; bears to (2) the total number of individuals who are enrolled for medical assistance under the Medicaid programs of all States that submit to the Secretary an application that meets the requirements of subsection (b). (d) Use of grant funds (1) In general A State that receives a grant under this section shall use the funds of such grant in accordance with the requirements of this subsection. (2) Supplement, not supplant A State shall use funds from a grant awarded under this section to supplement, and not supplant, the level of State funds expended for services in long-term care settings through programs in effect as of January 1, 2025. (3) Required implementation of certain activities The State shall use funds from a grant awarded under this section to implement and evaluate, or supplement the implementation of, activities (which shall include the activities described in paragraph (4)) to enhance, expand, or strengthen long-term care services and to improve compensation to the workforce that provides such services. (4) Activities to strengthen and expand the direct care professional workforce (A) In general The State strengthens and expands the direct care professional workforce that provides services across long-term care settings by— (i) adopting a salary review process to ensure that the rates payable for long-term care services under the State Medicaid program are sufficient to ensure access to such services under such program; (ii) requiring that at least 85 percent of all payments for long-term care services that are made under the State Medicaid program, including base payments and supplemental payments, are for compensation to direct care professionals and direct care professional managers