Sec. 2. Findings

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Congress finds the following: As of 2012, more than 41,000,000 Americans are age 65 or older. More than 75 percent of them suffer from chronic conditions which require person-centered, coordinated care that helps them to live in a home- or community-based setting. In 2012, the Government Accountability Office found that 34 percent of Americans 60 and older reported needing assistance performing Activities of Daily Living. Direct-care workers (referred to in this section as DCWs ) provide an estimated 70 to 80 percent of the paid hands-on long-term care and personal assistance received by elders and people with disabilities or other chronic conditions in the United States.

These workers help their clients bathe, dress, and negotiate a host of other daily tasks. They are a lifeline for those they serve, as well as for families and friends struggling to provide quality care. Eldercare and disability services positions account for nearly one-third of the 18,000,000 health care jobs in the United States. The direct-care workforce alone accounts for more than 4,000,000 jobs, expected to add 1,600,000 new positions by 2020. The majority of DCWs are now employed in home- and community-based settings, and not in institutional settings such as nursing care facilities or hospitals.

By 2020, home- and community-based DCWs are likely to outnumber facility workers by more than 2 to 1. A 2008 Institute of Medicine report, entitled Re-tooling for an Aging America: Building the Health Care Workforce , called for new models of care delivery and coordination, and dedicated a chapter to the central importance of the direct-care workforce in a re-tooled eldercare delivery system. An Institute of Medicine report on the future of nursing, released in October of 2010, recommended nurses should practice to the full extent of their education and training.

The report also states that all health care professionals should work collaboratively in team-based models, and that the goal should be to encourage care models that use every member of the team to the full capacity of his or her training and skills. The Patient Protection and Affordable Care Act ( Public Law 111–148 ) emphasizes the need for improving care and lowering costs by better coordination of care and integration of services, particularly for consumers with multiple chronic conditions.

This will require developing new models of care for those receiving long-term services and supports.

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Pub. L. 111-148

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Sec. 2

Findings

Pub. L.Pub. L. 111-148

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