[Congressional Record Volume 165, Number 20 (Thursday, January 31, 2019)]
[Senate]
[Pages S803-S804]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Cardin):
  S. 296. A bill to amend XVIII of the Social Security Act to ensure 
more timely access to home health services for Medicare beneficiaries 
under the Medicare program; to the Committee on Finance.
  Ms. COLLINS. Mr. President, I rise to introduce legislation with my 
colleague Senator Casey that would reauthorize the only federally 
funded programs that are specifically designed to develop a health 
provider workforce to care for our older Americans. The Geriatrics 
Workforce Improvement Act would reauthorize the Geriatrics Workforce 
Enhancement Program and also reinstate the Geriatrics Academic Career 
Award Program.
  The number of Americans aged 65 and older is growing rapidly. In my 
State of Maine, we are reaching an aging milestone faster than are 
other States. By 2020, the number of Maine seniors is projected to 
exceed the number of Maine children. This is 15 years ahead of the 
nationally projected date of 2035, at which point the number of 
Americans aged 65 and older will outnumber those under the age of 18 
for the first time in our Nation'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 1 million physicians are board certified 
as geriatricians. By 2030, we will need 30,000 geriatricians and even 
more geriatric health professionals and direct service workers. To 
achieve this goal, we will need to train 1,600 geriatric specialists 
per year over the next 12 years.
  For the State of Maine, with an aging population of more than a 
quarter million Mainers over the age of 65 and with only 40 
geriatricians, there is an acute need to quickly train more geriatric 
health professionals and direct service workers to meet the growing 
demand. The University of New England, College of Osteopathic Medicine 
has joined the University of Maine this year in proposing the ``Aging 
Maine Transformation Collaborative.'' I was pleased to lend my support 
to this collaboration earlier this year. If funded, AgingME would 
become our State's first Geriatric Workforce Enhancement Program and 
would bring with it much needed assistance to communities and families 
throughout our State.
  Nationwide, our bill would reauthorize this workforce enhancement 
program at $45 million per year over the next 5 years and would 
reinstate the Geriatrics Academic Career Award Program 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 ensure that older Americans will be cared for, for 
decades to come, by a healthcare workforce that will be specifically 
trained to meet their unique and complex healthcare challenges. This 
training of using the most efficient and effective methods for older 
adults will result in improved care while reducing unnecessary costs.
  I am pleased to say that our legislation is supported by the leading 
organizations in gerontology and geriatrics, including the Eldercare 
Workforce Alliance, the American Geriatrics Society, the Alzheimer's 
Impact Movement, and the National Association of Geriatric Education 
Centers.
  I ask unanimous consent that these letters of support be printed in 
the Record.
   There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 Eldercare Workforce Alliance,

                                 Washington, DC, January 25, 2019.
     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 Senator Susan Collins and Senator Bob Casey: On behalf 
     of the Eldercare Workforce Alliance (EWA), we are writing to 
     express our support of the Geriatrics Workforce Improvement 
     Act.
       EWA is a coalition of 32 national consumer, health care 
     professional, direct-care worker and family caregiver 
     organizations. The number of Americans over age 65 is 
     expected to reach 70 million by 2030, representing a 71% 
     increase from today's 41 million older adults. Today's health 
     care workforce is inadequate to meet the needs of older 
     Americans, many of whom have multiple chronic physical and 
     mental health conditions and cognitive impairments. Without a 
     national commitment to expand training and educational 
     opportunities, the workforce will be even more constrained in 
     its ability to care for the elderly population as the baby 
     boom generation ages.
       This bipartisan bill supports two critical objectives. 
     First, it would formally establish funding for the Geriatrics 
     Workforce Enhancement Program (GWEP). Second, it would 
     reestablish the Geriatric Academic Career Awards (GACAs), a 
     previously funded program for developing clinician-educators. 
     By supporting the GWEP and the GACAs, the Geriatrics 
     Workforce Improvement Act would:
       Foster education and engagement with family caregivers by 
     training providers who can assess and address their care 
     needs and preferences.
       Promote interdisciplinary team-based care by transforming 
     clinical training environments to integrate geriatrics and 
     primary care delivery systems.
       Improve the quality of care delivered to older adults by 
     providing education to families and caregivers on critical 
     care challenges like Alzheimer's disease and related 
     dementias.
       Reach underserved and rural communities by ensuring 
     clinician-educators are prepared to train the geriatrics 
     workforce of today and tomorrow.

[[Page S804]]

       This investment protects our most vulnerable elders and 
     invests in our country's future. We ask that you continue 
     your support for the programs at this crucial time, and thank 
     you for your leadership on this issue.
           Sincerely,
     Nancy Lundebjerg, MPA,
       EWA Co-Convener.
     Michele J. Saunders, DMD, MS, MPH,
       EWA Co-Convener.
                                  ____



                                  American Geriatrics Society,

                                   New York, NY, January 25, 2019.
     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 Senator Susan Collins and Senator Bob Casey: The 
     American Geriatrics Society (AGS), an organization devoted to 
     improving the health, independence and quality of life of 
     older adults, supports the Geriatrics Workforce Improvement 
     Act. The AGS is thankful for your support of the geriatrics 
     workforce training programs and for your efforts to improve 
     care of older Americans.
       The Geriatrics Workforce Improvement Act would authorize 
     the Geriatrics Workforce Enhancement Program (GWEP) and the 
     Geriatrics Academic Career Awards (GACAs) program under Title 
     VII of the Public Health Service Act. The AGS believes that 
     both programs must be authorized and funded if all Americans 
     are to have access to high-quality, person-centered care as 
     we grow older.
       The GWEP is currently the only federal program designed to 
     increase the number of providers, in a variety of 
     disciplines, with the skills and training to care for older 
     adults. The GWEPs educate and engage the broader frontline 
     workforce including family caregivers and focus on 
     opportunities to improve the quality of care delivered to 
     older adults, particularly in underserved and rural areas. 
     The GACA program is an essential complement to the GWEP 
     program. GACAs ensure we can equip early career clinician 
     educators to become leaders in geriatrics education and 
     research.
       The introduction of this important legislation follows 
     announcements of related funding opportunities from the 
     Health Resources and Services Administration (HRSA) in 
     November 2018. Authorization of the GWEPs and GACAs as 
     outlined in the Geriatrics Workforce Improvement Act will 
     help ensure that HRSA receives the funding necessary to carry 
     these critically important workforce training programs 
     forward.
       At a time when our nation is facing a severe shortage of 
     both geriatrics healthcare providers and faculty with the 
     expertise to train these providers, the AGS believes the 
     number of educational and training opportunities in 
     geriatrics and gerontology should be expanded, not reduced. 
     Thank you for your leadership on this issue.
           Sincerely,
     Laurie Jacobs, MD, AGSF,
       President.
     Nancy E. Lundebjerg, MPA,
       Chief Executive Officer.
                                  ____



                                  Alzheimer's Impact Movement,

                                 Washington, DC, January 31, 2019.
     Hon. Susan Collins,
     Chairman, Senate Committee on Aging,
     Washington, DC.
     Hon. Bob Casey,
     Ranking Member, Senate Committee on Aging,
     Washington, DC.
       Dear Chairwoman Collins and Ranking Member Casey: On behalf 
     of the Alzheimer's Association and the Alzheimer's Impact 
     Movement (AIM), including our nationwide networks of 
     advocates, thank you for your continued leadership on issues 
     and legislation important to Americans living with 
     Alzheimer's and other dementias, and to their caregivers. The 
     Alzheimer's Association and AIM are pleased to support the 
     Geriatrics Workforce Improvement Act.
       More than 5 million Americans are living with Alzheimer's 
     and, without significant action, nearly 14 million Americans 
     will have Alzheimer's by 2050. Today, another person develops 
     the disease every 65 seconds; by 2050, someone in the United 
     States will develop the disease every 33 seconds. This 
     explosive growth will cause Alzheimer's costs to increase 
     from an estimated $277 billion in 2018 to $1.1 trillion in 
     2050 (in 2018 dollars). These mounting costs threaten to 
     bankrupt families, businesses and our health care system. 
     Unfortunately, our work is only growing more urgent.
       The Geriatrics Workforce Improvement Act would develop a 
     workforce capable of providing complex, high-quality care 
     that improves health outcomes and reduces costs for a diverse 
     and growing aging population. It would reauthorize the 
     Geriatrics Workforce Enhancement Program (GWEP), and 
     reinstate the Geriatrics Academic Career Awards (GACAs) 
     Program, a previously funded program for developing 
     clinician-educators, two critical objectives to ensure 
     communities across the nation have access to health 
     professionals and other critical supports, improving care for 
     all of us as we age. By supporting the GWEP and GACAs the 
     Geriatrics Workforce Improvement Act would, foster education 
     and engagement with family caregivers by training providers 
     who can assess and address care needs and preferences, reach 
     underserved and rural communities by ensuring clinician-
     educators are prepared to train the geriatrics workforce of 
     today and tomorrow, and improve the quality of care delivered 
     to older adults by providing education to families and 
     caregivers on critical care challenges.
       The Alzheimer's Association and AIM deeply appreciate your 
     continued leadership on behalf of all Americans living with 
     Alzheimer's and other dementias. We look forward to 
     continuing to work with you and your colleagues to improve 
     care and support for individuals and families affected by 
     Alzheimer's disease and other dementias. If you have any 
     questions about this or any other legislation, please contact 
     Rachel Conant, Senior Director of Federal Affairs.
           Sincerely,
     Robert Egge,
       Chief Public Policy Officer, Executive Vice President, 
     Government Affairs, Alzheimer's Association.
                                  ____



                                       National Association of

                                  Geriatric Education Centers,

                                                 January 25, 2019.
     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 the Geriatrics Workforce 
     Improvement Act, which will reauthorize the GWEP and once 
     again make the Geriatrics Academic Career Award program 
     (GACA) a part of the effort 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 are 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 complement the GWEP, and 
     support faculty that will teach and lead geriatrics programs. 
     The bill will also 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,
     Catherine Carrico, PhD,
       President NAGE/NAGEC, Associate Director, Wyoming Geriatric 
     Workforce Enhancement Program, Wyoming Center on Aging, 
     Clinical Assistant Professor, College of Health Sciences, 
     University of Wyoming.
                                  ____


  Ms. COLLINS. Mr. President, I urge all of my colleagues to support 
this bipartisan bill that would ensure geriatric education for our 
current workforce while it would optimize resources to bolster academic 
careers in geriatrics and help to attract the best and the brightest 
into this field. Together, these programs would develop exactly the 
kind of highly qualified workforce that we need to care for Americans 
as our Nation grows older.
  I thank the Presiding Officer.
                                 ______