To provide low-income individuals with opportunities to enter and follow a career pathway in the health professions, and for other purposes.

Bill Number

H.R. 5370

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-09-16: Referred to the House Committee on Ways and Means.

Last Updated

2026-05-30T08:05:49Z

AI-Generated Summary

Purpose of the Legislation

The Pathways to Health Careers Act (H.R. 5370) aims to expand opportunities for low-income individuals to enter and advance in well-paying health professions careers. It does this by authorizing grants to support training programs, focusing on career pathways that combine education, skills development, and job placement in high-demand health roles. The bill emphasizes addressing workforce shortages and barriers faced by specific groups, such as those with criminal records or interest in maternal health services.

Key Provisions

• Grant Applications and Eligibility: Eligible organizations (e.g., workforce boards, states, tribes, colleges, hospitals, nonprofits) must submit detailed plans showing how they will use a "career pathway" approach—meaning a series of connected steps like basic education, training, and job support—to prepare low-income individuals (family income ≤200% of federal poverty level) for health jobs. Applications must include recruitment strategies, support services (e.g., child care, transportation), and consultations with local workforce boards.

• Preferences for Grant Awards: The Secretary of Health and Human Services (HHS) prioritizes applications from prior grantees, those with strong partnerships (e.g., government agencies, employers, unions), projects serving rural areas, and those offering stipends, mentoring, or emergency funds.

• Types of Grants:
• Competitive Grants: Awarded to train individuals for roles like allied health professionals (e.g., medical assistants), nurses, emergency medical technicians, and others. At least two grants per state (non-territories), plus dedicated grants for Indian tribes/tribal organizations (at least 10) and territories (at least 2).
• Demonstration Projects (5-year minimum duration):
• 25% of demonstration funds for projects helping individuals with arrest or conviction records enter health careers, requiring state policies allowing credentials despite records and plans for legal support.
• 25% for maternal health pathways in states recognizing doulas (non-medical birth supporters) or midwives, including training for pregnancy/postpartum roles.
• Grants run in 5-year cycles, with up to 12 months for planning.

• Use of Grant Funds: Required elements include basic skills assessments, guaranteed child care and transportation, ongoing career coaching/mentoring, and training leading to recognized credentials (e.g., certificates for job skills). Allowed uses cover stipends, emergency aid, tuition, uniforms, and legal help for criminal record barriers. At least 10% of participants in certain states must qualify for Temporary Assistance for Needy Families (TANF). Funds cannot support entertainment, except milestone celebrations.

• Income Disregard: Stipends or emergency payments to participants are not counted as taxable income, and no tax reporting is required for these payments.

• Technical Assistance and Evaluation: HHS provides tailored support, including peer conferences. Demonstration projects undergo rigorous evaluations (e.g., identifying best practices for workforce development). Grantees submit interim and final reports on outcomes like graduation rates, employment, and earnings.

• Funding: $435 million annually for fiscal years 2026–2030, allocated as: 75% for competitive grants, 4% for tribes, 5% for territories, 6% for demonstrations, 6% for technical assistance/staffing, and 4% for evaluations. $10 million yearly reserved for hiring/retaining 25 HHS civil servants to administer and evaluate the program.

• Reporting to Congress: Annual reports on participant demographics, outcomes, best practices, grant processes, and staffing. A one-time federal workforce analysis and ongoing summaries of prior program evaluations.

• Definitions: Key terms include "allied health profession" (support roles like therapists or technicians), "career pathway" (step-by-step progression to better jobs), "doula" (trained birth supporter), "eligible individual" (low-income), and others specifying entities like tribes and territories.

Significant Changes to Existing Law

This bill fully replaces Section 2008 of the Social Security Act (42 U.S.C. 1397g), which previously authorized Health Profession Opportunity Grants (HPOG). Key updates include:

• Introducing two new demonstration project types (for criminal records and maternal health), with minimum funding allocations.
• Adding guarantees for grants in every state, tribes, and territories.
• Expanding support services (e.g., mandatory child care/transportation, legal aid for records).
• Increasing funding scale and duration (5-year cycles vs. prior shorter terms).
• Prioritizing experienced HHS civil servants for administration and exempting these grants from some general subtitle rules, while applying certain fund-use limits.
• Enhancing evaluations and reporting, including long-term impact studies of prior HPOG grants.

Potential Impacts

• On Citizens: Low-income individuals gain better access to training and jobs in health fields, potentially increasing earnings, credentials, and employment stability. It targets barriers like criminal records or family needs, benefiting underserved groups (e.g., TANF-eligible, rural residents, tribes). Could reduce health workforce shortages by filling in-demand roles.

• On Government Agencies: HHS (via Administration for Children and Families) faces increased administrative duties, including grant awards, technical assistance, evaluations, and staffing (at least 25 new civil servants). Requires coordination with Labor and Education Departments (and Attorney General for some projects). States may need to align policies for credentials and maternal health recognition.

• On International Relations: No direct impacts; the bill is domestic-focused on U.S. workforce development.

Main Stakeholders Affected

• Low-Income Individuals: Primary beneficiaries, including TANF-eligible, those with criminal records, rural residents, and tribal members seeking health careers.
• Eligible Entities: Grantees like workforce boards, states/local governments, tribes/tribal colleges, universities, hospitals, nonprofits, and health centers responsible for program delivery.
• Health Employers and Partners: Hospitals, clinics, unions, and sector partnerships involved in hiring, apprenticeships, and training.
• Government Entities: HHS for administration/evaluation; state agencies for policy alignment (e.g., licensing); Labor/Education Departments for consultations.
• Communities: Rural areas, territories, and tribal populations with guaranteed funding access; families via support services.

Notable Legal, Constitutional, or Political Implications

• Legal: Establishes spending authority under the Social Security Act, with tax exemptions for stipends (avoiding IRS reporting). Requires states to have supportive policies for demonstrations, potentially influencing licensing laws without mandating changes. Evaluations may use randomized trials but are not required, allowing flexibility.

• Constitutional: Aligns with Congress's spending power (Article I, Section 8) to promote general welfare through workforce grants. No apparent free speech, due process, or equal protection issues; promotes equity for marginalized groups (e.g., criminal record holders) via rehabilitation opportunities.

• Political: Builds on existing HPOG program, signaling continuity in addressing health workforce needs amid shortages. Emphasizes equity (e.g., for tribes, territories, maternal health), which could foster bipartisan support, though introduced by Democrats. Requires congressional oversight via reports, ensuring accountability for federal funds.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Davis, Danny K. [D-IL-7]

Cosponsors (16)

Rep. Neal, Richard E. [D-MA-1], Rep. Doggett, Lloyd [D-TX-37], Rep. Thompson, Mike [D-CA-4], Rep. Larson, John B. [D-CT-1], Rep. Sewell, Terri A. [D-AL-7], Rep. Chu, Judy [D-CA-28], Rep. Moore, Gwen [D-WI-4], Rep. Boyle, Brendan F. [D-PA-2], Rep. Evans, Dwight [D-PA-3], Rep. Schneider, Bradley Scott [D-IL-10], Rep. Panetta, Jimmy [D-CA-19], Rep. Horsford, Steven [D-NV-4], Rep. Gomez, Jimmy [D-CA-34], Del. Plaskett, Stacey E. [D-VI-At Large], Rep. Suozzi, Thomas R. [D-NY-3], Rep. Salinas, Andrea [D-OR-6]

Recent Actions

• 2025-09-16: Referred to the House Committee on Ways and Means.
• 2025-09-16: Introduced in House
• 2025-09-16: Introduced in House

Bill Versions

• Pathways to Health Careers Act — issued 2025-09-16 — PDF (33 pages)