II 

115TH CONGRESS 

2D SESSION S. 2888 

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. 

IN THE SENATE OF THE UNITED STATES 

MAY 21, 2018 

Ms. COLLINS (for herself and Mr. CASEY) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Geriatrics Workforce 

5 Improvement Act’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) In 2016, 46,000,000 adults age 65 or older 

4 lived in the United States, and this number is ex5 pected to double to over 98,000,000 by 2060. Three 

6 out of four older adults are expected to have mul7 tiple chronic conditions, which increases the com8 plexity of care needed and increases medical expend9 itures. 

10 (2) Thirty percent of older adults in the United 

11 States, about 14,000,000 individuals, are projected 

12 to need specialized geriatric care by 2030. That care 

13 will require at least 20,000 geriatricians and even 

14 more geriatric-trained health professionals. There 

15 are nearly 1,000,000 physicians in the United 

16 States, less than 7,300 of whom are board-certified 

17 geriatricians. There are 3,600,000 nurses in the 

18 United States, of whom, less than 1 percent are reg19 istered nurses certified in geriatrics and less than 3 

20 percent are advanced practice nurses certified in ger21 iatrics. There are similarly few professionals cer22 tified in geriatrics among professionals in social 

23 work, pharmacy, psychiatry, and the allied health 

24 disciplines. 

25 (3) Health professionals trained in geriatrics 

26 understand the unique health needs and complex 


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1 care challenges associated with aging. Outcomes as2 sociated with interprofessional geriatric teams in3 clude improved health-related quality of life, fewer 

4 emergency room visits, fewer hospital admissions 

5 and, in the case of hospitalization, shorter length of 

6 stay and lower costs per admission. 

7 (4) Two federally funded initiatives have his8 torically aimed to reduce the widening gap between 

9 the numbers of older adults and health professionals 

10 trained in geriatrics: The Geriatrics Workforce En11 hancement Program (referred to in this section as 

12 ‘‘GWEP’’) and the Geriatrics Academic Career 

13 Award (referred to in this section as ‘‘GACA’’). 

14 SEC. 3. PURPOSE. 

15 It is the purpose of this Act to develop the next gen16 eration of geriatric scientists and innovators, improving 

17 health outcomes and care delivery for older adults. To18 gether, the Geriatrics Workforce Enhancement Program 

19 and the Geriatrics Academic Career Award develop a 

20 workforce capable of providing complex, high-quality care 

21 that improves health outcomes and saves valuable re22 sources by reducing unnecessary costs for a growing and 

23 diverse aging population. 


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1 SEC. 4. EDUCATION AND TRAINING RELATING TO GERI2 ATRICS. 

3 Section 753 of the Public Health Service Act (42 

4 U.S.C. 294c) is amended to read as follows: 

5 ‘‘SEC. 753. EDUCATION AND TRAINING RELATING TO GERI6 ATRICS. 

7 ‘‘(a) GERIATRICS WORKFORCE ENHANCEMENT PRO8 GRAM.— 

9 ‘‘(1) IN GENERAL.—The Secretary shall award 

10 grants under this subsection to entities described in 

11 paragraph (1), (3), or (4) of section 799B, section 

12 801(2), or section 865(d), or other health profes13 sions, schools, or programs approved by the Sec14 retary, for the establishment or operation of Geri15 atrics Workforce Enhancement Programs that meet 

16 the requirements of paragraph (2). 

17 ‘‘(2) REQUIREMENTS.— 

18 ‘‘(A) IN GENERAL.—A Geriatrics Work19 force Enhancement Program (referred to in this 

20 section as ‘GWEP’) meets the requirements of 

21 this paragraph if such program supports the 

22 development of a health care workforce that 

23 maximizes patient and family engagement and 

24 improves health outcomes for older adults by 

25 integrating geriatrics with primary care and 

26 other appropriate specialties. Special emphasis 


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1 shall be placed on providing the primary care 

2 workforce with the knowledge and skills to care 

3 for older adults and collaborating with commu4 nity partners to address gaps in health care for 

5 older adults through individual-, system-, com6 munity-, and population-level changes. 

7 ‘‘(B) PROGRAMMATIC FOCUS.—Areas of 

8 programmatic focus for a program meeting the 

9 requirements of this paragraph may include the 

10 following: 

11 ‘‘(i) Transforming clinical training en12 vironments into integrated geriatrics and 

13 primary care delivery systems to ensure 

14 trainees are well prepared to practice in 

15 and lead such systems. 

16 ‘‘(ii) Developing providers from mul17 tiple disciplines and specialties to work 

18 interprofessionally to assess and address 

19 the needs and preferences of older adults 

20 and their families and caregivers at the in21 dividual, community, and population levels. 

22 ‘‘(iii) Creating and delivering commu23 nity-based programs that will provide older 

24 adults and their families and caregivers 

25 with education and training to improve 


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1 health outcomes and the quality of care for 

2 such adults. 

3 ‘‘(iv) Providing education on Alz4 heimer’s disease and related dementias to 

5 families and caregivers of older adults, di6 rect care workers, and health professions 

7 students, faculty, and providers. 

8 ‘‘(3) DURATION.—The Secretary shall award 

9 grants under paragraph (1) for a period not to ex10 ceed 5 years. 

11 ‘‘(4) APPLICATIONS.—To be eligible to receive a 

12 grant under paragraph (1), an entity described in 

13 such paragraph shall submit to the Secretary an ap14 plication at such time, in such manner, and con15 taining such information as the Secretary may re16 quire, including the specific measures the applicant 

17 will use to demonstrate that the project is improving 

18 the quality of care provided to older adults in the 

19 applicant’s region, which may include— 

20 ‘‘(A) improvements in access to care pro21 vided by a health professional with training in 

22 geriatrics or gerontology; 

23 ‘‘(B) improvements in family caregiver ca24 pacity to care for older adults; 


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1 ‘‘(C) patient outcome data demonstrating 

2 an improvement in older adult health status or 

3 care quality; and 

4 ‘‘(D) reports on how the applicant will im5 plement specific innovations with the target au6 dience to improve older adults health status or 

7 the quality of care. 

8 ‘‘(5) PRIORITY.— 

9 ‘‘(A) IN GENERAL.—In awarding grants 

10 under paragraph (1), the Secretary— 

11 ‘‘(i) shall ensure an equitable geo12 graphic distribution of grant recipients 

13 based on State and regional aging demo14 graphics; 

15 ‘‘(ii) shall give priority to programs 

16 that demonstrate coordination with other 

17 programmatic efforts funded under this 

18 program or other public or private entities; 

19 and 

20 ‘‘(iii) may give priority to any pro21 gram that— 

22 ‘‘(I) substantially benefits rural, 

23 underserved, or Native American pop24 ulations of older adults; 


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1 ‘‘(II) integrates geriatrics and 

2 gerontology into primary care prac3 tice, especially with respect to med4 ical, dental, and psychosocial care, 

5 elder abuse, pain management, and 

6 advance care planning; 

7 ‘‘(III) offers courses to infuse 

8 core geriatric principles of care into 

9 other specialties across care settings, 

10 including practicing clinical special11 ists, health care administrators, fac12 ulty without backgrounds in geri13 atrics, students from all health profes14 sions, as approved by the Secretary, 

15 to improve knowledge and clinical 

16 skills for the care of older adults; 

17 ‘‘(IV) emphasizes integration into 

18 existing service delivery locations and 

19 care across settings, including pri20 mary care clinics, medical homes, 

21 Federally-qualified health centers, am22 bulatory care clinics, inpatient hos23 pitals, emergency care, assisted living 

24 and nursing facilities, and home- and 

25 community-based services, including 


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1 senior day care, in order to increase 

2 innovation and reduce redundancy 

3 across GWEPs; 

4 ‘‘(V) supports the training and 

5 retraining of faculty, preceptors, pri6 mary care providers, and other direct 

7 care providers to increase their knowl8 edge of geriatrics and gerontology; 

9 ‘‘(VI) emphasizes education and 

10 engagement of family caregivers on 

11 disease self-management, medication 

12 management, and stress-reduction 

13 strategies for older adults; 

14 ‘‘(VII) provides training to the 

15 health care workforce on disease self16 management, medication manage17 ment, stress-reduction strategies, and 

18 social determinants of health in older 

19 adults; or 

20 ‘‘(VIII) proposes to conduct out21 reach to communities that have a 

22 shortage of geriatric workforce profes23 sionals. 

24 ‘‘(B) SPECIAL CONSIDERATION.—In 

25 awarding grants under paragraph (1), particuVerDate Sep 11 2014 21:57 May 29, 2018 Jkt 079200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2888.IS S2888

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1 larly with respect to awarding, in fiscal year 

2 2019, any amount appropriated for such fiscal 

3 year for purposes of carrying out this sub4 section that is in excess of the amount appro5 priated for fiscal year 2018 for such purposes, 

6 the Secretary shall give special consideration to 

7 entities that operate— 

8 ‘‘(i) in communities that have a short9 age of geriatric workforce professionals; 

10 and 

11 ‘‘(ii) in States in which no entity has 

12 previously received an award under such 

13 paragraph (including under section 

14 753(a)(1) as in effect before the date of 

15 enactment of the Geriatrics Workforce Im16 provement Act). 

17 ‘‘(6) AWARD AMOUNTS.—Awards under para18 graph (1) shall be in an amount determined by the 

19 Secretary. Entities that submit applications under 

20 this subsection that describe a plan for providing 

21 geriatric education and training for home health 

22 workers and family caregivers are eligible to receive 

23 $100,000 per year more than entities that do not in24 clude a description of such a plan. 

25 ‘‘(7) REPORTING.— 


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1 ‘‘(A) REPORTS FROM ENTITIES.—Each en2 tity awarded a grant under paragraph (1) shall 

3 submit an annual report to the Secretary on the 

4 financial and programmatic performance under 

5 such grant, which may include factors such as 

6 the number of trainees, the number of profes7 sions and disciplines, the number of partner8 ships with health care delivery sites, the num9 ber of faculty and practicing professionals who 

10 participated in continuing education programs, 

11 and other factors, as the Secretary may require. 

12 ‘‘(B) REPORTS TO CONGRESS.— 

13 ‘‘(i) IN GENERAL.—Not later than 5 

14 years after the date of enactment of the 

15 Geriatrics Workforce Improvement Act, the 

16 Secretary shall submit to Congress a re17 port that provides a summary of the finan18 cial and programmatic performance of the 

19 funded grants, which may include factors 

20 such as the number trainees, the number 

21 of professions and disciplines, the number 

22 of partnerships with health care delivery 

23 sites, the number of faculty and practicing 

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1 tors that assess the impact of the program 

2 under this subsection on the health status 

3 of older adults, quality of care for older 

4 adults, and the knowledge and skills of the 

5 Nation’s health care workforce to care for 

6 older adults. 

7 ‘‘(ii) PUBLIC AVAILABILITY.—The 

8 Secretary shall make each report sub9 mitted under clause (i), and supporting 

10 data publicly available in an accessible for11 mat on the internet website of the Health 

12 Resources and Services Administration. 

13 ‘‘(8) AUTHORIZATION OF APPROPRIATIONS.— 

14 For purposes of carrying out this subsection, in ad15 dition to any other funding available for such pur16 pose, there is authorized to be appropriated 

17 $45,000,000 for each of fiscal years 2019 through 

18 2023. 

19 ‘‘(b) GERIATRIC ACADEMIC CAREER AWARDS.— 

20 ‘‘(1) ESTABLISHMENT OF PROGRAM.—The Sec21 retary shall establish a program to provide geriatric 

22 academic career awards to eligible entities applying 

23 on behalf of eligible individuals to promote the ca24 reer development of such individuals as academic 


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1 geriatricians or other academic geriatrics health pro2 fessionals. 

3 ‘‘(2) ELIGIBILITY.— 

4 ‘‘(A) ELIGIBLE ENTITY.—For purposes of 

5 this subsection, the term ‘eligible entity’ 

6 means— 

7 ‘‘(i) an entity described in paragraph 

8 (1), (3), or (4) of section 799B or section 

9 801(2); or 

10 ‘‘(ii) another accredited health profes11 sions school or graduate program approved 

12 by the Secretary. 

13 ‘‘(B) ELIGIBLE INDIVIDUAL.—For pur14 poses of this subsection, the term ‘eligible indi15 vidual’ means an individual who— 

16 ‘‘(i)(I) is board certified or board eli17 gible in internal medicine, family practice, 

18 psychiatry, or licensed dentistry, or has 

19 completed required training in a discipline 

20 and is employed in an accredited health 

21 professions school or graduate program 

22 that is approved by the Secretary; or 

23 ‘‘(II) has completed an approved fel24 lowship program in geriatrics or geron25 tology, or has completed specialty training 


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1 in geriatrics or gerontology as required by 

2 the discipline and any additional geriatrics 

3 or gerontology training as required by the 

4 Secretary; and 

5 ‘‘(ii) has a junior, nontenured, faculty 

6 appointment at an accredited health pro7 fessions school or graduate program in 

8 geriatrics or a geriatrics health profession 

9 such as psychology, pharmacy, nursing, so10 cial work, dentistry, public health, allied 

11 health, health care administration, or an12 other health discipline, as determined by 

13 the Secretary. 

14 ‘‘(3) APPLICATION REQUIREMENTS.—In order 

15 to receive an award under paragraph (1), the eligible 

16 entity shall, on behalf of eligible individuals— 

17 ‘‘(A) submit to the Secretary or a designee 

18 an application, at such time, in such manner, 

19 and containing such information as the Sec20 retary may require; 

21 ‘‘(B) provide, in such form and manner as 

22 the Secretary may require, assurances that the 

23 eligible individual on whose behalf an applica24 tion was submitted will meet the service re25 quirement described in paragraph (7); and 


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1 ‘‘(C) provide, in such form and manner as 

2 the Secretary may require, assurances that such 

3 eligible individual has a full-time faculty ap4 pointment in an accredited health professions 

5 school or graduate program and documented 

6 commitment from such school or program to 

7 spend 50 percent of the total time of such indi8 vidual on teaching and developing skills in 

9 interdisciplinary education in geriatrics. 

10 ‘‘(4) REQUIREMENTS.—In awarding grants 

11 under this subsection, the Secretary— 

12 ‘‘(A) shall give priority to eligible entities 

13 who have not received an award under sub14 section (a)(1) (including as such subsection was 

15 in effect prior to the date of enactment of the 

16 Geriatrics Workforce Improvement Act) and 

17 who establish a mentoring plan to support the 

18 integration of geriatrics education, training, 

19 and best practices into academic program cri20 teria; and 

21 ‘‘(B) shall ensure that grants are equitably 

22 distributed, including among rural or under23 served populations across the various geo24 graphical regions of the United States. 


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1 ‘‘(5) MAINTENANCE OF EFFORT.—An eligible 

2 entity receiving an award under paragraph (1) on 

3 behalf of an eligible individual shall provide assur4 ances to the Secretary that funds provided to such 

5 individual under this subsection will be used only to 

6 supplement, not to supplant, the amount of Federal, 

7 State, and local funds otherwise expended on behalf 

8 of the professional development, with respect to geri9 atrics, of such individual. 

10 ‘‘(6) AMOUNT AND DURATION.— 

11 ‘‘(A) AMOUNT.—The amount of an award 

12 under this subsection for an eligible individual 

13 for each fiscal year of such award shall be the 

14 lesser of— 

15 ‘‘(i) 50 percent of the eligible individ16 ual’s annual full-time salary for such fiscal 

17 year; or 

18 ‘‘(ii) $90,000. 

19 ‘‘(B) DURATION.—The Secretary shall 

20 make awards under paragraph (1) for a period 

21 not to exceed 5 years. 

22 ‘‘(C) PAYMENT TO INSTITUTION.—The 

23 Secretary shall make payments to institutions 

24 which include schools of medicine, osteopathic 

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1 tistry, and pharmacy, or other allied health dis2 cipline in an accredited health professions 

3 school or graduate program that is approved by 

4 the Secretary. 

5 ‘‘(7) SERVICE REQUIREMENT.—At the end of 

6 an award period, an eligible individual on whose be7 half an application was submitted and approved 

8 under paragraph (3) shall continue to teach geri9 atrics to geriatric health professionals in their fac10 ulty role, or continue to provide training in clinical 

11 geriatrics or gerontology, including the training of 

12 interdisciplinary teams of health care professionals, 

13 for a period of time that is equivalent to the dura14 tion of the award. 

15 ‘‘(8) AUTHORIZATION OF APPROPRIATIONS.— 

16 There is authorized to be appropriated $6,000,000 

17 for each of fiscal years 2019 through 2023 for pur18 poses of carrying out this subsection.’’. 

Æ 


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