Career Advancement for Direct Support Aid Workers Act or the CADSAW Act
This bill provides funding through FY2024 to the Department of Health and Human Services (HHS) for demonstration projects to train individuals for careers as home health aides, nursing assistants, or similar direct support aid workers.
HHS must award grants, in consultation with the Department of Labor, to states, tribal nations, institutions of higher education, and other organizations to carry out these projects.
In addition, the bill increases Medicare payments for services furnished by an individual who has completed training through such a project.
To amend subtitle A of title XX of the Social Security Act to authorize 
 direct support worker career advancement demonstration projects, 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 Act may be cited as the ``Career Advancement for Direct 
Support Aid Workers Act'' or the ``CADSAW Act''.

SEC. 2. DIRECT SUPPORT WORKER CAREER ADVANCEMENT DEMONSTRATION 
              PROJECTS.

    (a) In General.--Section 2008 of the Social Security Act (42 U.S.C. 
1397g) is amended--
            (1) by adding at the end the following new subsection:
    ``(e) Direct Support Worker Career Advancement Demonstration 
Projects.--
            ``(1) In general.--The Secretary, in consultation with the 
        Secretary of Labor, shall award, from the amount appropriated 
        under paragraph (4), grants to eligible entities to conduct 
        demonstration projects that are designed to provide eligible 
        individuals with opportunities for education, training, and 
        career advancement as a personal or home care aide, home health 
        aide, or nursing assistant.
            ``(2) Definitions.--In this subsection:
                    ``(A) Eligible entity.--The term `eligible entity' 
                has the meaning given such term in subsection (a).
                    ``(B) Eligible individual.--The term `eligible 
                individual' means an individual--
                            ``(i) whose income does not exceed 200 
                        percent of the poverty line (as defined in 
                        section 2110(c)(5)) applicable to a family of 
                        the size involved; and
                            ``(ii) who is employed as a personal or 
                        home care aide who--
                                    ``(I) has at least 30 percent 
                                patient volume (as estimated in 
                                accordance with a methodology 
                                established by the Secretary) 
                                attributable to individuals who are 
                                receiving medical assistance under 
                                title XIX; or
                                    ``(II) is employed by an agency 
                                that is a provider of personal or home 
                                care services that has at least 30 
                                percent of the agency's patient volume 
                                (as so estimated) attributable to such 
                                individuals.
                    ``(C) Personal or home care aide.--The term 
                `personal or home care aide' has the meaning given such 
                term in subsection (b).
            ``(3) Requirements.--
                    ``(A) Prioritization of projects that support rural 
                areas, underserved areas, and women and black and 
                latinx individuals.--The Secretary shall ensure that 
                not less than half of the demonstration projects 
                supported by grants awarded under this subsection 
                support--
                            ``(i) eligible individuals in rural areas 
                        (as defined in section 2007(f)(5));
                            ``(ii) eligible individuals in underserved 
                        urban areas (including urban health 
                        professional shortage areas (as defined in 
                        section 332 of the Public Health Service Act); 
                        or
                            ``(iii) eligible individuals who are women, 
                        who are Black or Latinx individuals, or who 
                        belong to other underserved and diverse 
                        populations such as Asian, Pacific Islander, 
                        Native American, or Alaska Native communities.
                    ``(B) Amount of grant.--In no case shall the 
                Secretary award an eligible entity a grant to conduct a 
                demonstration project under this subsection in an 
                amount that exceeds $750,000 for each year that the 
                entity conducts such project.
                    ``(C) Reports.--
                            ``(i) Interim reports.--An eligible entity 
                        awarded a grant to conduct a demonstration 
                        project under this subsection shall submit 
                        interim reports to the Secretary on the 
                        activities carried out under the project and a 
                        final report on such activities upon the 
                        conclusion of the entities' participation in 
                        the project.
                            ``(ii) Evaluation.--The Administrator of 
                        the Health Resources and Services 
                        Administration shall evaluate the demonstration 
                        projects conducted under this subsection. Such 
                        evaluation shall include identification of 
                        successful activities for creating 
                        opportunities for developing and sustaining, 
                        particularly with respect to low-income 
                        individuals and long-term workers, a health or 
                        human services professions workforce that has 
                        accessible opportunities for career 
                        advancement, that meets high standards for 
                        education, training, certification, and 
                        professional development, that provides 
                        increased wages and affordable benefits, 
                        including health care coverage, that are 
                        responsive to the workforce's needs, and that 
                        is responsive to the needs of diverse racial 
                        and ethnic communities.
                            ``(iii) Report to congress.--Not later than 
                        1 year after the demonstration projects 
                        conducted under this subsection conclude, the 
                        Secretary shall submit a final report to 
                        Congress on such demonstration projects that 
                        includes--
                                    ``(I) the result of the evaluation 
                                conducted under clause (ii); and
                                    ``(II) such recommendations for 
                                legislation or administrative actions 
                                as the Secretary deems appropriate.
                            ``(iv) Additional report.--Not later than 1 
                        year after the demonstration projects conducted 
                        under this subsection conclude, the Secretary 
                        shall submit to the Committee on Health, 
                        Education, Labor, and Pensions of the Senate 
                        and the Committee on Education and Labor of the 
                        House of Representatives and make publicly 
                        available, a report on the activities and 
                        results of such projects. Such report shall 
                        describe--
                                    ``(I) the number and geographic 
                                distribution of the grants awarded 
                                under this subsection;
                                    ``(II) the participation of 
                                underrepresented and economically 
                                disadvantaged participants in 
                                demonstration projects conducted under 
                                this subsection; and
                                    ``(III) recommendations for program 
                                revisions to achieve the desired 
                                program outcome.
            ``(4) Appropriation.--Out of any funds in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        to carry out this subsection $5,000,000 for each of fiscal 
        years 2022, 2023, and 2024.''.
    (b) Incentive Payments for Home Health Services Furnished by Home 
Health Aides Who Complete Certain Training.--Section 1834 of the Social 
Security Act (42 U.S.C. 1395m) is amended by adding at the end the 
following new subsection:
    ``(x) Incentive Payments for Home Health Services Furnished by Home 
Health Aides Who Complete Certain Training.--In the case of home health 
services furnished on or after October 1, 2022, by a home health aide 
who has successfully completed education or training under a Direct 
Support Worker Career Advancement demonstration project under section 
2008(e), in addition to the amount of payment that would otherwise be 
made for such services under this part, there also shall be paid an 
amount equal to 25 percent of the payment amount for the service under 
this part.''.
                                 <all>
CADSAW Act
A bill to amend subtitle A of title XX of the Social Security Act to authorize direct support worker career advancement demonstration projects, and for other purposes.
CADSAW Act
Career Advancement for Direct Support Aid Workers Act
Sen. King, Angus S., Jr.