Bill would create 'advanced aide' positions in nursing homes to improve transitions, dementia care

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Sen. Bob Casey (D-PA)
Sen. Bob Casey (D-PA)

Advanced certified nursing assistants — with specialized skills in care transitions, dementia and other areas — could become important staff leaders in long-term care facilities through newly proposed federal legislation. The “Improving Care for Vulnerable Older Citizens through Workforce Advancement Act of 2014” was introduced Thursday by Rep. Matt Cartwright (D-PA) and Sen. Bob Casey (D-PA).

The bill would establish six, three-year demonstration projects. Two would provide funding to train direct-care workers so they could take on “deeper clinical responsibilities” related to Alzheimer's/dementia, congestive heart failure and diabetes.

The other demonstration projects would focus on empowering direct-care workers to promote smoother transitions among different settings, incorporating them as “essential members” of interdisciplinary teams, and helping them to do more effective education of family caregivers.

Long-term care and rehabilitation facilities, home health agencies, managed care entities and hospitals would be among the organizations eligible to participate in the demonstration projects.

“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,” said Steve Edelstein, national policy director* of the Paraprofessional Healthcare Institute, which has endorsed the bill.

Participants would receive funding to plan, carry out and report on the outcomes of the projects. Outcome measures would include effects on direct-care worker job satisfaction and turnover, and patient/resident hospitalization rates.

*Editor's Note: A previous version of this article identified Edelstein as president of PHI, per information distributed by Rep. Cartwright's office. PHI has clarified that he is national policy director.

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