[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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