Title 42The Public Health and WelfareRelease 119-73not60

§1397m Enhancement of Long-term Care

Title 42 › Chapter 7— SOCIAL SECURITY › Subchapter XX— BLOCK GRANTS AND PROGRAMS FOR SOCIAL SERVICES AND ELDER JUSTICE › Part II— Programs To Promote Elder Justice › § 1397m

Last updated Apr 5, 2026|Official source

Summary

The Secretary must run programs to get more people to train for, take, and keep jobs that give direct care in long-term care settings. The Secretary will work with the Secretary of Labor and can give grants to eligible organizations to offer continuing training, different levels of certification based on how workers perform and how much direct care they give, and bonuses or higher pay for workers who earn certification. Grants can also pay for training and advice to improve management and keep caregivers, using proven practices like better pay tied to job reviews, respectful workplace culture, and extra on-the-job training. Organizations must apply for grants, and the Secretary may limit how many get grants. The law requires measures to show the money actually helps direct care workers and makes the long-term care workforce more stable. “Community-based long-term care” is defined by the Secretary. An “eligible entity” is either a long-term care facility or a community-based long-term care provider. The Secretary can also give grants to help long-term care facilities buy, lease, or set up certified electronic health record (EHR) technology to improve patient safety and cut medication errors. Grant money may pay for software, hardware, upgrades for e-prescribing, and staff training. Grantees must, where available, join state coordination efforts. The Secretary must set tech standards for clinical data that match other federal health IT rules and, not later than 10 years after March 23, 2010, must have ways to accept optional electronic data from facilities (but facilities are not forced to send data). The Secretary will make rules requiring states that get funds to collect and report needed data. Funding authorized: $20,000,000 for fiscal year 2011; $17,500,000 for fiscal year 2012; and $15,000,000 for each of fiscal years 2013 and 2014.

Full Legal Text

Title 42, §1397m

The Public Health and Welfare — Source: USLM XML via OLRC

(a)(1)The Secretary shall carry out activities, including activities described in paragraphs (2) and (3), to provide incentives for individuals to train for, seek, and maintain employment providing direct care in long-term care.
(2)(A)The Secretary shall coordinate activities under this subsection with the Secretary of Labor in order to provide incentives for individuals to train for and seek employment providing direct care in long-term care.
(B)(i)The Secretary shall make grants to eligible entities to carry out programs through which the entities—
(I)offer, to employees who provide direct care to residents of an eligible entity or individuals receiving community-based long-term care from an eligible entity, continuing training and varying levels of certification, based on observed clinical care practices and the amount of time the employees spend providing direct care; and
(II)provide, or make arrangements to provide, bonuses or other increased compensation or benefits to employees who achieve certification under such a program.
(ii)To be eligible to receive a grant under this subparagraph, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require (which may include evidence of consultation with the State in which the eligible entity is located with respect to carrying out activities funded under the grant).
(iii)Nothing in this subparagraph shall be construed as prohibiting the Secretary from limiting the number of applicants for a grant under this subparagraph.
(3)(A)The Secretary shall make grants to eligible entities to enable the entities to provide training and technical assistance.
(B)An eligible entity that receives a grant under subparagraph (A) shall use funds made available through the grant to provide training and technical assistance regarding management practices using methods that are demonstrated to promote retention of individuals who provide direct care, such as—
(i)the establishment of standard human resource policies that reward high performance, including policies that provide for improved wages and benefits on the basis of job reviews;
(ii)the establishment of motivational and thoughtful work organization practices;
(iii)the creation of a workplace culture that respects and values caregivers and their needs;
(iv)the promotion of a workplace culture that respects the rights of residents of an eligible entity or individuals receiving community-based long-term care from an eligible entity and results in improved care for the residents or the individuals; and
(v)the establishment of other programs that promote the provision of high quality care, such as a continuing education program that provides additional hours of training, including on-the-job training, for employees who are certified nurse aides.
(C)To be eligible to receive a grant under this paragraph, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require (which may include evidence of consultation with the State in which the eligible entity is located with respect to carrying out activities funded under the grant).
(D)Nothing in this paragraph shall be construed as prohibiting the Secretary from limiting the number of applicants for a grant under this paragraph.
(4)The Secretary shall develop accountability measures to ensure that the activities conducted using funds made available under this subsection benefit individuals who provide direct care and increase the stability of the long-term care workforce.
(5)In this subsection:
(A)The term “community-based long-term care” has the meaning given such term by the Secretary.
(B)The term “eligible entity” means the following:
(i)A long-term care facility.
(ii)A community-based long-term care entity (as defined by the Secretary).
(b)(1)The Secretary is authorized to make grants to long-term care facilities for the purpose of assisting such entities in offsetting the costs related to purchasing, leasing, developing, and implementing certified EHR technology (as defined in section 1395w–4(o)(4) of this title) designed to improve patient safety and reduce adverse events and health care complications resulting from medication errors.
(2)Funds provided under grants under this subsection may be used for any of the following:
(A)Purchasing, leasing, and installing computer software and hardware, including handheld computer technologies.
(B)Making improvements to existing computer software and hardware.
(C)Making upgrades and other improvements to existing computer software and hardware to enable e-prescribing.
(D)Providing education and training to eligible long-term care facility staff on the use of such technology to implement the electronic transmission of prescription and patient information.
(3)(A)To be eligible to receive a grant under this subsection, a long-term care facility shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require (which may include evidence of consultation with the State in which the long-term care facility is located with respect to carrying out activities funded under the grant).
(B)Nothing in this subsection shall be construed as prohibiting the Secretary from limiting the number of applicants for a grant under this subsection.
(4)A long-term care facility that receives a grant under this subsection shall, where available, participate in activities conducted by a State or a qualified State-designated entity (as defined in section 300jj–33(f) of this title) under a grant under section 300jj–33 of this title to coordinate care and for other purposes determined appropriate by the Secretary.
(5)The Secretary shall develop accountability measures to ensure that the activities conducted using funds made available under this subsection help improve patient safety and reduce adverse events and health care complications resulting from medication errors.
(c)(1)The Secretary shall adopt electronic standards for the exchange of clinical data by long-term care facilities, including, where available, standards for messaging and nomenclature. Standards adopted by the Secretary under the preceding sentence shall be compatible with standards established under part C of subchapter XI, standards established under subsections (b)(2)(B)(i) and (e)(4) of section 1395w–104 of this title, standards adopted under section 300jj–14 of this title, and general health information technology standards.
(2)(A)Not later than 10 years after March 23, 2010, the Secretary shall have procedures in place to accept the optional electronic submission of clinical data by long-term care facilities pursuant to the standards adopted under paragraph (1).
(B)Nothing in this subsection shall be construed to require a long-term care facility to submit clinical data electronically to the Secretary.
(3)The Secretary shall promulgate regulations to carry out this subsection. Such regulations shall require a State, as a condition of the receipt of funds under this part, to conduct such data collection and reporting as the Secretary determines are necessary to satisfy the requirements of this subsection.
(d)There are authorized to be appropriated to carry out this section—
(1)for fiscal year 2011, $20,000,000;
(2)for fiscal year 2012, $17,500,000; and
(3)for each of fiscal years 2013 and 2014, $15,000,000.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

Part C of subchapter XI, referred to in subsec. (c)(1), is classified to section 1320d et seq. of this title.

Reference

Citations & Metadata

Citation

42 U.S.C. § 1397m

Title 42The Public Health and Welfare

Last Updated

Apr 5, 2026

Release point: 119-73not60