The Long-Term Care Workforce Support Act provides guidelines for improving the support, training, recruitment, and labor protections for professionals in the long-term care industry. It includes sections focusing on enhancing Medicaid services, advancing workforce training and recruitment initiatives, protecting workers' rights, preventing workplace violence, ensuring job benefits, and establishing a strategy for fair compensation.

Congress recognizes the critical role of direct care professionals and aims to address the workforce crisis by improving wages, working conditions, and professional respect to ensure that older adults and individuals with disabilities receive quality care. The Act also focuses on eliminating disparities in the workforce and strengthening support for unpaid family caregivers.

This section provides definitions for various terms used in the Act, including types of services, care facilities, and professionals involved in long-term care and related sectors. It clarifies terms such as "activities of daily living," "apprenticeship program," and "direct care professional," and references other laws for comprehensive meanings of terms like "disability" and "Medicaid program."

The section amends the Social Security Act to provide additional federal support for Medicaid long-term care services through a 10% increase in federal funding for states from 2025 to 2034, as long as they meet certain conditions. These conditions include using most of the funds to improve jobs for direct care professionals, ensuring funds do not replace state spending, and providing regular reports on how the funds are used.

The bill requires the Secretary of Health and Human Services to award grants to states to improve and support long-term care services and direct care professionals. These grants aim to enhance recruitment, compensation, and retention of direct care workers while maximizing independence for people with disabilities and older adults, and they must include specific activities like updating pay rates and training programs.

The section amends the Social Security Act to make permanent the state's option to protect Medicaid recipients of home-based services from spousal impoverishment. It also updates another law to account for this change by tying its effective date to the enactment of a new workforce support act.

This section outlines changes to the funding for the Money Follows the Person program. It extends funding through 2025 and sets aside $500 million for each following year. Additionally, any grant money a state hasn't used after four years will be withdrawn and reallocated to future grants.

In this chapter, "eligible entity" refers to various organizations like states, labor groups, nonprofits experienced in related fields, educational institutions, or a combination of these, which must involve certain groups as advisors and consult with State Medicaid agencies. "Project participant" describes individuals involved in grant-supported projects, including direct care professionals. The "Secretary" is the head of Health and Human Services, and "supportive services" include necessary aids like transportation and childcare to help individuals join grant-related activities.

The section authorizes the Secretary, in collaboration with various other secretaries, to award grants to eligible entities under four specific categories: direct care professionals, direct care professional managers, self-directed care professionals, and home and community-based services. At least 30% of these grants are intended for projects that provide career advancement opportunities for direct care professionals, and entities can also use grants to continue existing similar activities.

Eligible entities seeking grants must submit detailed project plans to the Secretary, containing specific demographic, workforce, and advisory committee information, strategies for recruitment and retention of direct care professionals, and plans for education or training programs. These plans should also include methods for collecting workforce data, ensuring diverse consultation with stakeholders, and targeted outreach, particularly in areas where direct care professions are in high demand.

The section outlines how grant funds should be used by eligible entities, stating they must be used for specific projects and cannot exceed 5% on administrative costs, while at least 5% must support direct care professionals. Additionally, grants should add to, not replace, other funding for improving direct care services, cannot be used for activities requiring certain federal disclosures, and there is a $500 million annual budget for these grants from 2025 to 2029.

The text outlines a grant program led by the Secretary of Labor to support domestic workers through workforce training and related assistance. Eligible organizations, which must have experience working with older individuals or people with disabilities, can apply for these grants to provide services aimed at improving domestic workers' skills, wages, and working conditions, with $10 million authorized annually from 2025 to 2029 for these purposes.

The text outlines a plan where the U.S. Secretary of Health and Human Services, collaborating with the Secretary of Labor, will give grants to groups that help low-income people become direct care professionals, like home health aides. These projects must focus on supporting rural and underserved communities, women, people of color, and individuals with disabilities, with extra payments given to those who finish the training.

The proposed amendment to the Social Security Act introduces a new program named "Career Pathways through Health Profession Opportunity Grants." This program is designed to provide grants to eligible entities to train low-income individuals for health professions, offering support services like education, childcare, and transportation to ensure participants can successfully enter and progress in health-related careers.

The section outlines the requirements and procedures for health profession opportunity grants, aimed at providing education and training to low-income individuals for health-related careers. It details eligibility criteria, application components, grant usage, technical and post-employment support, and designated funding for various entities, including those serving rural and underserved communities.

The bill aims to increase workforce diversity in allied health and direct care professions by allowing the Secretary to award grants for student scholarships, program retention activities, and career pipeline development, with a focus on underrepresented groups. It requires award recipients to report on admissions and retention rates, and provides for program evaluations, and a budget of $10 million annually from 2025 to 2029.

The Secretary is authorized to give grants to educational programs to offer scholarships and support for students pursuing careers in therapies and direct care professions, focusing on underrepresented individuals. The program will evaluate outcomes, with funding up to $10 million annually from 2025 to 2029, and monitor educational program success to ensure continued eligibility for funding.

The section outlines a grant program authorized by the Secretary of Health and Human Services to create a national technical assistance center aimed at supporting the direct care professional workforce. This includes tasks like training, recruitment, retention, and career advancement through various activities and partnerships with educational institutions, disability organizations, and other relevant entities, as well as the formation of an advisory council to guide the center's efforts.

The Secretary of Health and Human Services is required to provide a report to Congress within 180 days, detailing efforts to improve the workforce of direct care professionals. This includes evaluating existing programs for training geriatric nursing faculty, increasing professionals in geriatric nursing and long-term care, improving coordination with other federal departments, and suggesting best practices.

The amendments to Section 865 of the Public Health Service Act update the language by replacing references to "the elderly" with "older individuals" and define "older individual" according to the Older Americans Act of 1965. Additionally, it changes the subsection title to "Definitions" and extends certain provisions through the years 2025 to 2029.

The section requires the Secretary of Labor, in collaboration with the Secretary of Health and Human Services, to submit a report to Congress within 180 days that evaluates apprenticeship programs for direct care professionals. The report should address workforce vacancies, review existing programs, propose recommendations for program design, and explore ways to partner with educational and governmental entities to enhance apprenticeship opportunities.

The section establishes a Rural Health Workforce Grant Program, where the U.S. Health Resources and Services Administration can provide grants up to $250,000 per year to eligible groups for five years. These grants aim to create programs that introduce students in underserved rural areas to health care careers and cover costs like student transportation and mentoring. The program requires matching funds and technical assistance, prioritizes high-need educational agencies, and includes annual reporting and evaluation processes.

The section establishes a rural health workforce grant program aimed at funding projects that introduce and engage elementary and secondary school students in underserved rural areas to health care career opportunities. The program provides up to $250,000 per year for up to 5 years to eligible consortia, which include education agencies and health care providers, to carry out these initiatives.

The section mandates the creation of a tool by the Secretary of Health and Human Services, along with relevant health agencies, to evaluate the well-being of direct care professionals. The collected data, while keeping individual identities confidential, will help improve working conditions, with findings reported to Congress, and the project funded up to $6 million annually from 2025 to 2030.

The National Direct Care Professional Training Standards Commission will be created to help develop and support national training standards for direct care professionals that are recognized and portable across states. The Commission will consist of representatives from various organizations, will study training standards, and provide recommendations, and is authorized a $500,000 budget for fiscal year 2025 to carry out its duties before it disbands after completing a final report.

The section establishes programs to improve mental health support for direct care professionals by awarding grants to eligible entities for the development or enhancement of programs focused on mental health and resiliency. It outlines eligibility criteria, requirements for program implementation, reporting obligations, and prioritization for areas with high vacancies, with authorized funding of $20 million annually from 2025 to 2029.

The section requires the Secretary of Health and Human Services to identify and share strategies that help prevent suicide and enhance mental health among direct care professionals. Within two years, the Secretary must find the best methods to improve mental wellness and offer appropriate training for these workers, and then share these methods with specific congressional committees.

The bill mandates that the Secretary of Health and Human Services create a national program to educate and raise awareness among direct care professionals about mental health and substance use disorders. This initiative aims to prevent these issues and reduce the stigma of seeking help. It also requires the Secretary to report to Congress on the program's activities and results within two years.

The section describes amendments to the Social Security Act to provide training grants for direct care professionals. It outlines how states, Indian tribes, and tribal organizations can use these grants for purposes like supporting wages, education, childcare, transportation, and other resources to recruit and retain workers in healthcare settings.

The section outlines a program that provides federal grants to states, Indian tribes, and tribal organizations to support training and resources for direct care professionals who work with elderly or disabled individuals. The funds can be used for wage subsidies, education assistance, childcare, transportation, and other supports, with specific guidelines on how the money should be allocated and reported.

Certain health care professionals, such as nurses and aides working in long-term care settings, will be eligible for a $5,000 tax credit starting from the tax year beginning after December 31, 2023, as per a new addition to the Internal Revenue Code. This amendment aims to provide financial relief to these essential workers by recognizing their contributions through a tax benefit.

In this section, there is a tax credit of $5,000 for eligible health care professionals like practitioners, nursing assistants, nurses, home health aides, personal or home care aides, and direct care professionals who work in long-term care settings. The terms used for different professionals and settings are defined by another law, the Long-Term Care Workforce Support Act.

The bill section establishes a national center to support fairness and diversity in the workforce that provides direct care, such as for elderly or disabled individuals. This center will create resources, conduct studies, and work with experts to address any unfair treatment within this workforce and receive $10 million annually from 2025 to 2029 to fund these activities.

In this section, the bill defines various key terms related to wage and hour enforcement, such as the "Administrator," "community partner," "covered employee," and "eligible entity," which refer to different stakeholders involved in the Department of Labor's efforts to ensure fair pay and working conditions. It also explains "strategic enforcement," which is a way for the Secretary of Labor to target industries that often violate wage laws to make systemic improvements.

The section establishes a grant program managed by the Secretary of Labor to help prevent and address wage theft, particularly focusing on workers in industries like long-term care. The program offers funding to eligible entities for activities such as employee education, employer training, and community partnerships, with priority given to those with a history of addressing wage violations; each grant can last up to three years and is subject to performance evaluations and compliance checks.

The section defines key terms used in the subtitle related to labor standards and care services. These terms include definitions for "child," "covered entity," "Medicaid HCBS-eligible older individual," "on-call shift," "parent," "Secretary," "shared living arrangement," and "spouse," with each term outlining specific conditions and examples to provide clear understanding in the context of care and labor services.

The section outlines requirements for written agreements between employers (referred to as "covered entities") and their direct care professionals. These agreements must detail job responsibilities, pay rates, work schedules, and various policies without including mandatory arbitration, non-disclosure, or non-compete clauses. The agreements need to be accessible, updated as needed, and stored for at least three years, with model templates to be provided by the Secretary.

The section outlines fair scheduling practices for direct care professionals, requiring covered entities to provide written notice of work schedules, including any changes at least 72 hours in advance, and to compensate professionals if schedules are altered on short notice. It also details the rights of workers to refuse schedule changes and exceptions applicable during emergencies or natural disasters, with the rules taking effect two years after the Act's enactment.

The section allows direct care professionals to request temporary changes to their work schedules due to personal events, such as caring for a family member or attending a legal proceeding. It permits up to two single-day changes or one two-day change each year, requires notifying the employer about the reason, and mandates a written record be submitted afterward.

The section outlines privacy protections for direct care professionals, stating that entities cannot monitor these professionals in private spaces or interfere with their personal communications unless it's proven to affect their work. It also clarifies what "private communications" include and emphasizes that this section does not override other laws.

A U.S. congressional bill section mandates that direct care professionals receive meal breaks after 5 hours of work and rest breaks after every 4 hours, both paid, unless an individual's safety is at risk. If duties prevent a full break, an on-duty break is allowed by agreement, with payment, and there's an exception for shared living arrangements.

The text outlines unlawful actions, such as firing or discriminating against direct care professionals who exercise their rights under this subtitle, engage in collective bargaining, or are involved in legal proceedings related to these rights. It also specifies that discrimination can include actions targeting immigration status and notes there is a presumption of retaliation if adverse actions occur within 90 days of a worker asserting their rights, which can be countered with clear evidence.

The section outlines the enforcement authority related to the protection of direct care professionals. It specifies the processes for investigating violations, penalties for covered entities, rights for direct care professionals to seek legal action, and the roles of different government agencies in enforcement.

The section clarifies that nothing in this part of the law should override or reduce existing employment agreements, collective bargaining agreements, or laws that offer better rights or benefits to direct care professionals. It also ensures that the section does not interfere with other laws or agreements that require reasonable accommodations or provide superior benefits, and it confirms that direct care professionals cannot waive their rights and remedies under this subtitle.

The section mandates that within one year, the Secretary of Labor must issue a temporary rule to help protect workers from violence in fields like healthcare and social services and that it should follow previous safety guidelines. It also specifies a schedule for developing a permanent rule within 42 months and details the processes of public notice, comments, and enforcement, including conditions if the temporary rule isn’t timely issued.

The section defines “covered facility” as various healthcare and treatment centers and certain services, excluding private medical offices. It also explains "covered services" to include healthcare and emergency services provided outside traditional settings but not child day care services, and describes “covered employer” as businesses employing individuals in these facilities, excluding private home-based employment.

The section describes the requirements for a Workplace Violence Prevention Plan that employers must develop and implement. This plan should include specific procedures for risk assessments, hazard prevention, incident reporting, training, recordkeeping, and anti-retaliation policies to protect employees from workplace violence.

The section explains that the new rules do not reduce the Secretary's existing powers, nor do they replace any rights of employees under other laws or agreements. It also clarifies that health and social service workers can still report violence to law enforcement and that protections against domestic violence, stalking, dating violence, and sexual assault remain unchanged.

The section provides definitions of terms related to workplace violence prevention, including various types of workplace violence (such as those by strangers or former employees), safety devices like alarms, and risk factors specific to the work environment or individuals. It also clarifies what constitutes workplace violence and outlines measures like engineering and work practice controls to help reduce these risks.

The section modifies the Social Security Act to require hospitals and nursing facilities that are not already governed by the Occupational Safety and Health Act to follow the new Workplace Violence Prevention Standard if they receive Medicare funds. These changes take effect one year after the interim final standard on workplace violence prevention is issued.

The section outlines definitions for terms related to labor and employment, such as child, employer, and employee, in addition to terms like public health emergency and victim services organization. These definitions are used to provide clarity for legal responsibilities and rights under the law, covering aspects like medical leave, public health situations, and support for victims of domestic violence and related issues.

Under this section, employers must provide direct care professionals with paid sick leave—earning at least 1 hour for every 30 hours worked—capped at 56 hours per year unless the employer allows more. Sick leave can be used for personal illness, medical needs, public health emergencies, and caring for family members under specific conditions, including situations involving domestic violence or public health emergencies, where additional leave is granted.

Employers must notify direct care professionals about their paid sick time, how to file complaints, and their rights, including protections and contact information for the Secretary. Employers are also required to post a notice with this information in visible places or in employee handbooks, and may face fines if they intentionally fail to do so.

The section makes it illegal for employers to interfere with employees' rights to take actions like using paid sick time or opposing unlawful practices related to this law. It also prohibits discrimination against anyone involved in legal proceedings or providing information about violations of this law.

The section grants the Secretary investigative powers to ensure compliance with labor regulations, enabling civil actions by affected workers for damages and equitable relief, and authorizing the Secretary to bring suits against employers who violate provisions. It also sets time limits for filing actions and empowers the Solicitor of Labor to represent the Secretary in related legal proceedings.

The section allows the Secretary to run a public awareness campaign about the paid sick time requirements, and it authorizes $20 million in funding for this campaign.

The section explains that employers must continue to honor any existing agreements or plans that offer more generous sick leave or benefits than those provided by the new law, and that these new rights for direct care professionals cannot be reduced by any agreements or programs.

Employers are encouraged to offer leave policies and benefits that are more generous than the minimum requirements, and they are also free to create agreements or programs that provide better rights to direct care professionals than those established by the law mentioned in this section.

The Secretary must create regulations to implement this subtitle within 180 days after the law is enacted. However, the rights and responsibilities outlined in the law must be followed immediately by employers and others, even if the regulations are not yet established.

If a public health emergency was already in effect when this law was passed, it is treated as if the emergency was declared on the day this law was enacted.

The section requires the Bureau of Labor Statistics to gather data on how much sick time direct care professionals have and use. It also mandates the Government Accountability Office to conduct a study on the effectiveness of these provisions and report the findings to specific Senate and House committees within five years.

The section provides definitions for terms used in the title: "Advisory Council" refers to the National Direct Care Professional Compensation Advisory Council, "Secretary" refers to the Secretary of Health and Human Services, and "Strategy" refers to the National Direct Care Professional Compensation Strategy.

The Secretary, with input from various agencies and the public, will create and regularly update a National Direct Care Professional Compensation Strategy to recommend ways to ensure fair wages for direct care workers, considering their unique job challenges and potential loss of benefits with wage increases. This strategy will be developed without dictating state or local resources allocation or best practice mandates, and $100,000 annually is authorized for an advisory committee from 2025 to 2029.

The section establishes a National Direct Care Professional Compensation Advisory Council, tasked with advising on how to compensate care professionals. The council, consisting of both appointed and non-voting federal members, meets regularly, and its members receive compensation for their service and related expenses. It must submit annual reports with recommendations for improving federal and state programs that support direct care workers, addressing challenges they face, and evaluating effects on federal programs like Medicare and Medicaid.

The section establishes that all the powers and responsibilities outlined in this title will come to an end 10 years after the law is enacted.

The section outlines a plan for the Secretary of Health and Human Services and the Secretary of Labor to hire an external evaluator to assess the results of this Act, focusing on impacts related to workforce, economy, and healthcare services. It also requires regular reports on State spending and efforts to improve the working conditions and benefits of direct care professionals, ensuring the findings are shared with government agencies and made publicly accessible.