Bicameral Bill Introduced to Test Advanced Roles for Aides

Sen. Bob Casey (D-PA) and Rep. Matt Cartwright (D-PA) introduced bicameral legislation on April 10 to boost the role of direct-care workers in improving the health care of older Americans.

The Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2014 (pdf) would establish demonstration projects to test models of care that use direct-care workers in advanced roles.

Direct-care workers provide an estimated 70-80 percent of the paid 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, they are not often recognized as essential contributors to care teams.

Moreover, few programs exist to train direct-care workers for the advanced skills needed to support better health care and reduce re-hospitalizations.

Demonstration Projects

The bill would create six three-year demonstration projects:

• Two would incorporate direct-care workers into interdisciplinary care coordination teams to promote smooth care transitions and prevent unnecessary re-hospitalizations;
• Two would have direct-care workers take on a greater role in monitoring, maintaining, and improving their consumers’ health status; and
• Two would train direct-care workers to care for specific diseases and conditions, including dementia, diabetes, and congestive heart failure.

“I am proud to work with Senator Casey to address the growing need for improved training and efficient use of direct-care workers,” Cartwright said. 

“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,” he continued. “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 bill is supported by advocates for consumers and workers alike.

“Family caregivers rely on direct-care workers to provide the lion’s share of in-home paid care for their elderly loved ones,” said John Schall, CEO of Caregiver Action Network. “The demands on these workers are constantly increasing as the American population ages. 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 family members so desperately need.”

Partnerships of health service providers, including at least one long-term care facility or home and personal care service provider, are encouraged to apply for demonstration funding if the bill passes into law.

— by Gail MacInnes, PHI National Policy Analyst