[Congressional Record Volume 164, Number 83 (Monday, May 21, 2018)]
[Senate]
[Pages S2795-S2796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. COLLINS (for herself and Mr. Casey):
S. 2888. A bill to amend Title VII of the Public Health Service Act
to reauthorize programs that support interprofessional geriatric
education, training, and advance research to develop a geriatric-
capable workforce, improving health outcomes for a growing and diverse
aging American population and their families, and for other purposes;
to the Committee on Health, Education, Labor, and Pensions.
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.
Mr. President. I urge my colleagues to support this bipartisan
legislation that would ensure geriatric education for our current
workforce, while optimizing resources to bolster academic careers in
geriatrics. Together, GWEP and GACA would develop a high-quality
geriatric workforce ready to provide care for Americans as we grow
older.
National Association for Geriatric Education, National
Association of Geriatric Education Centers,
May 21, 2018.
Hon. Susan Collins,
Chair, Special Committee on Aging,
U.S. Senate, Washington, DC.
Hon. Bob Casey,
Ranking Member, Special Committee on Aging,
U.S. Senate, Washington, DC.
Dear Chairman Collins and Ranking Member Casey: On behalf
of the HRSA Title VII and Title VIII funded Geriatrics
Workforce Enhancement Programs (GWEPs) across the country,
thank you for your past support of geriatric education and
for introducing the Geriatrics Workforce Improvement Act. The
National Association for Geriatric Education (NAGE) is
pleased to offer our support for this important legislation,
which will reauthorize the GWEP and once again make the
Geriatrics Academic Career Award program (GACA) a part of the
effort
[[Page S2796]]
to prepare the geriatrics workforce for the aging of our
population. We and the growing numbers of older adults,
caregivers, and clinicians caring for elders will urge
Congress to move quickly to pass your bill and provide the
resources to address our nation's growing demand for
geriatric care.
We appreciate the many discussions that your staff
facilitated with NAGE, as well as with the Eldercare
Workforce Alliance, the American Geriatrics Society, and The
Gerontological Society of America during the process of
developing this legislation. This authorization and related
funding is needed for the development of a health care
workforce specifically trained to care for older adults and
to support their family caregivers. Currently there are only
44 GWEP sites in 29 states. The modest increase in the
authorization in your bill will have an important impact on
training in geriatric care. Likewise, the funds you have
authorized for the GACA program will assist in ensuring that
rural and underserved areas will have geriatrics education
programs.
NAGE is a non-profit membership organization representing
GWEP sites, Centers on Aging, and Geriatric Education Centers
that provide education and training to health professionals
in the areas of geriatrics and gerontology. Our mission is to
help America's healthcare workforce be better prepared to
render age-appropriate care to today's older Americans and
those of tomorrow.
Thank you for your continued support for geriatric
education programs.
Sincerely,
Maura Brennan, MD, FACP, AGSF, FAAHPM, CHMD,
President NAGE/NAGEC; Project Director, Baystate Health,
Geriatrics Workforce Enhancement Program; Chief, Div. of
Geriatrics, Palliative Care & Post-Acute Medicine; Prof. of
Medicine, Univ. of Massachusetts-Baystate; Adjunct Prof. of
Medicine, Tufts University School of Medicine.
______
By Mr. CORNYN (for himself, Mr. King, and Mrs. Gillibrand):
S. 2890. A bill to improve the prosecution of criminal offenses
committed by juveniles on military installations, and for other
purposes; to the Committee on Armed Services.
Mr. CORNYN. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 2890
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. RELINQUISHMENT OF LEGISLATIVE JURISDICTION OF
CRIMINAL OFFENSES COMMITTED BY JUVENILES ON
MILITARY INSTALLATIONS.
(a) In General.--In the case of any military installation
or portion of a military installation of which legislative
jurisdiction of criminal offenses committed by juveniles is
retained by the United States as of the date of the enactment
of this Act, the Secretary concerned shall seek to relinquish
to the State, Commonwealth, territory, or possession
concerned legislative jurisdiction of such offenses such that
the United States and the State, Commonwealth, territory, or
possession, as the case may be, have concurrent legislative
jurisdiction of such offenses.
(b) Manner of Relinquishment.--Legislative jurisdiction
shall be relinquished pursuant to subsection (a) in the
manner provided in section 2683(a) of title 10, United States
Code.
(c) Deadline.--The Secretaries concerned shall, to the
extent practicable, complete relinquishment of legislative
jurisdiction pursuant to subsection (a) by not later than one
year after the date of the enactment of this Act.
(d) Reports.--
(1) In general.--Not later than 15 months after the date of
the enactment of this Act, each Secretary concerned shall
submit to Congress a report on the relinquishment of
legislative jurisdiction pursuant to subsection (a).
(2) Elements.--The report of a Secretary under this
subsection shall include the following:
(A) A list of the installations or portions of
installations under the jurisdiction of the Secretary of
which exclusive legislative jurisdiction of criminal offenses
committed by juveniles is retained by the United States as of
the date of the enactment of this Act.
(B) A list of the installations or portions of
installations listed pursuant to subparagraph (A) for which
legislative jurisdiction was relinquished pursuant to
subsection (a) as of the date that is one year after the date
of the enactment of this Act.
(C) A list of the installations or portions of
installations listed pursuant to subparagraph (A) for which
legislative jurisdiction was not relinquished pursuant to
subsection (a) as of the date that is one year after the date
of the enactment of this Act, and, for each such installation
or portion of installation, the reasons why legislative
jurisdiction was not so relinquished.
(e) Secretary Concerned Defined.--In this section, the term
``Secretary concerned'' has the meaning given that term in
section 101(a)(9) of title 10, United States Code.
SEC. 2. CONSIDERATION OF PROSECUTION BY FEDERAL PROSECUTORS
OF FELONY OFFENSES COMMITTED BY JUVENILES ON
MILITARY INSTALLATIONS WITH CONCURRENT FEDERAL-
STATE LEGISLATIVE JURISDICTION WHEN STATE
PROSECUTORS DECLINE TO PROSECUTE.
(a) In General.--In accordance with such regulations as the
Attorney General may prescribe, the Federal Government shall
consider the prosecution of charges in each circumstance
described in subsection (b).
(b) Covered Circumstances.--A circumstance described in
this subsection is any circumstance involving an alleged
felony offense of a juvenile on a military installation for
which legislative jurisdiction of such offense of the Federal
Government is concurrent with legislative jurisdiction of
such offense by a State, Commonwealth, territory, or
possession in which--
(1) a recommendation to bring charges is initially made to
the prosecutor of the State, Commonwealth, territory, or
possession concerned; and
(2) the prosecutor of the State, Commonwealth, territory,
or possession declines to bring charges.
(c) Felony Offense Defined.--In this section, the term
``felony offense'' means an offense punishable by a maximum
term of imprisonment of more than one year.
SEC. 3. ANNUAL REPORTS ON DISPOSITION OF FELONY OFFENSES
COMMITTED BY JUVENILES ON MILITARY
INSTALLATIONS.
(a) Annual Reports Required.--Not later than March 31 each
year, each Secretary concerned shall submit to Congress a
report on the disposition of alleged felony offenses
committed by juveniles on military installations under the
control of such Secretary, including installations in foreign
countries, during the previous calendar year.
(b) Elements.--Each report under this section shall
include, for the calendar year covered by such report, a list
of the alleged felony offenses committed by juveniles on
military installations under the control of the Secretary,
aggregated by installation, and with the information for each
alleged offense as follows:
(1) Nature of the alleged offense.
(2) Age and other appropriate data on the alleged offender,
including the connection, if any, of the alleged offender to
the Armed Forces.
(3) Age and other appropriate data on each victim,
including the connection, if any, of such victim to the Armed
Forces.
(4) Results of the investigation, if any, of the alleged
offense by any military, Federal, State, or local law
enforcement or criminal investigation organization.
(5) If as a result of an investigation as described in
paragraph (4), a determination was made not to recommend the
bringing of charges against the alleged offender, whether to
a Federal prosecutor or the prosecutor of a State,
Commonwealth, territory, or possession, the justification for
such determination.
(6) If as a result of an investigation as described in
paragraph (4), a determination was made to recommend the
bringing of charges against the alleged offender to a
prosecutor of a State, Commonwealth, territory, or
possession, and such prosecutor declined to bring charges,
the justification for lack of prosecution.
(7) If as a result of an investigation as described in
paragraph (4), a determination was made to recommend the
bringing of charges against the alleged offender to a Federal
prosecutor, whether or not the prosecutor subsequently met
with the victim or victims as provided for in section 3771 of
title 18, United States Code.
(8) If a Federal prosecutor declined to bring charges
against the alleged offender despite a recommendation for
such charges as described in paragraph (7), the justification
for lack of prosecution.
(c) Coordination With Attorney General.--The Attorney
General shall take appropriate actions to ensure that
information on actions of Federal prosecutors that is
required for purposes of paragraphs (7) and (8) of subsection
(b) is submitted promptly to the Secretaries concerned for
inclusion in the reports required by subsection (a).
(d) Definitions.--In this section:
(1) The term ``felony offense'' means an offense punishable
by a maximum term of imprisonment of more than one year.
(2) The term ``Secretary concerned'' has the meaning given
that term in section 101(a)(9) of title 10, United States
Code.
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