Senate File 2098 - Introduced SENATE FILE 2098 BY GIDDENS , MATHIS , JOCHUM , CELSI , LYKAM , WAHLS , KINNEY , DOTZLER , R. TAYLOR , BISIGNANO , T. TAYLOR , J. SMITH , HOGG , QUIRMBACH , BOLKCOM , PETERSEN , RAGAN , and BOULTON A BILL FOR An Act relating to the direct care workforce including the 1 creation of a direct care worker database, inclusion of 2 direct care workers in state skilled workforce programs, 3 and the establishment of a direct care worker tuition grant 4 program and a direct care worker tuition tax credit. 5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 6 TLSB 5439ST (7) 88 pf/rh

S.F. 2098 DIVISION I 1 CENTRALIZED DIRECT CARE WORKFORCE DATABASE 2 Section 1. CENTRALIZED DIRECT CARE WORKFORCE DATABASE —— 3 STAKEHOLDER WORKGROUP —— IMPLEMENTATION PLAN. 4 1. The department of inspections and appeals shall convene 5 a workgroup of stakeholders to develop a plan to implement a 6 centralized direct care workforce database as an expansion of 7 the Iowa direct care worker registry currently located within 8 the department of inspections and appeals. The purposes of the 9 database are: 10 a. To enable data-driven decision-making by providing 11 a means for collecting data and analyzing emerging trends 12 relating to the state’s direct care workforce in all settings; 13 identifying, at a minimum, the current number of direct care 14 workers in Iowa, the diversity in the direct care workforce, 15 and the employment settings utilized; and addressing the 16 growing demand for the direct care workforce. 17 b. To provide portability across employment settings 18 and populations served of the permanent record of trainings, 19 certifications, credentials, continuing education, and 20 experience of direct care workers by maintaining such records 21 in a central and secure location. 22 c. To improve the opportunity for consumers to engage 23 direct care workers with the training, skills, and availability 24 appropriate to their own situations. 25 d. To reduce the costs associated with repetitive training 26 resulting from training portability. 27 e. To increase public protection by streamlining the 28 process to enable completion of required background checks in 29 a timely and efficient manner. 30 f. To accelerate the onboarding of newly employed direct 31 care workers and direct care workers transitioning into new 32 employment opportunities. 33 2. The members of the stakeholder workgroup shall 34 include one representative of the department of education, 35 -1- LSB 5439ST (7) 88 pf/rh 1/ 12

S.F. 2098 Iowa workforce development, the department on aging, the 1 department of public health, the department of human services, 2 the department of public safety, division of criminal 3 investigation, the Iowa caregivers, AARP Iowa, the Iowa center 4 for nursing workforce, everystep care and support services, 5 the brain injury alliance of Iowa, the national alliance on 6 mental illness-Iowa, leadingage Iowa, the Iowa association of 7 community providers, united way of central Iowa-central Iowa 8 works, the Iowa health care association, a rural community 9 college and an urban community college, a public health entity, 10 the Iowa hospital association, and the university of Iowa 11 college of public health midwestern public health training 12 center. Additionally, the task force shall include two direct 13 care workers who have graduated from the Iowa caregivers 14 toughest job you’ll ever love leadership program and two 15 consumers. 16 3. The stakeholder workgroup shall do all of the following: 17 a. Review historical reports of efforts and recommendations 18 generated by previous state-led and federally funded 19 initiatives for consideration in informing future planning, and 20 assess whether the previous recommendations align with future 21 needs. 22 b. Review prior efforts including the results of the Iowa 23 better jobs better care program demonstration and the AMANDA 24 portal developed through the federal personal and home care 25 aide state training (PHCAST) grant to determine if these 26 technologies could be brought to scale or implemented to save 27 costs and resources in implementing the database. 28 c. Investigate initiatives by the centers for Medicare and 29 Medicaid services of the United States department of health and 30 human services relating to nurse aid registries. 31 d. Solicit input from stakeholders on the type of data to be 32 collected and the types of analyses to be performed in building 33 and retaining the high-demand direct care workforce. 34 e. Identify critical database system content and 35 -2- LSB 5439ST (7) 88 pf/rh 2/ 12

S.F. 2098 functionality including but not limited to all of the 1 following: 2 (1) A direct care worker’s verified education and training 3 records, credentials, certifications, and experience. 4 (2) A means to include existing qualified direct care 5 workers in the database through a phased-in grandfathering 6 process. 7 (3) An option for access to the database by employers and 8 consumers through a public portal to assist in identifying 9 direct care workers with particular knowledge and skills. 10 (4) Demographic and other information to assist in 11 workforce data collection and analysis. 12 (5) Accurate supply and demand projections regarding the 13 entirety of the direct care workforce. 14 f. Recommend strategies to provide state-recognized, 15 competency-based, comprehensive, cross-setting, portable 16 training approaches, including the prepare to care curriculum 17 and the mental health first aid curriculum, apprenticeships, 18 and other existing and new opportunities in order to provide a 19 recognized career path for, increase professionalism in, and 20 improve retention by, employers of the direct care workforce. 21 g. Explore state, federal, and other public sources 22 of funding and review the status of prior investments in 23 modifications to expand the Iowa direct care worker registry. 24 h. Solicit feedback from the public including through the 25 lifelong smiles coalition, united ways of Iowa, the university 26 of Iowa colleges of nursing and dentistry, Iowa state 27 university, the older Iowans legislature, the Olmstead consumer 28 task force, the Iowa assisted living association, the Iowa 29 public health association, the Iowa association of business and 30 industry, the Iowa developmental disabilities council, local 31 boards of health, county supervisors, and other persons deemed 32 appropriate by the workgroup. 33 4. The stakeholder workgroup shall convene no later than 34 September 1, 2020, and shall submit a phased-in implementation 35 -3- LSB 5439ST (7) 88 pf/rh 3/ 12

S.F. 2098 plan and recommendations to the governor and the general 1 assembly by June 30, 2021. 2 DIVISION II 3 SKILLED WORKFORCE PROGRAMS —— HIGH-DEMAND JOB DESIGNATION —— 4 DIRECT CARE WORKERS 5 Sec. 2. DEPARTMENT OF WORKFORCE DEVELOPMENT —— HIGH-DEMAND 6 JOB DESIGNATION —— DIRECT CARE WORKERS. Notwithstanding any 7 provision to the contrary, the workforce development board, 8 pursuant to section 84A.1B, subsection 14, shall add to the 9 list of high-demand jobs statewide, the job of direct care 10 worker, for the purposes of the future ready Iowa registered 11 apprenticeship development program created in section 15C.1, 12 the summer youth intern pilot program established under section 13 84A.12, the Iowa employer innovation program established 14 under section 84A.13, the future ready Iowa skilled workforce 15 last-dollar scholarship program established under section 16 261.131, the future ready Iowa skilled workforce grant program 17 established under section 261.132, and postsecondary summer 18 classes for high school students as provided under section 19 261E.8, subsection 8. For the purposes of this section, 20 “direct care worker” means a home health aide, nursing 21 assistant, or personal care aide as identified by the United 22 States department of labor, bureau of labor statistics. 23 DIVISION III 24 DIRECT CARE WORKER TUITION GRANT PROGRAM 25 Sec. 3. NEW SECTION . 261.133 Direct care worker tuition 26 grant program. 27 1. For the purposes of this section, “direct care worker” 28 means a home health aide, nursing assistant, or personal care 29 aide as identified by the United States department of labor, 30 bureau of labor statistics. 31 2. A direct care worker tuition grant may be awarded to 32 any resident of Iowa who is admitted and in attendance as a 33 full-time or part-time student in a direct care worker career 34 program to pursue an associate’s degree or other training at a 35 -4- LSB 5439ST (7) 88 pf/rh 4/ 12

S.F. 2098 community college in the state, and who establishes financial 1 need. 2 3. The amount of a direct care worker tuition grant shall 3 not exceed the lesser of one-half of a student’s tuition and 4 fees for an approved direct care worker career program or the 5 amount of the student’s established financial need. 6 4. All classes identified by the community college as 7 required for completion of the student’s approved direct care 8 worker program shall be considered a part of the student’s 9 direct care worker program for the purpose of determining the 10 student’s eligibility for a grant. Notwithstanding subsection 11 4, if a student is making satisfactory academic progress but 12 the student cannot complete a direct care worker program in 13 the time frame allowed for a student to receive a tuition 14 grant as provided in subsection 4 because additional classes 15 are required to complete the program, the student may continue 16 to receive a tuition grant for not more than one additional 17 enrollment period. 18 5. a. A qualified full-time student may receive tuition 19 grants for not more than four semesters or the trimester or 20 quarter equivalent of two full years of study. A qualified 21 part-time student enrolled in a course of study including at 22 least three semester hours but fewer than twelve semester hours 23 or the trimester or quarter equivalent may receive tuition 24 grants for not more than eight semesters or the trimester or 25 quarter equivalent of two full years of full-time study. 26 b. However, if a student resumes study after at least a 27 two-year absence, the student may again be eligible for the 28 specified amount of time, except that the student shall not 29 receive assistance for courses for which credit was previously 30 received. 31 6. A direct care worker tuition grant shall be awarded 32 on an annual basis, requiring reapplication by the student 33 for each year. Payments under the grant shall be allocated 34 equally among the semesters or quarters of the year upon 35 -5- LSB 5439ST (7) 88 pf/rh 5/ 12

S.F. 2098 certification by the community college that the student is 1 in full-time or part-time attendance in a direct care worker 2 program consistent with the requirements of this section. If 3 the student discontinues attendance before the end of any term 4 after receiving payment of the grant, the entire amount of any 5 refund due that student, up to the amount of any payments made 6 under the annual grant, shall be paid by the community college 7 to the state. 8 7. If a student receives financial aid under any other 9 program, the full amount of that financial aid shall be 10 considered part of the student’s financial resources available 11 in determining the amount of the student’s financial need for 12 that period. 13 8. The college student aid commission shall administer this 14 program and shall: 15 a. Provide application forms for distribution to students by 16 Iowa high schools and community colleges. 17 b. Adopt rules for approving direct care worker programs; 18 determining financial need; defining residence for the purposes 19 of this section; processing and approving applications for 20 grants; and determining priority for grants. 21 c. Approve and award grants on an annual basis. 22 d. Make an annual report to the governor and general 23 assembly, including the number of students receiving 24 assistance. 25 9. Each applicant, in accordance with the rules established 26 by the commission, shall: 27 a. Complete and file an application for a direct care worker 28 tuition grant. 29 b. Be responsible for the submission of the financial 30 information required for evaluation of the applicant’s need for 31 a grant, on forms determined by the commission. 32 c. Report promptly to the college student aid commission any 33 information requested. 34 d. Submit a new application for reevaluation of the 35 -6- LSB 5439ST (7) 88 pf/rh 6/ 12

S.F. 2098 applicant’s eligibility to receive a second-year renewal of the 1 grant. 2 DIVISION IV 3 DIRECT CARE WORKER LOAN REPAYMENT PROGRAM 4 Sec. 4. NEW SECTION . 261.134 Direct care worker loan 5 repayment program. 6 1. For purposes of this section, “direct care worker” means 7 a home health aide, nursing assistant, or personal care aide as 8 identified by the United States department of labor, bureau of 9 labor statistics. 10 2. A direct care worker loan repayment program is 11 established to be administered by the college student aid 12 commission to increase the number of direct care workers in 13 the state. Under the program, loan repayment may be made to 14 a recipient for loans for educational expenses incurred while 15 completing an approved direct care worker career program. 16 3. Each applicant for loan repayment shall, in accordance 17 with the rules of the college student aid commission, do the 18 following: 19 a. Complete and file an application for loan repayment. The 20 individual shall be responsible for the prompt submission of 21 any information required by the college student aid commission. 22 b. File a new application and submit information as required 23 by the college student aid commission annually on the basis 24 of which the applicant’s eligibility for the renewed loan 25 repayment will be evaluated and determined. 26 c. Complete and return, on a form approved by the college 27 student aid commission, an affidavit of employment verifying 28 that the applicant is a direct care worker who is practicing 29 full-time in this state. 30 4. The annual amount of loan repayment provided to a 31 recipient under this section shall not exceed twenty percent 32 of the recipient’s total eligible loan. A recipient is 33 eligible for the loan repayment program for not more than five 34 consecutive years. 35 -7- LSB 5439ST (7) 88 pf/rh 7/ 12

S.F. 2098 5. The college student aid commission shall adopt rules 1 pursuant to chapter 17A to administer this section and shall 2 establish by rule eligible loans and the evaluation criteria 3 to be used in evaluating applications submitted under this 4 section. Priority shall be given to applicants who are 5 residents of Iowa. 6 6. A direct care worker loan repayment fund is created 7 for deposit of moneys appropriated to or received by the 8 college student aid commission for use under the program. 9 Notwithstanding section 8.33, moneys deposited in the direct 10 care worker loan repayment fund shall not revert to any fund 11 of the state at the end of any fiscal year but shall remain in 12 the loan repayment fund and be continuously available for loan 13 repayment under the program. Notwithstanding section 12C.7, 14 subsection 2, interest or earnings on moneys deposited in the 15 health care loan fund shall be credited to the fund. 16 7. The college student aid commission shall submit in a 17 report to the general assembly by January 1, annually, the 18 number of individuals who received loan repayment pursuant 19 to this section, where the participants were employed, the 20 amount paid to each program participant, and other information 21 identified by the commission as indicators of outcomes of the 22 program. 23 DIVISION V 24 DIRECT CARE WORKER TUITION TAX CREDIT 25 Sec. 5. NEW SECTION . 422.120 School tuition organization 26 tax credit. 27 1. For purposes of this section: 28 a. “Direct care worker” means home health aides, nursing 29 assistants, and personal care aides as identified by the United 30 States department of labor, bureau of labor statistics. 31 b. “Eligible student taxpayer” means a student who is a 32 member of a household whose total annual income during the 33 calendar year before the student receives a tuition grant 34 for purposes of this section does not exceed an amount equal 35 -8- LSB 5439ST (7) 88 pf/rh 8/ 12

S.F. 2098 to four times the most recently published federal poverty 1 guidelines in the federal register by the United States 2 department of health and human services. 3 2. The taxes imposed under this division, less the credits 4 allowed under section 422.12, shall be reduced by a direct care 5 worker tuition tax credit equal to sixty-five percent of the 6 amount of the payments made by the eligible student taxpayer 7 during the tax year for tuition for a direct care worker career 8 program to pursue an associate’s degree or other training at 9 a community college in the state. The tax credit shall be 10 claimed by use of a tax credit certificate as provided in 11 subsection 4. 12 3. Any credit in excess of the tax liability is not 13 refundable but the excess for the tax year may be credited to 14 the tax liability for the following five tax years or until 15 depleted, whichever is the earlier. 16 4. a. In order for the eligible student taxpayer to claim 17 the tax credit under subsection 1, a tax credit certificate 18 issued by the community college to which the tuition payment 19 was made shall be included with the person’s tax return. The 20 tax credit certificate shall contain the taxpayer’s name, 21 address, tax identification number, the amount of the tuition 22 payment, the amount of the credit, and other information 23 required by the department. 24 b. The department shall authorize a community college to 25 issue tax credit certificates for tuition payments made to the 26 community college. 27 EXPLANATION 28 The inclusion of this explanation does not constitute agreement with 29 the explanation’s substance by the members of the general assembly. 30 This bill relates to the direct care worker workforce. 31 DIVISION I. Division I of the bill relates to development 32 of a plan for implementation of a centralized direct care 33 workforce database. 34 The division requires the department of inspections and 35 -9- LSB 5439ST (7) 88 pf/rh 9/ 12

S.F. 2098 appeals to convene a stakeholder workgroup to develop a 1 plan and make recommendations for a centralized direct care 2 workforce database as an expansion of the Iowa direct care 3 worker registry. 4 The division specifies the purposes of the database and the 5 membership and duties of the workgroup. 6 The division requires the stakeholder workgroup to convene 7 no later than September 1, 2020, and to submit a phased-in 8 implementation plan for the centralized direct care workforce 9 database, to the governor and the general assembly by June 30, 10 2021. 11 DIVISION II. Division II of the bill relates to skilled 12 workforce programs and the designation of high-demand 13 jobs. The bill requires the workforce development board, 14 notwithstanding any provision to the contrary, to add to the 15 list of high-demand jobs statewide the job of direct care 16 worker for the purposes of the future ready Iowa registered 17 apprenticeship development program, the summer youth intern 18 pilot program, the Iowa employer innovation program, the future 19 ready Iowa skilled workforce last-dollar scholarship program, 20 the future ready Iowa skilled workforce grant program, and 21 postsecondary summer classes for high school students. For 22 the purposes of the bill, “direct care worker” means a home 23 health aide, a nursing assistant, and a personal care aide as 24 identified by the United States department of labor, bureau of 25 labor statistics. 26 DIVISION III. Division III of the bill establishes a direct 27 care worker tuition grant program. The bill provides that a 28 direct care worker tuition grant may be awarded to any resident 29 of Iowa who is admitted and in attendance as a full-time or 30 part-time student in a direct care worker career program to 31 pursue an associate’s degree or other training at a community 32 college in the state, and who establishes financial need. The 33 amount of a direct care worker tuition grant shall not exceed 34 the lesser of one-half of a student’s tuition and fees for an 35 -10- LSB 5439ST (7) 88 pf/rh 10/ 12

S.F. 2098 approved direct care worker career program or the amount of 1 the student’s established financial need. The bill provides a 2 time frame during which a student may receive a grant, provides 3 that a direct care worker tuition grant shall be awarded on an 4 annual basis, and requires reapplication by the student for 5 each year. Payments under the grant program shall be allocated 6 equally among the semesters or quarters of the year, and if 7 the student discontinues attendance before the end of any term 8 after receiving payment of the grant, the entire amount of any 9 refund due that student, up to the amount of any payments made 10 under the annual grant, shall be paid by the community college 11 to the state. If a student receives financial aid under any 12 other program, the full amount of that financial aid shall be 13 considered part of the student’s financial resources available 14 in determining the amount of the student’s financial need for 15 that period. The college student aid commission is authorized 16 to administer the program. 17 DIVISION IV. Division IV of the bill establishes a direct 18 care worker loan repayment program to increase the number of 19 direct care workers in the state. Under the program, loan 20 repayment may be made to a recipient for loans for educational 21 expenses incurred while completing an approved direct care 22 worker career program. The bill establishes the requirements 23 for applicants and the annual amount and duration of loan 24 repayment to be provided. The college student aid commission 25 is required to adopt administrative rules to determine eligible 26 loans and the evaluation criteria to be used in evaluating 27 applications submitted. The bill creates a direct care worker 28 loan repayment fund for deposit of moneys appropriated to or 29 received by the commission for use under the program. The bill 30 requires the commission to submit in a report to the general 31 assembly by January 1, annually, the number of individuals who 32 received loan repayment pursuant, where the participants were 33 employed, the amount paid to each program participant, and 34 other information identified by the commission as indicators of 35 -11- LSB 5439ST (7) 88 pf/rh 11/ 12