# Presentation: 346031

## Testimony for Texas WHCOA Solutions ForumFriday, July 29, 2005, Austin, TexasGeriatrics & Gerontology Education:A Solution for Quality Care

- Michèle J. Saunders, DMD, MS, MPH
- Professor and Director, South, West and Panhandle Consortium GEC of TX / South Texas-Border Geriatric Education Center (SWAP-C GEC/STGEC),
- Department of Medicine, The University of Texas Health Science Center at San Antonio (UTHSCSA); and
- Associate Director, Geriatric Research, Education & Clinical Center (GRECC), South Texas Veterans Health Care System

## What is the issue?

- Practitioners cannot provide first-rate, quality health care for our aging population without education in:
- How care for the elderly is different
- How to provide geriatric health care
- Train primary care practitioners, specialists, all health care professionals

## Example

- 	Osteoporosis  Spinal Fracture  Pain  Narcotics  Constipation  Bowel Blockage  Prolonged Bedrest  Deconditioning  Congestive Heart Failure  Kidney Failure  Death

## Aging Well Requires that Health Care Practitioners Can:

- Provide health promotion activities tailored to needs of older adults
- Provide chronic disease management tailored to needs of older adults

## History of Education in Geriatrics and Gerontology

- VA GRECCs
- VA Fellowships
- BHPr/HRSA Geriatric Education Centers
- BHPr/HRSA Fellowships and
- Post-Fellowship Geriatric Academic Career Awards

- 	A few hours of training does not make a practitioner a geriatrician.

## Practitoner and Academician Shortages

- Rapidly expanding elderly population
- Poor practitioner to population ratio for many professions (medicine, nursing, dentistry, podiatry) especially in rural areas, even poorer ratio for geriatricians
- Shortage of geriatrics-trained academicians, especially minorities
- We cannot catch up with the increasing need

## Title VII Funding

- President proposed $0
- House voted $0
- Senate voted $2 million dollar cut for geriatric education programs (GECs, fellowships, career awards)
- Conference committee can cut funds more or stay at Senate $, either way geriatric education loses $2 million

## Solutions

- Conference committee could stay at Senate $, with geriatric education losing $2 million

## Solutions

- Recommendations of *A National Agenda for Geriatric Education: White Papers/ Forum Report*
**Cross-cutting issues** (increased training in managed care, long-term care, case management, ethnogeriatrics, interdisciplinary care of the elderly, improved recruitment and retention of students from underserved or minority backgrounds

## Solutions

- Recommendations of *A National Agenda for Geriatric Education: White Papers/ Forum Report*
**Discipline-specific** (increased geriatrics training at all education levels of allied and associated health professions, dentistry, medicine, nursing, public health and social work)

## Solutions

- Recommendations of *A National Agenda for Geriatric Education: White Papers/ Forum Report*
**Accreditation and Licensure Boards** (increased geriatrics content in training programs required by Boards, and increased geriatrics content in Board examinations)

## Key References

- BHPr, HRSA, USPHS (Klein, S.M., ed.). *A National Agenda for Geriatric Education (Volume 1): White Papers.* May 1996.
- BHPr, HRSA, USPHS (Klein, S.M., ed.). *A National Agenda for Geriatric Education (Volume 2): Forum Report.* September 1996.
- BHPr National Center for Health Workforce Information and Analysis. *HRSA State Health Workforce Profiles: Texas.* November 2000.
- AARP Public Policy Institute. (Flowers L, Cool RJ, and Melvin ME, authors) *State Profiles 2003: Reforming the Health Care System, 12th Edition*.
- Perweiler, E. Future of Geriatric Programs in Jeopardy. In National Association of Geriatric Education Centers. *GEC Pipeline*, Vol. 17, No. 4, p. 1, July/August 2005.
- Various web-sites for AARP, BHPr/HRSA, VA, DADS, CMS, _[www.SAGRECC.org](http://www.sagrecc.org/)_, Senator Kay Bailey Hutchison, Texas Higher Education Coordinating Board, Texas Department of Health