Congressman Matt Cartwright

Representing the 17th District of Pennsylvania
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Cartwright Introduces Legislation to Improve Quality of Health Care for Older Americans

Dec 8, 2016
Press Release

Washington, DC – Today, U.S. Rep. Matt Cartwright (PA-17) re-introduced legislation to improve the quality and lower the cost of health care for older Americans. 

The Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2016 (H.R. 6485) would establish demonstration projects to test models of care that use direct-care workers (DCWs) in advanced roles.  DCWs include nursing assistants, home health aides, and personal care aides and usually work in the client’s home or in residential settings such as nursing homes and assisted living facilities.  These workers are often responsible for treating the six in ten Americans 65 years old and over who suffer from multiple chronic conditions or are at risk of re-hospitalization.

“I am proud to introduce a bill that addresses the growing need for improved training and efficient use of direct-care workers,” said Cartwright.  “In Pennsylvania alone, older citizens comprise more than 15 percent of the population, and direct-care workers are among the fastest growing occupations in the state.  This legislation would help improve the care offered by direct-care workers and lower care costs for both older Americans and the health care industry.”

The Paraprofessional Healthcare Institute (PHI), a leading authority on direct care workers, has endorsed the bill.

According to Jodi M. Sturgeon, President of PHI, “This bill recognizes the untapped potential of the direct- care workforce to improve care and lower costs within new care coordination models.  With adequate training, compensation, and support, a newly created ‘advanced aide’ position could support health promotion, better chronic care management, and care transitions, resulting in less institutionalization and fewer re-hospitalizations.”

DCWs provide an estimated 70-80 percent of the long-term care and personal assistance received by older adults in the U.S.  However, DCWs are not often recognized as essential contributors to care teams.  Moreover, few programs exist to train DCWs for the advanced skills needed to support better health care and reduce re-hospitalizations.

The bill would amend Title IV of the Older Americans Act of 1965 to establish six, three-year demonstration projects.  All demonstrations would focus on care coordination and improved delivery of health services for older adults with chronic illness or at risk of re-hospitalization. Of the six demonstration projects:

  • Two will use the abilities of DCWs to promote smooth transitions in care and help to prevent unnecessary hospital readmissions. DCWs will be incorporated as essential members of interdisciplinary care coordination teams.
  • Two will focus on maintaining the health and improving the health status of older adults with multiple chronic conditions and long-term care needs. DCWs will help monitor health status, help consumers follow prescribed care, and educate the consumer and family caregiver(s).
  • Two will train DCWs to take on deeper clinical responsibilities related to specific diseases, such as Alzheimer’s, dementia, congestive heart failure, and diabetes. 
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