By Representative Matt Cartwright (17-PA)
Currently, 62 percent of Americans ages 65 and older suffer from multiple chronic conditions which require person-centered, coordinated care. Direct Care Workers (DCWs), such as nursing assistants, home health aides, or personal care aides provide an estimated 70 to 80 percent of the paid, hands-on, long-term care and personal assistance received by older adults in the U.S. DCWs are not, however, often recognized as essential contributors to care teams. Few existing models provide DCWs with the advanced training necessary to take on increased responsibilities.
As the demographics of America shift, health care services must evolve to meet new and increasing demands. The main factor driving projected growth in federal spending on major health care programs is the aging population. The Congressional Budget Office (CBO) has projected that the number of people age 65 or older will increase by roughly one-third over the next decade, and 80 percent by 2039.
Increasing life expectancy, longer retirements, and an increase in the number of retirees all mean that a larger share of the population will be utilizing health services and receiving benefits from Medicare. DCW jobs are currently among the fastest-growing occupations in the country, though their training programs and earnings fail to reflect their incredibly important roles. A recent report by the Brookings Institute found that personal care aides, and nursing, psychiatric and home health aides have median earnings of $21,000 and $25,000 respectively.
It is time to invest in these essential caregivers and our seniors. It is for this reason that I introduced H.R. 4445, the Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2014. The bill would amend the Older Americans Act of 1965 to establish six, three-year demonstration projects to test models of care using direct-care workers in advanced roles. These demonstrations would focus on care coordination and improved delivery of health services for older adults with chronic illness or at-risk of re-hospitalization. Two projects would train DCWs to take on increased responsibilities related to caring for patients with specific diseases, including Alzheimer’s, dementia, congestive heart failure, and diabetes. Two additional projects would include DCWs as members of interdisciplinary care coordination teams and use their abilities to promote smooth transitions in care. The final two would use DCWs to monitor patient health status, help consumers follow prescribed care, and educate consumers and family caregiver(s).
Investing in an advanced aide role for DWCs will not only lead to less institutionalization and fewer re-hospitalizations, but will improve quality of life for seniors and reduce costs, reducing the overall burden on the health care industry. Seniors deserve to stay in their homes as they age, enjoy a high quality of life, all while receiving high quality, cost-effective care. The Advanced Aide Act will ensure that this is attainable.
