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PRESS RELEASE: Senator Casey's Bill to Maximize Direct-Care Workers' Role in New Care Models Aims to Improve Elder Care and Reduce Costs

December 13, 2011

New Care Coordination Models Could Improve Jobs and Care

New York, NY — PHI strongly supports legislation introduced by U.S. Senator Robert Casey (D-PA) today to test new models of care coordination and service delivery that deploy direct-care workers (DCWs) in advanced roles to improve the efficiency and quality of care for frail elders in our health care system.

The Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2011 [S. 1982] would amend the Older Americans Act of 1965 to establish six three-year demonstrations that will focus on care coordination and service delivery redesign for older adults with chronic illness or at-risk of institutional placement.

Direct-care workers — nursing aides, home health aides, and personal care aides — provide an estimated 70 to 80 percent of the paid hands-on long-term care and personal assistance received by frail older adults and others in the U.S. Many experts believe that, with the right training, these three million workers, who are in daily contact with elders, can bring greater value to our health care system.

"Direct-care workers are key to providing services that improve the health of older Americans and reduce re-hospitalizations, vastly improving the quality of life for our older citizens and reducing costs and strain on the entire healthcare industry," said Senator Casey, a leader in supporting solutions that will improve care for America's elders by investing in the direct-care workforce.

"My legislation will help to better train and utilize direct-care workers to lower the cost and improve the quality of healthcare provided to older Americans," Casey said.

"This bill recognizes the untapped potential of the direct-care workforce to improve care and lower costs within new care coordination models," said Steven Dawson, president of PHI, the nation's leading expert on the direct-care workforce, which advised Senator Casey on the advanced aide concept.

"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," Dawson said.

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.

Selected entities will receive funding for one year of planning activities, including identifying competencies, designing curricula, and articulating a plan for achieving long-term financial sustainability. Planning grants will be followed by two years of funding to implement advanced training and competency evaluation of direct-care workers and other care team members.

Read the backgrounder (pdf) for more information on the Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2011.

Fastest-Growing Workforce in the Nation

More than 3 million direct-care workers were employed in 2008 to provide long-term services and supports.

Direct-care worker occupations are among the top 10 fastest-growing occupations in the nation. With a rapidly aging population, it is anticipated that the demand for these services will generate the most new jobs — 1.1 million — across the entire economy by 2018.

For more information about the direct-care workforce, read PHI FACTS 3 — Who Are Direct-Care Workers? (pdf) and visit PHI PolicyWorks for other resources, including the PHI State Data Center on the direct-care workforce.

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PHI ( is a national organization that works to improve the lives of people who need home or residential care — and of the direct-care workers who provide that care. PHI's work is grounded in the philosophy that quality jobs for direct-care workers will lead to quality care for long-term care consumers.


Carol Regan, PHI Government Affairs Director
202-223-8355; 301-580-9418 (cell)

Deane Beebe, PHI Media Relations Director
718-928-2033; 646-285-1039 (cell)

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