From: The Honorable Matt Cartwright
Sent By:
Bill: H.R. 4445
Date: 7/11/2014

Cosponsors (House): Grayson, Jackson Lee, Rangel, Jeffries, Shea-Porter

Cosponsors (Senate): Franken

Supported by: SEIU, Paraprofessional Healthcare Institute (PHI), the Caregiver Action Network, Community Catalyst, Direct Care Alliance, Altarum Institute’s Center for Elder Care and Advanced Illness, The Senior Citizens League

Dear Colleague,

Today 62% 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 70-80% of the paid, hands-on, long-term care and personal assistance received by older adults in the U.S. However, DCWs are not often recognized as essential contributors to care teams, and few existing models provide DCWs with the advanced training necessary to take on increased responsibilities.

This is why 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 that use direct-care workers in advanced roles. 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 incorporate DCWs as essential members of interdisciplinary care coordination teams, and use their abilities to promote smooth transitions in care and prevent unnecessary hospital readmissions.
  • Two will use DCWs to monitor health status, help consumers follow prescribed care, and educate consumers and family caregiver(s).
  • Two will train DCWs to take on increased clinical responsibilities related to specific diseases, including Alzheimer’s, dementia, congestive heart failure, and diabetes.

Investing in an advanced aide role for DCWs will not only lead to less institutionalization and fewer re-hospitalizations, it will improve the quality of life for seniors and reduce costs and the burden on the entire healthcare industry.

If you are interested in becoming a cosponsor of this bill or you have any questions, please contact Andrew Wolf in my office or at 202-225-5546.


Matt Cartwright

Member of Congress