What This Bill Does
This bill extends an emergency waiver (a temporary permission to skip certain rules) that allows nursing facilities to train and certify nurse aides without following all normal requirements. The waiver was created during COVID-19 and this bill keeps it going for at least 24 months after the law passes, with some changes to how it works.
Who It Affects
Skilled nursing facilities (medical care centers for people needing round-the-clock nursing)
Nursing facilities (long-term care homes for elderly or disabled people)
Nurse aides (workers who provide direct patient care under supervision)
The federal government agency called the Secretary (who oversees Medicare and Medicaid)
Key Provisions
• The emergency waiver allowing nursing facilities to train and certify nurse aides without normal restrictions stays in effect for at least 24 months after this law is passed (Sec. 2(h)(1))
• Work hours a nurse aide completes during the COVID-19 emergency period can count toward the required 75 hours of minimum training, instead of requiring all new 75 hours (Sec. 2(h)(2)(A))
• Nursing facilities can give competency evaluations (tests to check if someone is qualified) at their own facility if the state does not offer them at least once a week (Sec. 2(h)(2)(B))
• Within one year of the law passing, the Secretary must study whether this waiver should continue and report findings to Congress (Sec. 2(h)(3))
What Changes
If this becomes law, nursing facilities gain more flexibility in training nurse aides by counting past emergency work hours and using facility-based evaluations when states do not provide frequent testing options.
Important Definitions
None defined in the bill text.
I
118TH CONGRESS
1ST SESSION
H. R. 468
To amend title XI of the Social Security Act to extend beyond the COVID–
19 emergency period, with certain modifications, the Emergency Declara-
tion Blanket Waiver relating to training and certification of nurse aides
to alleviate burdens imposed on staff of skilled nursing facilities and
nursing facilities.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 24, 2023
Mr. GUTHRIE (for himself, Ms. DEAN of Pennsylvania, Ms. STEFANIK, Ms.
HOULAHAN, Mrs. MILLER-MEEKS, Mr. COHEN, Mr. PENCE, Ms. ROSS,
Mr. ROSE, Mr. MEUSER, Ms. BROWN, Ms. KUSTER, Mr. GUEST, Ms.
CASTOR of Florida, Mr. BAIRD, Ms. BARRAGA´N, Mrs. HARSHBARGER,
Mr. PAPPAS, Mr. FERGUSON, Mr. SOTO, Mrs. SPARTZ, and Mr. SMITH
of Nebraska) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee
on Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To amend title XI of the Social Security Act to extend
beyond the COVID–19 emergency period, with certain
modifications, the Emergency Declaration Blanket Waiv-
er relating to training and certification of nurse aides
to alleviate burdens imposed on staff of skilled nursing
facilities and nursing facilities.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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•HR 468 IH
SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Building America’s
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Health Care Workforce Act’’.
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SEC. 2. EXTENSION AND MODIFICATION OF COVID–19
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EMERGENCY DECLARATION BLANKET WAIV-
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ER RELATING TO TRAINING AND CERTIFI-
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CATION OF NURSE AIDES FOR CERTAIN EM-
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PLOYMENT AT NURSING FACILITIES.
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Section 1135 of the Social Security Act (42 U.S.C.
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1320b–5) is amended—
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(1) in subsection (e)(1), by striking ‘‘A waiver’’
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and inserting ‘‘Subject to subsection (h), a waiver’’;
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and
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(2) by adding at the end the following new sub-
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section:
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‘‘(h) WAIVERS FOR NURSE AIDES IN TRAINING.—
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‘‘(1) IN
GENERAL.—Notwithstanding sections
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1819 and 1919, the emergency waiver of require-
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ments under section 483.35(d) of title 42, Code of
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Federal Regulations, relating to training and certifi-
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cation of nurse aides for employment by skilled
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nursing facilities under title XVIII and nursing fa-
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cilities under title XIX, granted by the Secretary
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under the COVID–19 Emergency Declaration Blan-
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ket Waivers for Health Care Providers pursuant to
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this section shall remain in effect, subject to para-
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•HR 468 IH
graph (2), for a period that is not less than 24
1
months after the date of the enactment of this sub-
2
section.
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‘‘(2) MODIFICATIONS.—For the period de-
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scribed in paragraph (1), the emergency waiver de-
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scribed in such paragraph shall be applied consistent
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with the following:
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‘‘(A) Notwithstanding sections 1819(f)(2)
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and 1919(f)(2), the waiver shall allow for time
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worked by a nurse aide during the emergency
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period described in subsection (g)(1)(B) to
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count toward the 75 hours minimum training
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described
in
sections
1819(f)(2)(A)
and
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1919(f)(2)(A).
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‘‘(B)
Notwithstanding
sections
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1819(f)(2)(B)(iii)(I) and 1919(f)(2)(B)(iii)(I),
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for purposes of sections 1819 and 1919, a com-
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petency evaluation of a nurse aide may be con-
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ducted at the skilled nursing facility or nursing
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facility at which the aide is (or will be) em-
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ployed if the State in which the facility is lo-
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cated does not offer such an evaluation (in per-
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son or online) at least once a week.
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‘‘(3) STUDY.—Not later than 1 year after the
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date of the enactment of this subsection, the Sec-
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•HR 468 IH
retary shall conduct a study, and submit to Congress
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a report, on the appropriateness of maintaining the
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waiver described in paragraph (1), as modified pur-
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suant to paragraph (2). Such study shall include an
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examination of the extent to which the waiver and
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its continuation pursuant to this subsection, as
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modified, alleviated the burdens imposed on staff of
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skilled nursing facilities and nursing facilities.’’.
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Æ
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