Sec. 402. Pilot grant program to train public housing residents to provide covered home-based health services

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Section 34 of the United States Housing Act of 1937 ( 42 U.S.C. 1437z–6 ) is amended by adding at the end the following new subsections: The Secretary, in consultation with the Secretary of Health and Human Services, shall establish a competitive grant program to make grants to eligible entities under paragraph

(2)for use for the training of public housing residents as home health aides and as providers of home-based health services (including as personal and home care aides) to enable such residents to provide covered home-based health services to— residents of public housing who are elderly or disabled, or both (including elderly and disabled veterans who are residents of public housing); and subject to the criteria set forth pursuant to paragraph (3), residents of federally-assisted rental housing who are elderly or disabled, or both. A grant under this subsection may be made only to an entity that— is a public housing agency or other unit of State or local government (including an agency of such unit), community health center, home care provider organization, faith-based organization, labor organization, or other organization determined to be qualified by the Secretary; and demonstrates to the satisfaction of the Secretary that it has established, or provides such assurances that it will establish, an employment training program to train public housing residents to provide covered home-based health services that complies with regulations that the Secretary shall issue. The Secretary may set forth criteria under which an entity receiving funding under this subsection may train public housing residents to provide covered home-based health services to elderly and disabled residents of federally-assisted rental housing. To be eligible for a grant under this subsection an eligible entity under paragraph

(2)shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary shall require. The Secretary shall establish policies and procedures for reviewing and approving funding for eligible entities through a competitive process taking into consideration— with respect to the service area in which public housing residents trained under an employment training program described in paragraph (2)(B) will provide covered home-based health services— the percentage of residents age 62 and older; the percentage of disabled residents; and the percentage of unemployed or underemployed residents; the ability of an eligible entity to provide training that leads to the provision of quality care; the record of the quality of care of an eligible entity; and such other criteria as determined by the Secretary. In awarding grants, the Secretary shall consider a geographic mix of a variety of eligible entities so that the grant program will include at least— one employment training program described in paragraph (2)(B) that primarily serves an urban population; one employment training program described in paragraph (2)(B) that primarily serves a rural population; one employment training program described in paragraph (2)(B) that primarily serves an Indian population; and one employment training program described in paragraph (2)(B) that primarily serves a population in the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, American Samoa, or the Commonwealth of the Northern Mariana Islands. An entity receiving funding under this subsection may use such funds— to establish (or maintain) and carry-out an employment training program to train public housing residents to provide covered home-based health care services to elderly and disabled public housing residents and elderly and disabled residents of federally-assisted rental housing; for the transportation expenses of public housing residents in training under such an employment training program; for the child care expenses of public housing residents in training under such an employment training program; for the administrative expenses of carrying out such an employment training program; and for any other activity the Secretary determines appropriate. Not later than 24 months after the date of the enactment of the Together We Care Act of 2017 , the Secretary shall submit to Congress a report on the use and impact of the grant program established by this subsection. The report shall include— a review of the effectiveness of the program in— providing jobs for public housing residents; meeting the unmet health and long-term care needs of elderly and disabled residents of public housing and elderly and disabled residents of federally-assisted rental housing; and enabling the provision of quality care; and any recommendations the Secretary determines appropriate regarding the grant program. As used in this subsection, subsection (g), and subsection (h): The term home-based health services means health care and long-term services provided to an individual in a place of residence used as such individual’s home and includes— home health services described in section 1861(m) of the Social Security Act ( 42 U.S.C. 1395x(m) ); personal care services described in section 1905(a)(24) of such Act ( 42 U.S.C. 1396d(a)(24) ); and home-based services which may be covered under a waiver under subsection

(c)or

(d)of section 1915 of such Act ( 42 U.S.C. 1396n ). The term home health aide has the meaning given the term in section 1891(a)(3)(E) of the Social Security Act ( 42 U.S.C. 1395bbb(a)(3)(E) ). The term covered means, with respect to home-based health services, such services— for which medical assistance is available under a State plan under title XIX of the Social Security Act; or for which financial assistance is available under subsection (g). The term federally-assisted rental housing means— housing assisted under section 202 of the Housing Act of 1959 ( 12 U.S.C. 1701q ); housing assisted under section 515 of the Housing Act of 1949 ( 42 U.S.C. 1485 ); housing assisted under section 8 of the United States Housing Act of 1937 ( 42 U.S.C. 1437f ) (including project-based and tenant-based assistance); housing assisted under the block grant program under the Native American Housing Assistance and Self-Determination Act of 1996 ( 25 U.S.C. 4101 et seq.); housing financed by a mortgage insured under section 221(d)(3) of the National Housing Act ( 12 U.S.C. 1715l(d)(3) ) or held by the Secretary, a State, or State agency; and housing assisted under section 811 of the Cranston-Gonzalez National Affordable Housing Act ( 42 U.S.C. 8013 ). Subsections

(a)through

(e)shall not apply to this subsection, subsection (g), and subsection (h). This subsection and subsection

(g)may not be construed as affecting any requirement under State law for training, licensure, or any other certification as a home health aide or as a provider of any home-based health service under this subsection and subsection (g). Not later than 6 months after the date of enactment of the Together We Care Act of 2017 , the Secretary shall issue regulations to carry out this subsection. There are authorized to be appropriated $2,500,000 for each of the fiscal years 2018, 2019, and 2020, for grants under this subsection. The Secretary, in consultation with the Secretary of Health and Human Services, may provide financial assistance under this subsection to entities receiving grant funds under the pilot program established under subsection

(f)that provide training for public housing residents as home health aides and as providers of home-based health services and provide (or pay for) such services for use only for their costs in providing (or paying for) such services to— residents of public housing who are elderly or disabled, or both (including elderly or disabled veterans who are residents of public housing); or at the discretion of the Secretary, residents of federally-assisted rental housing who are elderly or disabled, or both. Assistance under paragraph

(1)may be provided only for services furnished in locations in which medical assistance for home-based health services is not available under a State plan under title XIX of the Social Security Act. Assistance under paragraph

(1)may be used only for costs of services described in paragraph

(1)that are provided by public housing residents trained by an entity receiving grant funds under the pilot program established under subsection (f). To be eligible for financial assistance under this subsection an entity shall— provide such assurances as the Secretary shall require that it will use the funds only as provided in paragraphs

(1)and (2); submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary requires; and comply with such other terms and conditions as the Secretary shall establish to carry out this subsection. There are authorized to be appropriated $2,500,000 for each of the fiscal years 2018, 2019, and 2020, for financial assistance under this subsection. For any resident of public housing who is trained as a home health aide or as a provider of home-based health services pursuant to the program under subsection (f), any income received by such resident for providing covered home-based health services shall apply towards eligibility for benefits under Federal housing programs as follows: No income received shall apply for the 12 months after the completion of the training of such resident. Twenty-five percent of income received shall apply for the period that is 12 to 24 months after the completion of the training of such resident. Fifty percent of income received shall apply for the period that is 24 to 36 months after the completion of the training of such resident. One hundred percent of income received shall apply for any period that begins after 36 months after the completion of the training of such resident. .

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