119-hr5370

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5370 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 5370

 To provide low-income individuals with opportunities to enter and 
 follow a career pathway in the health professions, and for other 
 purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 September 16, 2025

Mr. Davis of Illinois (for himself, Mr. Neal, Mr. Doggett, Mr. Thompson 
 of California, Mr. Larson of Connecticut, Ms. Sewell, Ms. Chu, Ms. 
 Moore of Wisconsin, Mr. Boyle of Pennsylvania, Mr. Evans of 
Pennsylvania, Mr. Schneider, Mr. Panetta, Mr. Horsford, Mr. Gomez, Ms. 
 Plaskett, and Mr. Suozzi) introduced the following bill; which was 
 referred to the Committee on Ways and Means

_______________________________________________________________________

 A BILL

 To provide low-income individuals with opportunities to enter and 
 follow a career pathway in the health professions, and for other 
 purposes.

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

SECTION 1. SHORT TITLE.

 This section may be cited as the ``Pathways to Health Careers 
Act''.

SEC. 2. CAREER PATHWAYS THROUGH HEALTH PROFESSION OPPORTUNITY GRANTS.

 Effective October 1, 2025, 

section 2008 of the Social Security Act 
(42 U.S.C. 1397g) is amended to read as follows:

``

SEC. 2008. CAREER PATHWAYS THROUGH HEALTH PROFESSION OPPORTUNITY 
 GRANTS.

 ``

    (a) Application Requirements.--An eligible entity desiring a 
grant under this section for a project shall submit to the Secretary an 
application for the grant, that includes the following:
 ``

    (1) A description of how the applicant will use a career 
 pathways approach to train eligible individuals for health 
 professions that pay well or will put eligible individuals on a 
 career path to an occupation that pays well, under the project.
 ``

    (2) A description of the adult basic education and 
 literacy activities, work readiness activities, training 
 activities, and case management and career coaching services 
 that the applicant will use to assist eligible individuals to 
 gain work experience, connection to employers, and job 
 placement, and a description of the plan for recruiting, 
 hiring, and training staff to provide the case management, 
 mentoring, and career coaching services, under the project 
 directly or through local governmental, apprenticeship, 
 educational, or charitable institutions.
 ``

    (3) In the case of an application for a grant under this 
 section for a demonstration project described in subsection
            (c) (2)
        (B)
            (i) 
            (I) --
 ``
        (A) a demonstration that the State in which the 
 demonstration project is to be conducted has in effect 
 policies or laws that permit certain allied health and 
 behavioral health care credentials to be awarded to 
 people with certain arrest or conviction records (which 
 policies or laws shall include appeals processes, 
 waivers, certificates, and other opportunities to 
 demonstrate rehabilitation to obtain credentials, 
 licensure, and approval to work in the proposed health 
 careers), and a plan described in the application that 
 will use a career pathway to assist participants with 
 such a record in acquiring credentials, licensing, and 
 employment in the specified careers;
 ``
        (B) a discussion of how the project or future 
 strategic hiring decisions will demonstrate the 
 experience and expertise of the project in working with 
 job seekers who have arrest or conviction records or 
 employers with experience working with people with 
 arrest or conviction records;
 ``
            (C) an identification of promising innovations or 
 best practices that can be used to provide the 
 training;
 ``
            (D) a proof of concept or demonstration that the 
 applicant has done sufficient research on workforce 
 shortage or in-demand jobs for which people with 
 certain types of arrest or conviction records can be 
 hired;
 ``
        (E) a plan for recruiting students who are 
 eligible individuals into the project; and
 ``
        (F) a plan for providing post-employment support 
 and ongoing training as part of a career pathway under 
 the project.
 ``

    (4) In the case of an application for a grant under this 
 section for a demonstration project described in subsection
            (c) (2)
        (B)
            (i) 
            (II) --
 ``
        (A) a description of the partnerships, strategic 
 staff hiring decisions, tailored program activities, or 
 other programmatic elements of the project, such as 
 training plans for doulas and other community health 
 workers and training plans for midwives and other 
 allied health professions, that are designed to support 
 a career pathway in pregnancy, birth, or postpartum 
 services; and
 ``
        (B) a demonstration that the State in which the 
 demonstration project is to be conducted recognizes 
 doulas or midwives, as the case may be.
 ``

    (5) A demonstration that the applicant has experience 
 working with low-income populations, or a description of the 
 plan of the applicant to work with a partner organization that 
 has the experience.
 ``

    (6) A plan for providing post-employment support and 
 ongoing training as part of a career pathway under the project.
 ``

    (7) A description of the support services that the 
 applicant will provide under the project, including a plan for 
 how child care and transportation support services will be 
 guaranteed and, if the applicant will provide a cash stipend or 
 wage supplement, how the stipend or supplement would be 
 calculated and distributed.
 ``

    (8) A certification by the applicant that the project 
 development included--
 ``
        (A) consultation with a local workforce 
 development board established under 

section 107 of the 
 Workforce Innovation and Opportunity Act;
 ``
        (B) consideration of apprenticeship and pre-
 apprenticeship models registered under the Act of 
 August 16, 1937 (also known as the `National 
 Apprenticeship Act');
 ``
            (C) consideration of career pathway programs in 
 the State in which the project is to be conducted; and
 ``
            (D) a review of the State plan under 

section 102 
 or 103 of the Workforce Innovation and Opportunity Act.
 ``

    (9) A description of the availability and relevance of 
 recent labor market information and other pertinent evidence of 
 in-demand jobs or worker shortages.
 ``

    (10) A certification that the applicant will directly 
 provide or contract for the training services described in the 
 application.
 ``

    (11) A commitment by the applicant that, if the grant is 
 made to the applicant, the applicant will--
 ``
        (A) during the planning period for the project, 
 provide the Secretary with any information needed by 
 the Secretary to establish adequate data reporting and 
 administrative structure for the project;
 ``
        (B) hire staff to direct the project not later 
 than the end of the planning period applicable to the 
 project;
 ``
            (C) accept all technical assistance offered by 
 the Secretary with respect to the grant;
 ``
            (D) participate in peer technical assistance 
 conferences as are regularly scheduled by the 
 Secretary; and
 ``
        (E) provide all data required by the Secretary 
 under subsection

    (g) .
 ``

    (b) Preferences in Considering Applications.--In considering 
applications for a grant under this section, the Secretary shall give 
preference to--
 ``

    (1) applications submitted by applicants to whom a grant 
 was made under this section or any predecessor to this section;
 ``

    (2) applications submitted by applicants who have 
 business and community partners in each of the following 
 categories:
 ``
        (A) State and local government agencies and 
 social service providers, including a State or local 
 entity that administers a State program funded under 
 part A of this title;
 ``
        (B) institutions of higher education, 
 apprenticeship programs, and local workforce 
 development boards established under 

section 107 of the 
 Workforce Innovation and Opportunity Act; and
 ``
            (C) health care employers, health care industry 
 or sector partnerships, labor unions, and labor-
 management partnerships;
 ``

    (3) applications that include opportunities for mentoring 
 or peer support, and make career coaching available, as part of 
 the case management plan;
 ``

    (4) applications which describe a project that will serve 
 a rural area in which--
 ``
        (A) the community in which the individuals to be 
 enrolled in the project reside is located;
 ``
        (B) the project will be conducted; or
 ``
            (C) an employer partnership that has committed to 
 hiring individuals who successfully complete all 
 activities under the project is located;
 ``

    (5) applications that include a commitment to providing 
 project participants with a cash stipend or wage supplement; 
 and
 ``

    (6) applications which have an emergency cash fund to 
 assist project participants financially in emergency 
 situations.
 ``
            (c) Grants.--
 ``

    (1) Competitive grants.--
 ``
        (A) Grant authority.--
 ``
            (i) In general.--The Secretary, in 
 consultation with the Secretary of Labor and 
 the Secretary of Education, shall make a grant 
 in accordance with this paragraph to an 
 eligible entity whose application for the grant 
 meets the applicable requirements of subsection

    (a) and is approved by the Secretary, to 
 conduct a project designed to train low-income 
 individuals for allied health professions, 
 health information technology, physicians 
 assistants, nursing assistants, registered 
 nurse, advanced practice nurse, emergency 
 medical technicians, paramedics, and other 
 professions considered part of a health care 
 career pathway model.
 ``
            (ii) Guarantee of grantees in each state 
 and the district of columbia.--For each grant 
 cycle, the Secretary shall award a grant under 
 this paragraph to at least 2 eligible entities 
 in each State that is not a territory, to the 
 extent there are a sufficient number of 
 applications submitted by the entities that 
 meet the requirements applicable with respect 
 to such a grant. If, for a grant cycle, there 
 are fewer than 2 such eligible entities in a 
 State, the Secretary shall include that 
 information in the report required by 
 subsection

    (g)

    (2) that covers the fiscal year.
 ``
        (B) Guarantee of grants for indian populations.--
 From the amount reserved under subsection
            (i) (2)
        (B) for 
 each fiscal year, the Secretary shall award a grant 
 under this paragraph to at least 10 eligible entities 
 that are an Indian tribe, a tribal organization, or a 
 tribal college or university, to the extent there are a 
 sufficient number of applications submitted by the 
 entities that meet the requirements applicable with 
 respect to such a grant.
 ``
            (C) Guarantee of grantees in the territories.--
 From the amount reserved under subsection
            (i) (2)
            (C) for 
 each fiscal year, the Secretary shall award a grant 
 under this paragraph to at least 2 eligible entities 
 that are located in a territory, to the extent there 
 are a sufficient number of applications submitted by 
 the entities that meet the requirements applicable with 
 respect to such a grant.
 ``

    (2) Grants for demonstration projects.--
 ``
        (A) Grant authority.--The Secretary, in 
 consultation with the Secretary of Labor and the 
 Secretary of Education (and, with respect to 
 demonstration projects of the type described in 
 subparagraph
        (B)
            (i) 
            (I) , the Attorney General) shall 
 make a grant in accordance with this subsection to an 
 eligible entity whose application for the grant is 
 approved by the Secretary, to conduct a demonstration 
 project that meets the requirements of subparagraph
        (B) .
 ``
        (B) Requirements.--The requirements of this 
 subparagraph are the following:
 ``
            (i) Type of project.--The demonstration 
 project shall be of 1 of the following types:
 ``
            (I) Individuals with arrest or 
 conviction records demonstration.--The 
 demonstration project shall be of a 
 type designed to provide education and 
 training for eligible individuals with 
 arrest or conviction records to enter 
 and follow a career pathway in the 
 health professions through occupations 
 that pay well and are expected to 
 experience a labor shortage or be in 
 high demand.
 ``
            (II) Maternal mortality career 
 pathway demonstration.--The 
 demonstration project shall be of a 
 type designed to provide education and 
 training for eligible individuals to 
 enter and follow a career pathway in 
 the field of pregnancy, childbirth, and 
 postpartum, in a State that recognizes 
 doulas or midwives and that provides 
 payment for services provided by doulas 
 or midwives, as the case may be, under 
 private or public health insurance 
 plans.
 ``
            (ii) Duration.--The demonstration project 
 shall be conducted for not less than 5 years.
 ``
            (C) Minimum allocation of funds for each type of 
 demonstration project.--
 ``
            (i) Individuals with arrest or conviction 
 records demonstrations.--Not less than 25 
 percent of the amounts made available for 
 grants under this paragraph shall be used to 
 make grants for demonstration projects of the 
 type described in subparagraph
        (B)
            (i) 
            (I) .
 ``
            (ii) Maternal mortality career pathway 
 demonstrations.--Not less than 25 percent of 
 the amounts made available for grants under 
 this paragraph shall be used to make grants for 
 demonstration projects of the type described in 
 subparagraph
        (B)
            (i) 
            (II) .
 ``

    (3) Grant cycle.--The grant cycle under this section 
 shall be not less than 5 years, with a planning period of not 
 more than the 1st 12 months of the grant cycle. During the 
 planning period, the amount of the grant shall be in such 
 lesser amount as the Secretary determines appropriate.
 ``
            (d) Use of Grant.--
 ``

    (1) In general.--An entity to which a grant is made under 
 this section shall use the grant in accordance with the 
 approved application for the grant.
 ``

    (2) Support to be provided.--
 ``
        (A) Required support.--A project for which a 
 grant is made under this section shall include the 
 following:
 ``
            (i) An assessment for adult basic skill 
 competency, and provision of adult basic skills 
 education if necessary for lower-skilled 
 eligible individuals to enroll in the project 
 and go on to enter and complete post-secondary 
 training, through means including the 
 following:
 ``
            (I) Establishing a network of 
 partners that offer pre-training 
 activities for project participants who 
 need to improve basic academic skills 
 or English language proficiency before 
 entering a health occupational training 
 career pathway program.
 ``
            (II) Offering resources to enable 
 project participants to continue 
 advancing adult basic skill proficiency 
 while enrolled in a career pathway 
 program.
 ``
            (III) Embedding adult basic skill 
 maintenance as part of ongoing post-
 graduation career coaching and 
 mentoring.
 ``
            (ii) A guarantee that child care is an 
 available and affordable support service for 
 project participants through means such as the 
 following:
 ``
            (I) Referral to, and assistance 
 with, enrollment in a subsidized child 
 care program.
 ``
            (II) Direct payment to a child 
 care provider if a slot in a subsidized 
 child care program is not available or 
 reasonably accessible.
 ``
            (III) Payment of co-payments or 
 associated fees for child care.
 ``
            (iii) Case management plans that include 
 career coaching (with the option to offer 
 appropriate peer support and mentoring 
 opportunities to help develop soft skills and 
 social capital), which may be offered on an 
 ongoing basis before, during, and after initial 
 training as part of a career pathway model.
 ``
            (iv) A plan to provide project 
 participants with transportation through means 
 such as the following:
 ``
            (I) Referral to, and assistance 
 with enrollment in, a subsidized 
 transportation program.
 ``
            (II) If a subsidized 
 transportation program is not 
 reasonably available, direct payments 
 to subsidize transportation costs.
 ``
            (v) In the case of a demonstration 
 project of the type described in subsection
            (c) (2)
        (B)
            (i) 
            (I) , access to legal assistance for 
 project participants for the purpose of 
 addressing arrest or conviction records and 
 associated workforce barriers.
 ``
        (B) Allowed support.--The goods and services 
 provided under a project for which a grant is made 
 under this section may include the following:
 ``
            (i) A cash stipend.
 ``
            (ii) A reserve fund for financial 
 assistance to project participants in emergency 
 situations.
 ``
            (iii) Tuition, and training materials 
 such as books, software, uniforms, shoes, and 
 hair nets, and personal protective equipment.
 ``
            (iv) In-kind resource donations such as 
 interview clothing and conference attendance 
 fees.
 ``
            (v) Assistance with accessing and 
 completing high school equivalency or adult 
 basic education courses as necessary to achieve 
 success in the project and make progress toward 
 career goals.
 ``
            (vi) Assistance with programs and 
 activities, including legal assistance, deemed 
 necessary to address arrest or conviction 
 records as an employment barrier.
 ``
            (vii) Other support services as deemed 
 necessary for family well-being, success in the 
 project, and progress toward career goals.
 ``

    (3) Training.--A project for which a grant is made under 
 this section shall train project participants to earn a 
 recognized postsecondary credential (including an industry-
 recognized credential, and a certificate awarded by a local 
 workforce development board established under 

section 107 of 
 the Workforce Innovation and Opportunity Act) that is awarded 
 in recognition of attainment of measurable technical or 
 occupational skills necessary to gain employment or advance 
 within an occupation, and shall provide each project 
 participant with a number of hours of the training equal to--
 ``
        (A) not less than the number of hours of training 
 required for certification in that level of skill by 
 the State in which the project is conducted; or
 ``
        (B) if there is no such requirement, such number 
 of hours of training as the Secretary finds is 
 necessary to achieve that skill level.
 ``

    (4) Inclusion of tanf recipients.--In the case of a 
 project for which a grant is made under this section that is 
 conducted in a State that has a program funded under part A of 
 title IV, at least 10 percent of the eligible individuals to 
 whom support is provided under the project shall meet the 
 income eligibility requirements under that State program, 
 without regard to whether the individuals receive benefits or 
 services directly under that State program.
 ``

    (5) Income limitation.--An entity to which a grant is 
 made under this section shall not use the grant to provide 
 support to a person who is not an eligible individual.
 ``

    (6) Prohibition.--An entity to which a grant is made 
 under this section shall not use the grant for purposes of 
 entertainment, except that case management and career coaching 
 services may include celebrations of specific career-based 
 milestones such as completing a semester, graduation, or job 
 placement.
 ``

    (e) Income Disregard.--Amounts paid to an eligible individual as 
a cash stipend or as emergency assistance under a project for which a 
grant is made under this section shall not be considered income for any 
purpose under the Internal Revenue Code of 1986, and an entity making 
such a payment shall not be required to submit an information return 
under subtitle F of such Code with respect to the payment.
 ``

    (f) Technical Assistance.--
 ``

    (1) In general.--The Secretary shall provide technical 
 assistance--
 ``
        (A) to assist eligible entities in applying for 
 grants under this section;
 ``
        (B) that is tailored to meet the needs of 
 grantees at each stage of the administration of 
 projects for which grants are made under this section;
 ``
            (C) that is tailored to meet the specific needs 
 of Indian tribes, tribal organizations, and tribal 
 colleges and universities;
 ``
            (D) that is tailored to meet the specific needs 
 of the territories;
 ``
        (E) that is tailored to meet the specific needs 
 of eligible entities in carrying out demonstration 
 projects for which a grant is made under this section; 
 and
 ``
        (F) to facilitate the exchange of information 
 among eligible entities regarding best practices and 
 promising practices used in the projects.
 ``

    (2) Peer technical assistance conferences.--The Secretary 
 shall hold peer technical assistance conferences for entities 
 to which a grant is made under this section or was made under 
 the immediate predecessor of this section.
 ``

    (g) Evaluation of Demonstration Projects.--
 ``

    (1) In general.--The Secretary shall, by grant, contract, 
 or interagency agreement, conduct rigorous and well-designed 
 evaluations of the demonstration projects for which a grant is 
 made under this section.
 ``

    (2) Requirement applicable to individuals with arrest or 
 conviction records demonstration.--In the case of a project of 
 the type described in subsection
            (c) (2)
        (B)
            (i) 
            (I) , the 
 evaluation shall include identification of successful 
 activities for creating opportunities for developing and 
 sustaining, particularly with respect to low-income individuals 
 with arrest or conviction records, a health professions 
 workforce that has accessible entry points, that meets high 
 standards for education, training, certification, and 
 professional development, and that provides increased wages and 
 affordable benefits, including health care coverage, that are 
 responsive to the needs of the workforce.
 ``

    (3) Requirement applicable to maternal mortality career 
 pathway demonstration.--In the case of a project of the type 
 described in subsection
            (c) (2)
        (B)
            (i) 
            (II) , the evaluation shall 
 include identification of successful activities for creating 
 opportunities for developing and sustaining, particularly with 
 respect to low-income individuals and other entry-level 
 workers, a career pathway that has accessible entry points, 
 that meets high standards for education, training, 
 certification, and professional development, and that provides 
 increased wages and affordable benefits, including health care 
 coverage, that are responsive to the needs of the birth, 
 pregnancy, and postpartum workforce.
 ``

    (4) Rule of interpretation.--Evaluations conducted 
 pursuant to this subsection may include a randomized controlled 
 trial, but this subsection shall not be interpreted to require 
 an evaluation to include such a trial.
 ``

    (h) Reports to the Secretary.--An eligible entity awarded a grant 
to conduct a project under this section shall submit interim reports to 
the Secretary on the activities carried out under the project, and, on 
the conclusion of the project, a final report on the activities. Each 
such report shall include data on participant outcomes related to 
graduation rate, graduation timeliness, credential attainment, 
employment in health professions, overall employment, earnings, 
participant demographics, and other data specified by the Secretary.
 ``
            (i) Funding.--
 ``

    (1) In general.--Out of any funds in the Treasury of the 
 United States not otherwise appropriated, there are 
 appropriated to the Secretary to carry out this section 
 $435,000,000 for each of fiscal years 2026 through 2030, of 
 which $10,000,000 for each fiscal year shall be reserved to 
 supplement the cost of employing or retaining at least 25 
 career civil servants at the Administration for Children and 
 Families for the purpose of administering and evaluating the 
 activities carried out under this section.
 ``

    (2) Allocation of funds.--Of the amount appropriated for 
 a fiscal year under paragraph

    (1) of this subsection that is 
 not reserved--
 ``
        (A) 75 percent shall be available for grants 
 under subsection
            (c) (1)
        (A) ;
 ``
        (B) 4 percent shall be reserved for grants under 
 subsection
            (c) (1)
        (B) ;
 ``
            (C) 5 percent shall be reserved for grants under 
 subsection
            (c) (1)
            (C) ;
 ``
            (D) 6 percent shall be available for 
 demonstration project grants under subsection
            (c) (2) ;
 ``
        (E) 6 percent, plus all amounts referred to in 
 subparagraphs
        (A) through
            (D) of this paragraph that 
 remain unused after all grant awards are made for the 
 fiscal year, shall be available for the provision of 
 technical assistance and sufficient staffing to ensure 
 that the technical assistance and related support is 
 locally informed and provided to grantees in a timely 
 manner; and
 ``
        (F) 4 percent shall be available for--
 ``
            (i) studying the effects of the 
 demonstration and non-demonstration projects 
 for which a grant is made under this section;
 ``
            (ii) carrying out the `Analysis Plan for 
 HPOG 2.0 National Evaluation Longer-Term Impact 
 Report', published by the Administration for 
 Children and Families, as planned;
 ``
            (iii) submitting to the Congress annual 
 progress reports on carrying out that plan; and
 ``
            (iv) associated staffing for the purpose 
 of supporting--
 ``
            (I) the rigorous evaluation of 
 the demonstration projects; and
 ``
            (II) the continued study of the 
 short-, medium-, and long-term effects 
 of all such projects, including the 
 effectiveness of specific elements of 
 the non-demonstration projects.
 ``

    (3) Administration.--In employing and retaining career 
 civil servants pursuant to paragraph

    (1) , the Secretary shall 
 give priority to persons with prior experience conducting or 
 overseeing relevant research and evaluation, prior experience 
 working for the Department of Health and Human Services, prior 
 experience working on or evaluating discretionary grant 
 programs, or prior experience administering Federal workforce 
 career pathway programs or other means-tested programs.
 ``

    (j) Reports to Congress.--
 ``

    (1) HPOG participant analysis.--During each Congress, the 
 Secretary shall submit to the Committee on Ways and Means of 
 the House of Representatives and the Committee on Finance of 
 the Senate a report--
 ``
        (A) on the demographics of the participants in 
 the projects for which a grant is made under this 
 section;
 ``
        (B) on the rate of which project participants 
 completed all activities under the projects;
 ``
            (C) on the employment credentials acquired by 
 project participants;
 ``
            (D) on the employment of project participants on 
 completion of activities under the projects, and the 
 earnings of project participants at entry into 
 employment;
 ``
        (E) on best practices and promising practices 
 used in the projects;
 ``
        (F) on the nature of any technical assistance 
 provided to grantees under this section;
 ``
        (G) on, with respect to the period since the 
 period covered in the most recent prior report 
 submitted under this paragraph--
 ``
            (i) the number of applications submitted 
 under this section, with a separate statement 
 of the number of applications referred to in 
 subsection

    (b)

    (5) ;
 ``
            (ii) the number of applications that were 
 approved, with a separate statement of the 
 number of such applications referred to in 
 subsection

    (b)

    (5) ;
 ``
            (iii) how grants were made in any case 
 described in the last sentence of subsection
            (c) (1)
        (A)
            (ii) ;
 ``
            (iv) the length of time needed to decide 
 on requests for technical assistance, decide on 
 grant awards and provide notice of grant awards 
 to grantees;
 ``
            (v) the length of time needed to disburse 
 grants to grantees; and
 ``
            (vi) any additional staffing or expertise 
 needed to administer and evaluate the 
 activities conducted under this section, and 
 any associated additional funding or other 
 legislation that may be needed to follow 
 through on the analysis; and
 ``
        (H) that includes an assessment of the 
 effectiveness of the projects with respect to 
 addressing health professions workforce shortages or 
 in-demand jobs.
 ``

    (2) Federal workforce analysis.--Within 6 months after 
 the date of the enactment of this section, the Secretary shall 
 submit to the committees specified in paragraph

    (1) a report 
 that contains an analysis of the personnel employed or retained 
 pursuant to subsection
            (i) (3) , including--
 ``
        (A) a historical or projected time line of hiring 
 and retaining the personnel, including the proportion 
 of employees given priority pursuant to subsection
            (i) (3) who had prior experience working for the 
 Department of Health and Human Services;
 ``
        (B) hiring and retention data on the full-time 
 and part-time personnel required to administer the 
 program under this section and perform related 
 activities, including the percentage of work time the 
 personnel spent on the program as compared to the 
 percentage of work time spent on other programs; and
 ``
            (C) an attestation that the personnel receive 
 benefits, civil service protections, and adequate 
 training and continuing education as needed.
 ``

    (3) Annual reports on federal personnel actions.--The 
 Secretary shall submit annually to the committees specified in 
 paragraph

    (1) a report on any personnel actions taken with 
 respect to the personnel.
 ``

    (4) Annual summary of national evaluations of prior 
 grants.--The Secretary shall submit annually to the committees 
 specified in paragraph

    (1) a summary of evaluations by the 
 Secretary of reports on the long-term and longer-term effects 
 of grants made under 

section 2008 as in effect before the 
 effective date of this section.
 ``

    (k) 

=== Definitions. ===
-In this section:
 ``

    (1) Allied health profession.--The term `allied health 
 profession' has the meaning given in 

section 799B

    (5) of the 
 Public Health Service Act.
 ``

    (2) Career pathway.--The term `career pathway' has the 
 meaning given that term in 

section 3

    (7) of the Workforce 
 Innovation and Opportunity Act.
 ``

    (3) Doula.--The term `doula' means, with respect to an 
 application to conduct a project under this section, an 
 individual who--
 ``
        (A)
            (i) has completed 60 hours of training in 
 providing non-medical information, emotional support, 
 and physical support to clients during pregnancy, 
 childbirth, and the postpartum period;
 ``
            (ii) is certified, by an organization that has 
 been established for not less than 5 years and that 
 requires the completion of continuing education to 
 maintain the certification, to provide the information 
 and support referred to in clause
            (i) ; and
 ``
            (iii) maintains the certification by completing 
 the required continuing education; or
 ``
        (B) has the permission of the local government in 
 the State in which the applicant intends to conduct the 
 project, to provide the information and support 
 referred to in subparagraph
        (A)
            (i) .
 ``

    (4) Eligible entity.--The term `eligible entity' means 
 any of the following entities that demonstrates in an 
 application submitted under this section that the entity has 
 the capacity to fully develop and administer the project 
 described in the application:
 ``
        (A) A local workforce development board 
 established under 

section 107 of the Workforce 
 Innovation and Opportunity Act.
 ``
        (B) A State or territory, a political subdivision 
 of a State or territory, or an agency of a State, 
 territory, or such a political subdivision, including a 
 State or local entity that administers a State program 
 funded under part A of this title.
 ``
            (C) An Indian tribe, a tribal organization, or a 
 tribal college or university.
 ``
            (D) An institution of higher education (as 
 defined in the Higher Education Act of 1965).
 ``
        (E) A hospital (as defined in 

section 1861

    (e) ).
 ``
        (F) A high-quality skilled nursing facility.
 ``
        (G) A Federally qualified health center (as 
 defined in 

section 1861

    (aa)

    (4) ).
 ``
        (H) A nonprofit organization described in 

section 501
            (c) (3) of the Internal Revenue Code of 1986, a labor 
 organization, or an entity with shared labor-management 
 oversight, that has a demonstrated history of providing 
 health profession training to eligible individuals.
 ``
            (I) In the case of a demonstration project of the 
 type provided for in subsection
            (c) (2)
        (B)
            (i) 
            (II) of 
 this section, an entity recognized by a State, Indian 
 tribe, or tribal organization as qualified to train 
 doulas or midwives, if midwives or doulas, as the case 
 may be, are permitted to practice in the State 
 involved.
 ``
        (J) An opioid treatment program (as defined in 
 

section 1861

    (jjj)

    (2) ), and other high quality 
 comprehensive addiction care providers.
 ``

    (5) Eligible individual.--The term `eligible individual' 
 means an individual whose family income does not exceed 200 
 percent of the Federal poverty level.
 ``

    (6) Federal poverty level.--The term `Federal poverty 
 level' means the poverty line (as defined in 

section 673

    (2) of 
 the Omnibus Budget Reconciliation Act of 1981, including any 
 revision required by such section applicable to a family of the 
 size involved).
 ``

    (7) Indian tribe; tribal organization.--The terms `Indian 
 tribe' and `tribal organization' have the meaning given the 
 terms in 

section 4 of the Indian Self-Determination and 
 Education Assistance Act (25 U.S.C. 450b).
 ``

    (8) Institution of higher education.--The term 
 `institution of higher education' has the meaning given the 
 term in 

section 101 or 102

    (a)

    (1)
        (B) of the Higher Education Act 
 of 1965.
 ``

    (9) Midwife.--The term `midwife' means a midwife who 
 meets, at a minimum, the international definition of the 
 midwife and global standards for midwifery education as 
 established by the International Confederation of Midwives.
 ``

    (10) Territory.--The term `territory' means the 
 Commonwealth of Puerto Rico, the United States Virgin Islands, 
 Guam, the Northern Mariana Islands, and American Samoa.
 ``

    (11) Tribal college or university.--The term `tribal 
 college or university' has the meaning given the term in 
 

section 316

    (b) of the Higher Education Act of 1965.
 ``

    (12) Tribal midwife.--The term `tribal midwife' means an 
 individual who is recognized by an Indian tribe (as defined in 
 

section 4 of the Indian Health Care Improvement Act (25 U.S.C. 
 1603)) to practice midwifery for the tribe.
 ``
            (l) Nonapplicability of Preceding Sections of This Subtitle.--
 ``

    (1) In general.--Except as provided in paragraph

    (2) , the 
 preceding sections of this subtitle shall not apply to a grant 
 awarded under this section.
 ``

    (2) Exception for certain limitations on use of grants.--
 

Section 2005

    (a) (other than paragraphs

    (2) ,

    (3) ,

    (5) ,

    (6) , and

    (8) ) shall apply to a grant awarded under this section to the 
 same extent and in the same manner as such section applies to 
 payments to States under this subtitle.''.
 <all>