---
kind: "section"
citation: "42 U.S.C. § 1397g"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1397g"
heading: "Demonstration projects to address health professions workforce needs"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1397g"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XX — Block Grants and Programs for Social Services and Elder Justice"
  - "Division A — Block Grants to States for Social Services"
---

# §1397g. Demonstration projects to address health professions workforce needs

- (a) **Demonstration projects to provide low-income individuals with opportunities for education, training, and career advancement to address health professions workforce needs—**
  - (1) **Authority to award grants—** The [Secretary](/usc/42/1301.md?p=a-6), in consultation with the [Secretary](/usc/42/1301.md?p=a-6) of Labor, shall award [grants](/usc/42/1397j.md?p=10) to [eligible entities](/usc/42/1397j.md?p=7) to conduct demonstration [projects](/usc/42/13641.md?p=2) that are designed to provide eligible individuals with the opportunity to obtain education and training for occupations in the health care field that pay well and are expected to either experience labor shortages or be in high demand.
  - (2) **Requirements—**
    - (A) **Aid and supportive services—**
      - (i) **In general—** A demonstration [project](/usc/42/13641.md?p=2) conducted by an [eligible entity](/usc/42/1397j.md?p=7) awarded a [grant](/usc/42/1397j.md?p=10) under this section shall, if appropriate, provide eligible individuals participating in the [project](/usc/42/13641.md?p=2) with financial aid, [child](/usc/42/1382c.md?p=c) care, case management, and other supportive services.
      - (ii) **Treatment—** Any aid, services, or incentives provided to an eligible beneficiary participating in a demonstration [project](/usc/42/13641.md?p=2) under this section shall not be considered income, and shall not be taken into account for purposes of determining the individual’s eligibility for, or amount of, benefits under any means-tested program.
    - (B) **Consultation and coordination—** An [eligible entity](/usc/42/1397j.md?p=7) applying for a [grant](/usc/42/1397j.md?p=10) to carry out a demonstration [project](/usc/42/13641.md?p=2) under this section shall demonstrate in the application that the entity has consulted with the [State agency](/usc/42/629a.md?p=a-3) responsible for administering the [State](/usc/42/619.md?p=5) TANF program, the local workforce investment board in the area in which the [project](/usc/42/13641.md?p=2) is to be conducted (unless the applicant is such board), the [State](/usc/42/619.md?p=5) workforce development board established under [section 3111 of title 29](/usc/29/3111.md), and the [State](/usc/42/619.md?p=5) Apprenticeship [Agency](/usc/42/1397n–12.md?p=1) recognized under the Act of August 16, 1937 (commonly known as the “National Apprenticeship Act”) [[29 U.S.C. 50](/usc/29/50.md) et seq.] (or if no [agency](/usc/42/1397n–12.md?p=1) has been recognized in the [State](/usc/42/619.md?p=5), the Office of Apprenticeship of the Department of Labor) and that the [project](/usc/42/13641.md?p=2) will be carried out in coordination with such entities.
    - (C) **Assurance of opportunities for Indian populations—** The [Secretary](/usc/42/1301.md?p=a-6) shall award at least 3 [grants](/usc/42/1397j.md?p=10) under this subsection to an [eligible entity](/usc/42/1397j.md?p=7) that is an [Indian tribe](/usc/42/619.md?p=4-A), [tribal organization](/usc/42/619.md?p=4-A), or Tribal College or University.
  - (3) **Reports and evaluation—**
    - (A) **Eligible entities—** An [eligible entity](/usc/42/1397j.md?p=7) awarded a [grant](/usc/42/1397j.md?p=10) to conduct a demonstration [project](/usc/42/13641.md?p=2) under this subsection shall submit interim reports to the [Secretary](/usc/42/1301.md?p=a-6) on the activities carried out under the [project](/usc/42/13641.md?p=2) and a final report on such activities upon the conclusion of the entities’ participation in the [project](/usc/42/13641.md?p=2). Such reports shall include assessments of the effectiveness of such activities with respect to improving outcomes for the eligible individuals participating in the [project](/usc/42/13641.md?p=2) and with respect to addressing health professions workforce needs in the areas in which the [project](/usc/42/13641.md?p=2) is conducted.
    - (B) **Evaluation—** The [Secretary](/usc/42/1301.md?p=a-6) shall, by [grant](/usc/42/1397j.md?p=10), contract, or interagency agreement, evaluate the demonstration [projects](/usc/42/13641.md?p=2) 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 other entry-level workers, a health professions workforce that has accessible entry points, that meets high [standards](/usc/42/1320d.md?p=7) for education, training, certification, and professional development, and that provides increased [wages](/usc/42/409.md?p=a) and affordable benefits, [including](/usc/42/1301.md?p=b) health care coverage, that are responsive to the workforce’s needs.
    - (C) **Report to Congress—** The [Secretary](/usc/42/1301.md?p=a-6) shall submit interim reports and, based on the evaluation conducted under [subparagraph (B)](#a-3-B), a final report to Congress on the demonstration [projects](/usc/42/13641.md?p=2) conducted under this subsection.
  - (4) **Definitions—** In this subsection:
    - (A) **Eligible entity—** The term “[eligible entity](/usc/42/1397j.md?p=7)” means a [State](/usc/42/619.md?p=5), an [Indian tribe](/usc/42/619.md?p=4-A) or [tribal organization](/usc/42/619.md?p=4-A), an [institution of higher education](/usc/42/11851.md?p=7), a local workforce development board established under [section 3122 of title 29](/usc/29/3122.md), a sponsor of an apprenticeship program registered under the National Apprenticeship Act [[29 U.S.C. 50](/usc/29/50.md) et seq.] or a community-based organization.
    - (B) **Eligible individual—**
      - (i) **In general—** The term “eligible individual” means a[^1] individual receiving assistance under the [State](/usc/42/619.md?p=5) TANF program.
      - (ii) **Other low-income individuals—** Such term may include other low-income individuals described by the [eligible entity](/usc/42/1397j.md?p=7) in its application for a [grant](/usc/42/1397j.md?p=10) under this section.
    - (C) **Indian tribe; tribal organization—** The terms “[Indian tribe](/usc/42/619.md?p=4-A)” and “[tribal organization](/usc/42/619.md?p=4-A)” have the meaning given such terms in [section 5304 of title 25](/usc/25/5304.md).
    - (D) **Institution of higher education—** The term “[institution of higher education](/usc/42/11851.md?p=7)” has the meaning given that term in [section 1001 of title 20](/usc/20/1001.md).
    - (E) **State—** The term “[State](/usc/42/619.md?p=5)” means each of the 50 [States](/usc/42/619.md?p=5), the District of Columbia, the Commonwealth of Puerto Rico, the [United States](/usc/42/1301.md?p=a-2) Virgin Islands, Guam, and American Samoa.
    - (F) **State TANF program—** The term “[State](/usc/42/619.md?p=5) TANF program” means the temporary assistance for needy families program funded under part A of subchapter IV.
    - (G) **Tribal College or University—** The term “Tribal College or University” has the meaning given that term in section 1059c(b)of title 20.
- (b) **Demonstration project to develop training and certification programs for personal or home care aides—**
  - (1) **Authority to award grants—** Not later than 18 months after March 23, 2010, the [Secretary](/usc/42/1301.md?p=a-6) shall award [grants](/usc/42/1397j.md?p=10) to [eligible entities](/usc/42/1397j.md?p=7) that are [States](/usc/42/619.md?p=5) to conduct demonstration [projects](/usc/42/13641.md?p=2) for purposes of developing core training competencies and certification programs for personal or home care aides. The [Secretary](/usc/42/1301.md?p=a-6) shall—
    - (A) evaluate the efficacy of the core training competencies described in [paragraph (3)(A)](#b-3-A) for newly hired personal or home care aides and the methods used by [States](/usc/42/619.md?p=5) to implement such core training competencies in accordance with the issues specified in [paragraph (3)(B)](#b-3-B); and
    - (B) ensure that the number of hours of training provided by [States](/usc/42/619.md?p=5) under the demonstration [project](/usc/42/13641.md?p=2) with respect to such core training competencies are not less than the number of hours of training required under any applicable [State](/usc/42/619.md?p=5) or Federal law or regulation.
  - (2) **Duration—** A demonstration [project](/usc/42/13641.md?p=2) shall be conducted under this subsection for not less than 3 years.
  - (3) **Core training competencies for personal or home care aides—**
    - (A) **In general—** The core training competencies for personal or home care aides described in this subparagraph include competencies with respect to the following areas:
      - (i) The role of the personal or home care aide ([including](/usc/42/1301.md?p=b) differences between a personal or home care aide employed by an [agency](/usc/42/1397n–12.md?p=1) and a personal or home care aide employed directly by the health care consumer or an independent provider).
      - (ii) Consumer rights, ethics, and confidentiality ([including](/usc/42/1301.md?p=b) the role of proxy decision-makers in the case where a health care consumer has impaired decision-making capacity).
      - (iii) Communication, cultural and linguistic competence and sensitivity, problem solving, behavior management, and relationship skills.
      - (iv) Personal care skills.
      - (v) Health care support.
      - (vi) Nutritional support.
      - (vii) Infection control.
      - (viii) Safety and emergency training.
      - (ix) Training specific to an individual consumer’s needs ([including](/usc/42/1301.md?p=b) older individuals, younger individuals with disabilities, individuals with developmental disabilities, individuals with dementia, and individuals with mental and behavioral health needs).
      - (x) Self-Care.
    - (B) **Implementation—** The implementation issues specified in this subparagraph include the following:
      - (i) The length of the training.
      - (ii) The appropriate trainer to student ratio.
      - (iii) The amount of instruction time spent in the classroom as compared to on-site in the home or a [facility](/usc/42/1320a–3.md?p=c-5-B).
      - (iv) Trainer qualifications.
      - (v) Content for a “hands-on” and written certification exam.
      - (vi) Continuing education requirements.
  - (4) **Application and selection criteria—**
    - (A) **In general—**
      - (i) **Number of States—** The [Secretary](/usc/42/1301.md?p=a-6) shall enter into agreements with not more than 6 [States](/usc/42/619.md?p=5) to conduct demonstration [projects](/usc/42/13641.md?p=2) under this subsection.
      - (ii) **Requirements for States—** An agreement entered into under [clause (i)](#b-4-A-i) shall require that a participating [State](/usc/42/619.md?p=5)—
        - (I) implement the core training competencies described in [paragraph (3)(A)](#b-3-A); and
        - (II) develop written materials and protocols for such core training competencies, [including](/usc/42/1301.md?p=b) the development of a certification test for personal or home care aides who have completed such training competencies.
      - (iii) **Consultation and collaboration with community and vocational colleges—** The [Secretary](/usc/42/1301.md?p=a-6) shall encourage participating [States](/usc/42/619.md?p=5) to consult with community and vocational colleges regarding the development of curricula to implement the [project](/usc/42/13641.md?p=2) with respect to activities, as applicable, which may include consideration of such colleges as partners in such implementation.
    - (B) **Application and eligibility—** A [State](/usc/42/619.md?p=5) seeking to participate in the [project](/usc/42/13641.md?p=2) shall—
      - (i) submit an application to the [Secretary](/usc/42/1301.md?p=a-6) containing such information and at such time as the [Secretary](/usc/42/1301.md?p=a-6) may specify;
      - (ii) meet the selection criteria established under [subparagraph (C)](#b-4-C); and
      - (iii) meet such additional criteria as the [Secretary](/usc/42/1301.md?p=a-6) may specify.
    - (C) **Selection criteria—** In selecting [States](/usc/42/619.md?p=5) to participate in the program, the [Secretary](/usc/42/1301.md?p=a-6) shall establish criteria to ensure (if applicable with respect to the activities involved)—
      - (i) geographic and demographic diversity;
      - (ii) that participating [States](/usc/42/619.md?p=5) offer medical assistance for personal care services under the [State](/usc/42/619.md?p=5) Medicaid plan;
      - (iii) that the existing training [standards](/usc/42/1320d.md?p=7) for personal or home care aides in each participating [State](/usc/42/619.md?p=5)—
        - (I) are different from such [standards](/usc/42/1320d.md?p=7) in the other participating [States](/usc/42/619.md?p=5); and
        - (II) are different from the core training competencies described in [paragraph (3)(A)](#b-3-A);
      - (iv) that participating [States](/usc/42/619.md?p=5) do not reduce the number of hours of training required under applicable [State](/usc/42/619.md?p=5) law or regulation after being selected to participate in the [project](/usc/42/13641.md?p=2); and
      - (v) that participating [States](/usc/42/619.md?p=5) recruit a minimum number of eligible health and [long-term care](/usc/42/1397j.md?p=14-A) providers to participate in the [project](/usc/42/13641.md?p=2).
    - (D) **Technical assistance—** The [Secretary](/usc/42/1301.md?p=a-6) shall provide technical assistance to [States](/usc/42/619.md?p=5) in developing written materials and protocols for such core training competencies.
  - (5) **Evaluation and report—**
    - (A) **Evaluation—** The [Secretary](/usc/42/1301.md?p=a-6) shall develop an experimental or control group testing protocol in consultation with an independent evaluation contractor selected by the [Secretary](/usc/42/1301.md?p=a-6). Such contractor shall evaluate—
      - (i) the impact of core training competencies described in [paragraph (3)(A)](#b-3-A), [including](/usc/42/1301.md?p=b) curricula developed to implement such core training competencies, for personal or home care aides within each participating [State](/usc/42/619.md?p=5) on job satisfaction, mastery of job skills, beneficiary and family [caregiver](/usc/42/1397j.md?p=3) satisfaction with services, and additional measures determined by the [Secretary](/usc/42/1301.md?p=a-6) in consultation with the expert panel;
      - (ii) the impact of providing such core training competencies on the existing training infrastructure and resources of [States](/usc/42/619.md?p=5); and
      - (iii) 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.
    - (B) **Reports—**
      - (i) **Report on initial implementation—** Not later than 2 years after March 23, 2010, the [Secretary](/usc/42/1301.md?p=a-6) shall submit to Congress a report on the initial implementation of activities conducted under the demonstration [project](/usc/42/13641.md?p=2), [including](/usc/42/1301.md?p=b) any available results of the evaluation conducted under [subparagraph (A)](#b-5-A) with respect to such activities, together with such recommendations for legislation or administrative action as the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate.
      - (ii) **Final report—** Not later than 1 year after the completion of the demonstration [project](/usc/42/13641.md?p=2), the [Secretary](/usc/42/1301.md?p=a-6) shall submit to Congress a report containing the results of the evaluation conducted under [subparagraph (A)](#b-5-A), together with such recommendations for legislation or administrative action as the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate.
  - (6) **Definitions—** In this subsection:
    - (A) **Eligible health and long-term care provider—** The term “eligible health and [long-term care](/usc/42/1397j.md?p=14-A) provider” means a personal or home care [agency](/usc/42/1397n–12.md?p=1) ([including](/usc/42/1301.md?p=b) personal or home care public authorities), a nursing home, a home health [agency](/usc/42/1397n–12.md?p=1) (as defined in [section 1395x(o)](/usc/42/1395x.md?p=o) of this title), or any other [health care provider](/usc/42/1320d.md?p=3) the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate which—
      - (i) is licensed or authorized to provide services in a participating [State](/usc/42/619.md?p=5); and
      - (ii) receives payment for services under subchapter XIX.
    - (B) **Personal care services—** The term “personal care services” has the meaning given such term for purposes of subchapter XIX.
    - (C) **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](/usc/42/1301.md?p=b) an individual with Alzheimer’s disease or other dementia) to live in their own home or a residential care [facility](/usc/42/1320a–3.md?p=c-5-B) (such as a nursing home, assisted living [facility](/usc/42/1320a–3.md?p=c-5-B), or any other [facility](/usc/42/1320a–3.md?p=c-5-B) the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate) by providing routine personal care services and other appropriate services to the individual.
    - (D) **State—** The term “[State](/usc/42/619.md?p=5)” has the meaning given that term for purposes of subchapter XIX.
- (c) **Funding—**
  - (1) **In general—** Subject to [paragraph (2)](#c-2), out of any funds in the Treasury not otherwise appropriated, there are appropriated to the [Secretary](/usc/42/1301.md?p=a-6) to carry out subsections [(a)](#a) and [(b)](#b), $85,000,000 for each of [fiscal years](/usc/42/619.md?p=3) 2010 through 2019.
  - (2) **Training and certification programs for personal and home care aides—** With respect to the demonstration [projects](/usc/42/13641.md?p=2) under [subsection (b)](#b), the [Secretary](/usc/42/1301.md?p=a-6) shall use $5,000,000 of the amount appropriated under [paragraph (1)](#c-1) for each of [fiscal years](/usc/42/619.md?p=3) 2010 through 2012 to carry out such [projects](/usc/42/13641.md?p=2). No funds appropriated under [paragraph (1)](#c-1) shall be used to carry out demonstration [projects](/usc/42/13641.md?p=2) under [subsection (b)](#b) after [fiscal year](/usc/42/619.md?p=3) 2012.
- (d) **Nonapplication—**
  - (1) **In general—** Except as provided in [paragraph (2)](#d-2), the preceding sections of this division shall not apply to [grant](/usc/42/1397j.md?p=10)[^2] awarded under this section.
  - (2) **Limitations on use of grants—** [Section 1397d(a) of this title](/usc/42/1397d.md?p=a) (other than paragraph (6)) shall apply to a [grant](/usc/42/1397j.md?p=10) awarded under this section to the same extent and in the same manner as such section applies to payments to [States](/usc/42/619.md?p=5) under this division.

## Footnotes

[^1]: So in original. Probably should be “an”.
[^2]: So in original.

## Source credit

(Aug. 14, 1935, ch. 531, title XX, § 2008, as added and amended Pub. L. 111–148, title V, § 5507(a), title VI, § 6703(d)(1)(B), Mar. 23, 2010, 124 Stat. 663, 803; Pub. L. 113–93, title II, § 208, Apr. 1, 2014, 128 Stat. 1046; Pub. L. 113–128, title V, § 512(dd)(4), July 22, 2014, 128 Stat. 1718; Pub. L. 114–10, title II, § 217, Apr. 16, 2015, 129 Stat. 153; Pub. L. 115–123, div. E, title VI, § 50611, Feb. 9, 2018, 132 Stat. 232.)

## Notes

### Editorial Notes

### References in Text

The Act of August 16, 1937, referred to in subsec. (a)(2)(B), (4)(A), is act Aug. 16, 1937, ch. 663, 50 Stat. 664, popularly known as the National Apprenticeship Act, which is classified generally to chapter 4C (§ 50 et seq.) of Title 29, Labor. For complete classification of this Act to the Code, see Short Title note set out under section 50 of Title 29 and Tables.

Part A of subchapter IV, referred to in subsec. (a)(4)(F), is classified to § 601 et seq. of this title.

### Amendments

2018—Subsec. (c)(1). Pub. L. 115–123 substituted “2019” for “2017”.

2015—Subsec. (c)(1). Pub. L. 114–10 substituted “2017” for “2015”.

2014—Subsec. (a)(2)(B). Pub. L. 113–128, § 512(dd)(4)(A), substituted “the State workforce development board established under section 3111 of title 29” for “the State workforce investment board established under section 2821 of title 29”.

Subsec. (a)(4)(A). Pub. L. 113–128, § 512(dd)(4)(B), substituted “a local workforce development board established under section 3122 of title 29,” for “a local workforce investment board established under section 2832 of title 29,”.

Subsec. (c)(1). Pub. L. 113–93 substituted “2015” for “2014”.

2010—Subsec. (d). Pub. L. 111–148, § 6703(d)(1)(B), which directed substitution of “this division” for “this subchapter” wherever appearing in subtitle 1 of title XX of act Aug. 14, 1935, was executed by making the substitution in two places in subsec. (d) of this section, which is in subtitle A of title XX act Aug. 14, 1935, to reflect the probable intent of Congress.

### Statutory Notes and Related Subsidiaries

### Effective Date of 2014 Amendment

Amendment by Pub. L. 113–128 effective on the first day of the first full program year after July 22, 2014 (July 1, 2015), see section 506 of Pub. L. 113–128, set out as an Effective Date note under section 3101 of Title 29, Labor.

### Extension of Demonstration Projects To Address Health Professions Workforce Needs

Pub. L. 116–136, div. A, title III, § 3823, Mar. 27, 2020, 134 Stat. 433, provided that: “Activities authorized by section 2008 of the Social Security Act [42 U.S.C. 1397g] shall continue through November 30, 2020, in the manner authorized for fiscal year 2019, and out of any money in the Treasury of the United States not otherwise appropriated, there are hereby appropriated such sums as may be necessary for such purpose. Grants and payments may be made pursuant to this authority through the date so specified at the pro rata portion of the total amount authorized for such activities in fiscal year 2019.”