Geriatric Healthcare Workforce Fact Sheet

In January 2009, U.S. Senators Herb Kohl (D-WI), chairman of the Special Committee on Aging, Blanche Lincoln (D-AR), and Bob Casey (D-PA) re-introduced the “Retooling the Health Care Workforce for an Aging America Act of 2009,” (S. 245).  The same bill (H.R. 468) was introduced in the U. S. House of Representatives by Representative Jan Schakowsky (D-IL) on January 13, 2009.  A number of the provisions in this legislation were included in health care reform legislation, the “Patient Protection and Affordable Care Act,” that was signed into law by President Obama on March 23, 2010. 

This legislation addresses the current and future shortage of health care personnel who are trained to care for older adults. The bill was prompted by a report issued by the Institute of Medicine (IOM) in April 2008, which painted a grim picture of health care for older Americans.  AAGP has been in the forefront of efforts to remedy the problems identified by the IOM study.

AAGP leaders and staff worked closely with Senator Kohl’s staff on the Senate Aging Committee on the bill’s mental health provisions. 

S. 245/H.R 468 includes authorization of two studies that address issues high on AAGP’s list of priorities:

  • A complementary IOM report on the composition of the mental health workforce that is needed to meet the needs of the aging population.   This provision was funded in the appropriations bill for the Department of Health and Human Services (HHS) for Fiscal Year 2010, and AAGP worked with HHS and IOM on contours of the study, which began in March 2011. 
  • A study to be conducted by the Government Accountability Office (GAO) which would examine National Institutes of Health spending on conditions and illnesses that disproportionately affect the health of older adults. This study would examine the number of older adults included in clinical trials supported by NIH institutes, an issue that AAGP has raised with Senate and House members on numerous occasions in recent years.  

AAGP also strongly supported a provision that was included in health care reform legislation that will expand authorization for Geriatric Education Centers (GECs) to include new grants for short-term intensive courses (mini-fellowships) in geriatrics, chronic care management and long-term care to faculty members of medical and other health professions school. It would require
GECs applying for these grants to incorporate mental health and dementia “best practices” training into most of their courses.

Other provisions of S. 245/H.R. 468 would:

  • Expand other geriatrics programs under Title VII and Title VIII of the Public Health Service Act to be more inclusive of allied health professions.
  • Require state veterans employment and job counseling services to provide information on opportunities in geriatrics and long-term care.
  • Establish tuition stipends for direct care workers (nurse aides, home health aides and person or home-care aides) in the long-term care sector to advance to into nursing.
  • Establish programs to develop the opportunities in for high school and college students studying in various allied healthcare disciplines to work with low-income seniors.
  • Establish model demonstration programs for developing best practices in training of mid-level professionals to advance in the aging services field.
  • Develop online training for caregivers to demonstrate techniques for activities of daily living assistance.
  • Establish a national demonstration program to develop and evaluate core training competencies for personal and home care aides as well as additional training content, supplement current federal requirements, for home health aides and nurse aides.
  • Provide better integration of services and information to meet of the needs of family caregivers.
  • Authorize studies by the GAO on projected needs of lower-income individuals and on successful practices in reducing turnover and improve retention among direct care staff in nursing homes, assisted living facilities, and home health agencies.

AAGP Position
AAGP strongly supports this legislation, which was endorsed by a broad range of organizations interested in aging and health care issues.  While some provisions were included in the health care reform legislation enacted in March 2010, AAGP and allied organizations will continue to advocate for the remaining provisions as well as other initiatives to address the geriatric health care workforce during the 112th Congress.  The complex problems associated with aging require a supply of health care professionals and paraprofessionals with special training in geriatrics, better geriatrics education and training for the entire health care workforce, and better information and support for family caregivers.  It is critical that action be taken now to alleviate the serious shortage of health care professionals trained to meet the special needs of older people.

(March 3, 2011)