A key House committee this week advanced several bills designed to ease nursing home hiring and ensure expanded access to telehealth for another two years.

The Telehealth Modernization Act of 2024, as amended Wednesday, would extend flexibilities first authorized during the COVID-19 public health emergency. The legislation would allow therapists and speech-language pathologists to provide telehealth services and continue the suspension of rules that limited telehealth use by geographic location.

Instead of the provisions expiring at the end of the year; the extension would run through 2026.

Skilled nursing providers, especially those in rural areas, have used the expansion of telehealth to bring in additional specialty care, help avoid unnecessary hospitalizations, and treat in place patients who might be vulnerable in repeated trips to off-site clinicians.

The House Committee on Energy and Commerce on Wednesday also approved the Building America’s Health Care Workforce Act and Ensuring Seniors’ Access to Quality Care Act. Both bills would improve CNA training for nursing homes.

Their path to full House passage remains unclear. While the bills could be tacked on to a broader government funding bill, House leadership has so far been unable to secure the votes needed to pass a continuing resolution that would keep the government open after most funding runs out Sept. 30.

Boosting the CNA ranks

For now, however, long-term care advocates are cheering the attention to high-priority issues that have dragged on throughout this session of Congress.

“We applaud Chairwoman [Cathy] McMorris Rodgers (R-WA) and members of the committee for their commitment to passing real solutions that will help long-term care facilities build a strong labor force,” said Clif Porter, senior vice president of government relations and incoming president & CEO of the American Health Care Association/National Center for Assisted Living. “CNAs are an integral part of nursing home staff, and these bills will create a more viable path to train and develop these crucial caregivers.”

Building America’s Health Care Workforce Act would give assistant nurse aides working in nursing homes 24 months to become CNAs, instead of the current four months. The legislation would also allow assistant nurse aides to apply their on-the-job experience and training toward the 75-hour federal training requirement to become a CNA.

Skilled nursing providers found success with a similar allowance during the public health emergency, but consumer advocates have battled against the bill, arguing it erodes care quality.

The Ensuring Seniors’ Access to Quality Care Act would allow nursing homes that have received significant civil monetary penalties to once again run in-house CNA training programs to resume those programs, once deficiencies are corrected.

Symbolism praised, prescribing help sought

Despite what looks like a win on one telehealth front, ATA Action, the lobbying arm of the American Telemedicine Association, said in a statement that it was still looking for Congress to tackle related challenges before the end of the year.

“An additional, critical telehealth priority supported by ATA Action, which, like many other flexibilities, has been in place for nearly half a decade, is the remote prescribing of controlled substances. If left unaddressed, this issue could create dire consequences,” said Kyle Zebley, senior vice president of public policy and ATA executive director.

 “We urgently request that Congress press the DEA to sustain these vital flexibilities by issuing a special registration proposed rule and extending the current waivers for two more years, alongside other Medicare telehealth flexibilities. With limited time left in the year, prescribers, patients, and stakeholders are not equipped to adapt to a new rule immediately.”

Porter also praised the committee’s willingness to pass a Congressional Review Act resolution (H.J.Res.139) that seeks to overturn the Biden administration’s nursing home staffing staffing mandate.

The vote was largely symbolic. Senate Republicans said earlier this week they do not plan to press for a vote on the CRA, leaving the House bill dead in the water. Still, Porter supported the message being sent by House Republicans.

“The vote to overturn the staffing mandate underscores the flawed approach taken by the administration to demand more staff without any substantive support and in the midst of a growing caregiver shortage,” Porter said. “We urge Congress to advance these bills, and we look forward to working with lawmakers to pass additional supportive measures that will strengthen the long term care workforce and safeguard seniors’ access to quality care.”