I 
111TH CONGRESS 
1ST SESSION 
H. R. 468 
To expand, train, and support all sectors of the health care workforce to 
care for the growing population of older individuals in the United States. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 13, 2009 
Ms. SCHAKOWSKY introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on Education and Labor, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisdiction of the committee concerned 
A BILL 
To expand, train, and support all sectors of the health care 
workforce to care for the growing population of older 
individuals in the United States. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Retooling the Health Care Workforce for an Aging 
America Act of 2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
TITLE I—AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT 
Subtitle A—Health Professions Education Related to Geriatrics 
Sec. 101. Geriatric education centers. 
Sec. 102. Improving geriatric training for physicians, dentists, and behavior 
and mental health professionals. 
Sec. 103. Geriatric academic career awards. 
Sec. 104. Geriatric Career Incentive Awards. 
Sec. 105. National Center for Health Workforce Analysis. 
Subtitle B—Improved Nursing Services 
Sec. 121. Comprehensive geriatric education nursing grant program. 
TITLE II—AMENDMENTS TO THE WORKFORCE INVESTMENT ACT 
OF 1998 
Sec. 201. Core services. 
Sec. 202. Individual training accounts. 
Sec. 203. Collaboration between State boards and the veterans agencies of the 
States. 
Sec. 204. Collaboration between Department of Labor and Department of Vet-
erans Affairs. 
Sec. 205. Training opportunities for direct care workers. 
TITLE III—AMENDMENTS TO THE OLDER AMERICANS ACT OF 
1965 
Sec. 301. Family caregiver training. 
Sec. 302. Redesignations in provisions for multigenerational and civic engage-
ment activities. 
Sec. 303. National Resource Center on Volunteers, Students, and Seniors. 
TITLE IV—AMENDMENTS TO THE SOCIAL SECURITY ACT 
Sec. 401. Demonstration program for personal or home care aides, nurse aides, 
and home health aides in long-term care settings. 
Sec. 402. Medicare family caregiver information and referral. 
Sec. 403. Medicaid assessment of family caregiver support needs. 
TITLE V—STUDIES AND REPORTS 
Sec. 501. Studies and reports. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) The United States will not be able to meet 
near-term demands for chronic, geriatric, and long- 
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term care without a workforce that is prepared for 
the job. 
(2) Between 2005 and 2030, it is estimated 
that the number of adults aged 65 and older will al-
most double from 37,000,000 to over 70,000,000, 
increasing from 12 percent of the population of the 
United States to almost 20 percent of the popu-
lation. 
(3) Because the overall size of the population of 
older adults in the United States will increase rap-
idly, the number of older adults in the United States 
who are disabled will soar in the coming decades. 
Between 2000 and 2040 the number of older adults 
who are disabled will more than double, increasing 
from an estimated 10,000,000 to an estimated 
21,000,000. 
(4) A 2008 report by the Institute of Medicine 
of the National Academies, entitled, ‘‘Retooling for 
an Aging America’’ concludes that the health care 
workforce will lack the capacity, in both size and 
ability, to meet the needs of older patients in the fu-
ture unless action is taken immediately. 
(5) Inadequate training in geriatrics, geron-
tology, chronic care management, and long-term 
care is known to result in misdiagnoses, medication 
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errors, and inadequate coordination of services and 
treatments that result in poor care and is costly for 
the health care system as a whole. 
(6) Currently, only 1 percent of all physicians 
(approximately 7,000) in the United States are cer-
tified geriatricians, even as the population of older 
adults is on track to double by 2030. 
(7) Inadequate amounts of time devoted to geri-
atric training are reported by 1⁄4 of graduating med-
ical students, and close to 1⁄2 of graduating medical 
students say they are unprepared to care for resi-
dents in nursing homes. 
(8) Less than 1 percent of all nurses are cer-
tified gerontological nurses. Absent any change, by 
the year 2020, the total supply of nurses in the 
United States is projected to fall 29 percent below 
requirements, resulting in a severe shortage of nurs-
ing expertise relative to the demand for care of 
medically complex, frail older adults. 
(9) Estimates suggest that there are currently 
only 700 practicing geropsychologists in the United 
States, falling far short of the current need for 
5,000 to 7,500 geropsychologists. 
(10) The Bureau of Labor Statistics of the De-
partment of Labor predicts that personal or home 
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TITLE I—AMENDMENTS TO THE 
PUBLIC HEALTH SERVICE ACT 
Subtitle A—Health Professions 
Education Related to Geriatrics 
SEC. 101. GERIATRIC EDUCATION CENTERS. 
Section 753 of the Public Health Service Act (42 
U.S.C. 294) is amended by adding at the end the fol-
lowing: 
‘‘(d) GRANTS TO EXPAND AND IMPROVE GERIATRIC 
EDUCATION CENTERS.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or contracts under this subsection to entities 
that operate a geriatric education center pursuant to 
subsection (a)(1). 
‘‘(2) APPLICATION.—To be eligible for an 
award under paragraph (1), an entity described in 
such paragraph shall submit to the Secretary an ap-
plication at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
‘‘(3) USE OF FUNDS.—Amounts awarded under 
a grant or contract under paragraph (1) shall be 
used to— 
‘‘(A) carry out the fellowship program de-
scribed in paragraph (4); and 
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‘‘(B) carry out 2 of the 3 activities de-
scribed in paragraph (5). 
‘‘(4) FELLOWSHIP PROGRAM.— 
‘‘(A) IN
GENERAL.—Pursuant to para-
graph (3), a geriatric education center that re-
ceives an award under this subsection shall use 
such funds to offer short-term intensive courses 
(referred to in this subsection as a ‘fellowship’) 
that focus on geriatrics, chronic care manage-
ment, and long-term care that provide supple-
mental training for faculty members in medical 
schools and other health professions schools 
with programs in psychology, pharmacy, nurs-
ing, social work, dentistry, public health, or 
other health disciplines, as approved by the Sec-
retary. Such a fellowship shall be open to cur-
rent faculty, and appropriately credentialed vol-
unteer faculty and practitioners, who do not 
have formal training in geriatrics, to upgrade 
their knowledge and clinical skills for the care 
of older adults and adults with functional limi-
tations and to enhance their interdisciplinary 
teaching skills. 
‘‘(B) LOCATION.—A fellowship shall be of-
fered either at the geriatric education center 
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that is sponsoring the course, in collaboration 
with other geriatric education centers, or at 
medical schools, schools of nursing, schools of 
pharmacy, schools of social work, graduate pro-
grams in psychology, or other health professions 
schools approved by the Secretary with which 
the geriatric education centers are affiliated. 
‘‘(C) CME CREDIT.—Participation in a fel-
lowship under this paragraph shall be accepted 
with respect to complying with continuing med-
ical education requirements. As a condition of 
such acceptance, the recipient shall agree to 
subsequently provide a minimum of 18 hours of 
voluntary instructional support through a geri-
atric education center that is providing clinical 
training to students or trainees in long-term 
care settings. 
‘‘(5) ADDITIONAL
REQUIRED
ACTIVITIES
DE-
SCRIBED.—Pursuant to paragraph (3), a geriatric 
education center that receives an award under this 
subsection shall use such funds to carry out 2 of the 
3 activities: 
‘‘(A) FAMILY
CAREGIVER
TRAINING.—A 
geriatric education center that receives an 
award under this subsection shall offer at least 
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2 courses each year, at no charge or nominal 
cost, to family caregivers that are designed to 
provide practical training for supporting frail 
elders and individuals with disabilities. The Sec-
retary shall require such Centers to work with 
appropriate community partners, including fam-
ily caregivers and family caregiver organiza-
tions, to develop training program content and 
to publicize the availability of training courses 
in their service areas. All family caregiver train-
ing programs shall include instruction on the 
management of psychological and behavioral as-
pects of dementia, communication techniques 
for working with individuals who have demen-
tia, and the appropriate, safe, and effective use 
of medications for older adults. 
‘‘(B) DIRECT CARE WORKING TRAINING.— 
A geriatric education center that receives an 
award under this subsection shall offer at least 
2 courses each year to certified nurse aides, 
home health aides, personal or home care aides 
and other types of direct care workers on ‘best 
practices’ for working with frail elders and indi-
viduals with disabilities, including individuals 
with dementia, urinary incontinence, and prob-
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lems with balance or mobility, and raising 
awareness of medication issues for older adults. 
‘‘(C) INCORPORATION
OF
BEST
PRAC-
TICES.—A geriatric education center that re-
ceives an award under this subsection shall de-
velop and include material on depression and 
other mental disorders common among older 
adults, medication safety issues for older adults, 
and management of the psychological and be-
havioral aspects of dementia and communica-
tion techniques with individuals who have de-
mentia in all training courses, where appro-
priate. 
‘‘(6) TARGETS.—A geriatric education center 
that receives an award under this subsection shall 
meet targets approved by the Secretary for providing 
geriatric training to a certain number of faculty or 
practitioners during the term of the grant, as well 
as other parameters established by the Secretary, in-
cluding guidelines for the content of the fellowships. 
‘‘(7) AMOUNT
OF
AWARD.—An award under 
this subsection shall be in an amount of $150,000. 
Not more than 24 geriatric education centers may 
receive an award under this subsection. 
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