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Today, U.S. Representative Matt Cartwright 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 would establish demonstration projects to test models of care that use direct-care workers (DCWs) in advanced roles. These demonstration projects would study care coordination and improved delivery of health services for older adults with chronic illness or at-risk of re-hospitalization.

“We must address the growing need for improved training and efficient use of direct-care workers,” said Rep. 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.”

DCWs include nursing assistants, home health aides, or personal care aides, and often work in the client’s home or in residential settings such as nursing homes and assisted living facilities. These workers provide 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. 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) endorsed this legislation. 

“This bill would improve both the quality of jobs for direct care workers nationwide, as well as the care they deliver, by helping to create expanded roles with sufficient training and compensation, and by helping them support people with increased complex conditions including Alzheimer’s Disease and related dementias, congestive heart failure, diabetes, and other chronic disease,” said Jodi M. Sturgeon, President of PHI. “In a time when providers are struggling to recruit and retain direct care workers, and the paid caregiving shortage continually worsens, we need innovative, pro-active solutions that make these jobs more satisfying and that improve the coordination and quality of care.”