; wages and earnings for home care workers are even lower in rural areas. Because of low wages, variable work hours, and the inability to access workplace-based benefits, 19 percent of home care workers live below the Federal poverty level as compared to 9 percent of the general United States workforce. Nearly half of direct care workers rely on some form of public assistance to support themselves and their families. (8) According to PHI, approximately 9 in 10 direct care workers are women, more than half are women of color, and one quarter of direct care workers are immigrants. (9) The direct care workforce is plagued with high turnover, low job satisfaction, and workforce shortages. These conditions can contribute to reduced quality of care and threaten the availability of supports for older individuals and individuals with disabilities. (10) Because of the nature of the work, direct care workers suffer from disproportionately high rates of injury. In 2016, the injury rate for nursing assistants was 337 per 10,000 as compared to 100 per 10,000 for other occupations. (11) Training has been shown to reduce worker turnover, reduce rates of injury, and lead to increased job satisfaction. (12) The Institute of Medicine found that to ensure that the United States is prepared to meet the health care needs of older individuals during the 21st century, it is essential that the capacity of the direct care workforce be enhanced in both the number of workers available and their ability to meet their own health care and quality of life needs. 3. Definitions In this Act: (1) Apprenticeship program The term apprenticeship program means an apprenticeship program registered under the Act of August 16, 1937 (commonly known as the National Apprenticeship Act ; 50 Stat. 664, chapter 663; 29 U.S.C. 50 et seq.). (2) Direct care worker The term direct care worker has the meaning given the term in section 799B of the Public Health Service Act ( 42 U.S.C. 295p ). (3) Eligible entity The term eligible entity means— (A) a State