Congressman Matt Cartwright

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

Apr 10, 2014
Press Release

Washington – Today, U.S. Rep. Matt Cartwright (D-PA) and U.S. Senator Bob Casey (D-PA) introduced bicameral 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 2014 would establish demonstration projects to test models of care that use direct-care workers (DCWs) in advanced roles.  Direct-care workers include home health aides, personal care aides, and certified nurse aides.  The majority of these professionals work in homes and nursing homes.  These workers are often responsible for treating the six in ten Americans over 65 years in age who suffer from multiple chronic conditions or are at-risk of re-hospitalization.

“I am proud to work with Senator Casey to address 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 the direct-care workforce is 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.”

“This legislation will improve the quality of care for seniors living at home by expanding the training and support of the direct care workforce that care for these seniors,” Senator Casey said.  “I’m pleased to work with Congressman Cartwright on this initiative.  This legislation is a commonsense plan to improve the health of seniors.”

DCWs provide an estimated 70-80 percent of the long-term care and personal assistance received by older adults in the U.S.  These workers help with numerous daily tasks including bathing and dressing their clients.  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.

The Paraprofessional Healthcare Institute (PHI) and the Caregiver Action Network have both endorsed the bill.

According to Steve Edelstein, National Policy Director at 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.”

“Family caregivers rely on direct-care workers to provide the lion’s share of in-home paid care for their elderly loved ones.  The demands on these workers are constantly increasing as the American population ages,” said John Schall, CEO of Caregiver Action Network.  “This bill will test new ways for direct-care workers to improve the quality of care and lower costs.  This is exactly what older Americans and their over-burdened families members so desperately need.”