Reintroducing a bill in Congress is often the political equivalent of introducing your shy cousin “who has a good personality” to yet another of the most popular girls or guys in your circle.
The odds of a sweetheart relationship are dead on arrival. But whether it was Mom or a special interest group, somebody put you up to going through the motions anyway.
So is that the case with this week’s reintroduction of a bill that would waive certain training requirements for certified nurse aides for two years after the public health emergency is ended? Not exactly.
Reps. Brett Guthrie (R-KY) and Madeleine Dean (D-PA) made a big splash in provider circles Wednesday when they reintroduced the Building America’s Health Care Workforce Act.
An earlier version rounded up 44 cosponsors — 10% of the US House — but it died on the vine, never advancing out of committee.
The status quo has changed, however. Guthrie is now chairman of the House Energy and Commerce Committe’s health subcommittee. Leaders of committees can hold tremendous sway.
Perhaps the most powerful recent reminder of this is when then-Senate Majority Leader Mitch McConnell refused in 2016 to allow a confirmation hearing for Merrick Garland, who was then-President Obama’s choice to fill a vacant Supreme Court seat. McConnell, who was echoed by the 11 Republicans on the Judiciary Committee, said it did not matter that Obama still had 11 months left in his presidency and that there were still nine months before the election to determine who would succeed him. Garland, a veteran jurist who had enjoyed support from both sides of the aisle previously, never got as much as a pre-hearing interview on his nomination.
The stakes and leverage aren’t quite as dramatic now with Guthrie and the nurse-aide training bill. But the point that the game has changed — if players want to take it in a new direction — is well taken.
Critics might point out that keeping lesser-trained aides on the floor could be dangerous, but Guthrie pointed out that competency checks have been put in place.
Others will note that the federal Centers for Medicare & Medicaid Services has granted waivers to more than a dozen states. But needy pockets exist in every state and a federal standard should blanket the country.
Proponents of the extension — who include the major nursing home associations and their minions — remind that in many instances this is merely an administrative issue. There are many trained, experienced aides awaiting clearance testing. The capacity to assess them, however, doesn’t exist.
Which brings up another of the elephants in the room: Without allowing more aides to stay on the floor, there will be even fewer floors and corridors to service needy seniors. Financial struggles and staffing shortages have continued to shrink the US’s skilled nursing capacity.
Overseers, including lawmakers and federal regulators, seem to have acknowledged that the skilled nursing business is not merely a bunch of burger joints fighting for market share.
Now it’s up to them to start acting like it, in the best interests of their frail and elderly citizens — and those who want to take care of them under reasonable conditions.
James M. Berklan is McKnight’s Executive Editor.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
