Statements on Introduced Bills and Joint Resolutions

Floor Speech

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Mrs. COLLINS. Mr. President, I rise today to introduce legislation, with my colleague from Pennsylvania, Senator Casey, that would reauthorize the only federally funded programs specifically designed to develop a health provider workforce to care for older Americans. The Geriatrics Workforce Improvement Act would reauthorize the Geriatrics Workforce Enhancement Program, known as GWEP, and also reinstate the Geriatric Academic Career Awards program, known as GACA.

The number of Americans aged 65 and older is growing rapidly. In Maine, we are reaching an aging milestone faster than other States--by 2020, the number of seniors is projected to outnumber children. This is 15 years aheadV the national projected date of 2035, at which point the number of Americans 65 and older will outnumber those under age 18 for the first time in U.S. history.

The United States is facing a critical shortage of geriatric health professionals and direct service workers to support our aging population. Today, we need 20,000 geriatricians; however, fewer than 7,300 of our Nation's nearly one million physicians are board-certified geriatricians. By 2030, we will need 3.1,000 geriatricians and even more geriatric health professionals and direct service workers. We need to train 1,600 geriatricians per year over the next 12 years to reach the targeted need by 2030.

As many as 90 percent of older adults are expected to have one or more chronic health conditions. Multiple chronic conditions, multiple medications, and changes that occur in aging make caring for older adults complex and challenging, yet also rewarding to healthcare professionals who choose this specialty. In any given year, it is expected that 30 percent of older adults and their families will require specialized geriatric care.

Today there are 44 geriatric workforce enhancement programs or GWEPs in 29 states. GWEP sites include 25 schools of medicine, ten schools of nursing, five healthcare facilities, two schools of allied health, a school of social work, and a certified nurse assistant program. GWEPs have the flexibility to tailor training in geriatrics to the unique needs of their own communities.

GWEP programs focus on Geriatric Education by:

1. Changing clinical training environments so that geriatrics is integrated into primary care delivery systems;

2. Training providers to assess and address the needs of older adults, their families, and caregivers at multiple levels within their communities;

3. Delivering community-based programs for patients, families and caregivers; and

4. Providing Alzheimer's disease education for families and caregivers, including direct care workers and other providers.

In 2016, the 44 GWEPs produced significant outcomes. They provided continuing education courses to 94,000 practicing public health professionals, from disciplines such as medicine, nursing, allied health, heath services administration, social work, and psychology. They have also created opportunities for healthcare providers in rural and underserved areas to learn from and consult with top experts in geriatric care through tele-consults, and educational webcasts, as well as online geriatric education programs that are publicly available and accessible online, 24 hours a day, 7 days a week, for free.

GACA programs focus on Resource Optimization. Established in 1998, GACA programs were funded to increase the number of faculty engaged in geriatric education. Transitioning from clinical training and practice into an academic faculty role is particularly challenging, and requires gaining new skills as an educator. These skills are not typically taught in clinical training programs.

Following a restructuring of the geriatric workforce program, GACA has gone unfunded since 2015. GACA would be reauthorized as a stand- alone resource within our legislation in order to optimize future growth and stability of early-career geriatric faculty. GACA supports early career development for emerging leaders by providing funding that supports 50 percent of their effort to develop skills as an inter- professional educator in geriatrics.

The Geriatrics Workforce Improvement Act would reauthorize the GWEP program at $45 million per year over the next five years, and reinstate GACA at $6 million per year. Together, these programs would train the current workforce and family caregivers, while simultaneously developing a cadre of emerging leaders in geriatric education, in a variety of disciplines. By doing both, we will assure that older Americans will be cared for by a health care workforce specifically trained to meet their unique and complex health needs for decades to come. This training to use the most efficient and effective methods for older adults will result in improved care while saving valuable resources, and reducing unnecessary costs.

Exposure to geriatrics, particularly through pre-clinical and clinical education, has been identified as an important factor for increasing interest in the field. This exposure provides faculty the opportunities needed to demonstrate the specialty is a viable, complex, yet rewarding specialty. The Geriatrics Workforce Improvement Act would provide these critical platforms by creating the infrastructure needed to attract the best and the brightest into the field of geriatrics.

This legislation already has broad support. I ask to enter into the record a letter of support from the National Association for Geriatric Education and the National Association of Geriatric Education Centers.

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