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-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Building America’s 
Health Care Workforce Act’’. 
SEC. 2. EXTENSION AND MODIFICATION OF COVID–19 
EMERGENCY DECLARATION BLANKET WAIV-
ER RELATING TO TRAINING AND CERTIFI-
CATION OF NURSE AIDES FOR CERTAIN EM-
PLOYMENT AT NURSING FACILITIES. 
Section 1135 of the Social Security Act (42 U.S.C. 
1320b–5) is amended— 
(1) in subsection (e)(1), by striking ‘‘A waiver’’ 
and inserting ‘‘Subject to subsection (h), a waiver’’; 
and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) WAIVERS FOR NURSE AIDES IN TRAINING.— 
‘‘(1) IN
GENERAL.—Notwithstanding sections 
1819 and 1919, the emergency waiver of require-
ments under section 483.35(d) of title 42, Code of 
Federal Regulations, relating to training and certifi-
cation of nurse aides for employment by skilled 
nursing facilities under title XVIII and nursing fa-
cilities under title XIX, granted by the Secretary 
under the COVID–19 Emergency Declaration Blan-
ket Waivers for Health Care Providers pursuant to 
this section shall remain in effect, subject to para-
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graph (2), for a period that is not less than 24 
months after the date of the enactment of this sub-
section. 
‘‘(2) MODIFICATIONS.—For the period de-
scribed in paragraph (1), the emergency waiver de-
scribed in such paragraph shall be applied consistent 
with the following: 
‘‘(A) Notwithstanding sections 1819(f)(2) 
and 1919(f)(2), the waiver shall allow for time 
worked by a nurse aide during the emergency 
period described in subsection (g)(1)(B) to 
count toward the 75 hours minimum training 
described 
in 
sections 
1819(f)(2)(A) 
and 
1919(f)(2)(A). 
‘‘(B) 
Notwithstanding 
sections 
1819(f)(2)(B)(iii)(I) and 1919(f)(2)(B)(iii)(I), 
for purposes of sections 1819 and 1919, a com-
petency evaluation of a nurse aide may be con-
ducted at the skilled nursing facility or nursing 
facility at which the aide is (or will be) em-
ployed if the State in which the facility is lo-
cated does not offer such an evaluation (in per-
son or online) at least once a week. 
‘‘(3) STUDY.—Not later than 1 year after the 
date of the enactment of this subsection, the Sec-
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retary shall conduct a study, and submit to Congress 
a report, on the appropriateness of maintaining the 
waiver described in paragraph (1), as modified pur-
suant to paragraph (2). Such study shall include an 
examination of the extent to which the waiver and 
its continuation pursuant to this subsection, as 
modified, alleviated the burdens imposed on staff of 
skilled nursing facilities and nursing facilities.’’. 
Æ 
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