved for tribal organizations.
Money References
- (2) REPORT TO THE CONGRESS.—Not later than 3 years after the date of the enactment of this section, and every 4 years thereafter, the Secretary shall submit to the Congress a written report outlining how the States have used the grants made under this section during the period covered by the report, which shall include— (A) the total amount expended in each State for each type of use described in paragraph (1) or (2) of subsection (b); (B) the total number of non-State organizations in each State to which grant funds were provided, and the amount so provided to each such organization; (C) the change in the number of individuals working in each job category described in subsection (f)(2) in an eligible setting; (D) the average duration of employment for each such job category, by State; (E) the average annual wage of workers in each job category described in subsection (f)(2) in an eligible setting; (F) the average amount of paid time off to which a worker in each job category described in subsection (f)(2) in an eligible setting is entitled by their contract; and (G) such other data elements as the Secretary deems relevant. (e) Appropriation.—Out of any funds in the Treasury not otherwise appropriated, there is appropriated to the Secretary $400,000,000 for each of fiscal years 2025 through 2028 to carry out this section, of which 2 percent shall be reserved for grants to Indian tribes and tribal organizations. (f) Definitions.—In this section: (1) AVAILABLE AMOUNT.—The term “available amount” means, with respect to a fiscal year, the amount specified in subsection (e) that remains after the reservation required by such subsection for the fiscal year, plus all amounts remitted to the Secretary under subsection (b)(5) that have not been reallotted under subsection (a)(1)(B)(iii).