Policy Impact Analysis - 117/HR/7744

Bill Overview

Title: Building America’s Health Care Workforce Act

Description: This bill extends certain flexibilities relating to training and competency requirements for nurse aides in Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities (NFs). Generally, SNFs and NFs may not hire nurse aides for longer than four months unless they meet certain training and certification requirements. The Centers for Medicare & Medicaid Services waived some of these requirements during the COVID-19 emergency period so as to allow facilities to maintain adequate staffing levels; the waiver ends in June 2022. The bill extends these flexibilities for at least two years after the bill's enactment and specifies that (1) any time worked by a nurse aide during the emergency period counts toward the 75 hours required for initial training, and (2) a competency evaluation may be conducted at the SNF or NF where the nurse aide is employed if the state does not offer such an evaluation at least once a week.

Sponsors: Rep. Guthrie, Brett [R-KY-2]

Target Audience

Population: Nurse aides in SNFs and NFs around the world

Estimated Size: 300000

• The bill impacts nurse aides who are working or seeking to work in Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs) across the United States, as it involves their training and competency evaluations.
• The bill affects healthcare facilities that employ nurse aides by allowing more flexibility in hiring and maintaining their staff, thereby affecting facilities’ operations and staffing strategies.
• Families and patients who receive care in SNFs and NFs may be indirectly impacted due to potential changes in the workforce availability and competency due to this bill.
• The original waiver by the CMS was applicable during the COVID-19 pandemic and was meant to ensure adequate staffing levels; this bill seeks to extend some of that flexibility.
• It is not directly stated, but the bill might implicitly impact state regulatory bodies and workforce certification processes as it alters requirements for training and competency evaluation.

Reasoning

• Given the budget constraints, the policy likely prioritizes areas with a higher need for workforce support, particularly in SNFs and NFs with chronic understaffing issues.
• The target population primarily includes nurse aides, who are the frontline workers in SNFs and NFs. The policy helps by reducing barriers to long-term employment and ensuring these individuals can continue working in their roles without disruption.
• Facility administrators could benefit from this policy as it provides them with more flexibility in maintaining their workforce, potentially reducing turnover rates and ensuring better patient care consistency.
• There could be indirect impacts on the families and patients due to improved staffing levels and continuity of care, which can improve their well-being.
• The policy could indirectly affect state regulatory bodies as they may need to adjust training protocols and evaluation processes to accommodate these changes.

Simulated Interviews

Cost Estimates

Key Considerations

• The main cost consideration is administrative in nature, concerning the certification and training processes of nurse aides which may have deferred costs.
• Savings are primarily in operational efficiencies and potentially reduced state-level oversight burdens.
• As this policy provides temporary flexibility, the long-term financial impacts are likely minor and indirect.