,,ii  #aaeth ,,congress  #b;d ,session  
,s4 #bhhh  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #ba1 #bjah
 ,ms4 ,collins 7for herself and ,mr4    
,casey7 introduced the following bill2  
which was read twice and referred to the
 ,committee on ,health1 ,education1     
,labor1 and ,pensions  ,a ,,bill  ,to   
amend ,title ,,vii of the ,public       
,health ,service ,act to reauthorize    
programs that support interprofessional 
geriatric education1 training1 and      
advance research to develop a           
geriatric-capable workforce1 improving  
health outcomes for a growing and       
diverse aging ,american population and  
their families1 and for other purposes4 
#a4 ,short title  ,this ,act may be     
cited as the ,geriatrics ,workforce     
,improvement ,act4  #b4 ,findings       
,congress finds the following3  7#a7 ,in
 #bjaf1 #df1jjj1jjj adults age #fe or   
older lived in the ,united ,states1 and 
this number is expected to double to    
over #ih1jjj1jjj by #bjfj4 ,three out of

 four older adults are expected to have 
multiple chronic conditions1 which      
increases the complexity of care needed 
and increases medical expenditures4     
7#b7 ,thirty percent of older adults in 
the ,united ,states1 about #ad1jjj1jjj  
individuals1 are projected to need      
specialized geriatric care by #bjcj4    
,that care will require at least #bj1jjj
 geriatricians and even more            
geriatric-trained health professionals4 
,there are nearly #a1jjj1jjj physicians 
in the ,united ,states1 less than #g1cjj
 of whom are board-certified            
geriatricians4 ,there are #c1fjj1jjj    
nurses in the ,united ,states1 of whom1 
less than #a percent are registered     
nurses certified in geriatrics and less 
than #c percent are advanced practice   
nurses certified in geriatrics4 ,there  
are similarly few professionals         
certified in geriatrics among           
professionals in social work1 pharmacy1 
psychiatry1 and the allied health       
disciplines4  7#c7 ,health professionals

 trained in geriatrics understand the   
unique health needs and complex care    
challenges associated with aging4       
,outcomes associated with               
interprofessional geriatric teams       
include improved health-related quality 
of life1 fewer emergency room visits1   
fewer hospital admissions and1 in the   
case of hospitalization1 shorter length 
of stay and lower costs per admission4  
7#d7 ,two federally funded initiatives  
have historically aimed to reduce the   
widening gap between the numbers of     
older adults and health professionals   
trained in geriatrics3 ,the ,geriatrics 
,workforce ,enhancement ,program        
7referred to in this section as ,,gwep7 
and the ,geriatrics ,academic ,career   
,award 7referred to in this section as  
,,gaca74  #c4 ,purpose ,it is the       
purpose of this ,act to develop the next
 generation of geriatric scientists and 
innovators1 improving health outcomes   
and care delivery for older adults4     
,together1 the ,geriatrics ,workforce   

,enhancement ,program and the           
,geriatrics ,academic ,career ,award    
develop a workforce capable of providing
 complex1 high-quality care that        
improves health outcomes and saves      
valuable resources by reducing          
unnecessary costs for a growing and     
diverse aging population4  #d4          
,education and training relating to     
geriatrics ,section #gec of the ,public 
,health ,service ,act 7#db ,u4,s4,c4    
#bid;c7 is amended to read as follows3  
#gec4 ,education and training relating  
to geriatrics  7a7 ,geriatrics workforce
 enhancement program  7#a7 ,in general  
,the ,secretary shall award grants under
 this subsection to entities described  
in paragraph 7#a71 7#c71 or 7#d7 of     
section #gii;,b1 section #hja7b71 or    
section #hfe7;d71 or other health       
professions1 schools1 or programs       
approved by the ,secretary1 for the     
establishment or operation of           
,geriatrics ,workforce ,enhancement     
,programs that meet the requirements of 

paragraph 7#b74  7#b7 ,requirements     
7,a7 ,in general ,a ,geriatrics         
,workforce ,enhancement ,program        
7referred to in this section as ,,gwep7 
meets the requirements of this paragraph
 if such program supports the           
development of a health care workforce  
that maximizes patient and family       
engagement and improves health outcomes 
for older adults by integrating         
geriatrics with primary care and other  
appropriate specialties4 ,special       
emphasis shall be placed on providing   
the primary care workforce with the     
knowledge and skills to care for older  
adults and collaborating with community 
partners to address gaps in health care 
for older adults through individual-1   
system-1 community-1 and                
population-level changes4  7,b7         
,programmatic focus ,areas of           
programmatic focus for a program meeting
 the requirements of this paragraph may 
include the following3  7i7             
,transforming clinical training         

environments into integrated geriatrics 
and primary care delivery systems to    
ensure trainees are well prepared to    
practice in and lead such systems4  7ii7
 ,developing providers from multiple    
disciplines and specialties to work     
interprofessionally to assess and       
address the needs and preferences of    
older adults and their families and     
caregivers at the individual1 community1
 and population levels4  7iii7 ,creating
 and delivering community-based programs
 that will provide older adults and     
their families and caregivers with      
education and training to improve health
 outcomes and the quality of care for   
such adults4  7iv7 ,providing education 
on ,alzheimer's disease and related     
dementias to families and caregivers of 
older adults1 direct care workers1 and  
health professions students1 faculty1   
and providers4  7#c7 ,duration ,the     
,secretary shall award grants under     
paragraph 7#a7 for a period not to      
exceed #e years4  7#d7 ,applications ,to

 be eligible to receive a grant under   
paragraph 7#a71 an entity described in  
such paragraph shall submit to the      
,secretary an application at such time1 
in such manner1 and containing such     
information as the ,secretary may       
require1 including the specific measures
 the applicant will use to demonstrate  
that the project is improving the       
quality of care provided to older adults
 in the applicant's region1 which may   
include--  7,a7 improvements in access  
to care provided by a health            
professional with training in geriatrics
 or gerontology2  7,b7 improvements in  
family caregiver capacity to care for   
older adults2  7,c7 patient outcome data
 demonstrating an improvement in older  
adult health status or care quality2 and
  7,d7 reports on how the applicant will
 implement specific innovations with the
 target audience to improve older adults
 health status or the quality of care4  
7#e7 ,priority  7,a7 ,in general ,in    
awarding grants under paragraph 7#a71   

the ,secretary-- 7i7 shall ensure an    
equitable geographic distribution of    
grant recipients based on ,state and    
regional aging demographics2  7ii7 shall
 give priority to programs that         
demonstrate coordination with other     
programmatic efforts funded under this  
program or other public or private      
entities2 and  7iii7 may give priority  
to any program that-- 7,i7 substantially
 benefits rural1 underserved1 or ,native
 ,american populations of older adults2 
7,,ii7 integrates geriatrics and        
gerontology into primary care practice1 
especially with respect to medical1     
dental1 and psychosocial care1 elder    
abuse1 pain management1 and advance care
 planning2  7,,iii7 offers courses to   
infuse core geriatric principles of care
 into other specialties across care     
settings1 including practicing clinical 
specialists1 health care administrators1
 faculty without backgrounds in         
geriatrics1 students from all health    
professions1 as approved by the         

,secretary1 to improve knowledge and    
clinical skills for the care of older   
adults2  7,,iv7 emphasizes integration  
into existing service delivery locations
 and care across settings1 including    
primary care clinics1 medical homes1    
,federally-qualified health centers1    
ambulatory care clinics1 inpatient      
hospitals1 emergency care1 assisted     
living and nursing facilities1 and home-
 and community-based services1 including
 senior day care1 in order to increase  
innovation and reduce redundancy across 
,g,w,e,ps2  7,v7 supports the training  
and retraining of faculty1 preceptors1  
primary care providers1 and other direct
 care providers to increase their       
knowledge of geriatrics and gerontology2
  7,,vi7 emphasizes education and       
engagement of family caregivers on      
disease self-management1 medication     
management1 and stress-reduction        
strategies for older adults2  7,,vii7   
provides training to the health care    
workforce on disease self-management1   

medication management1 stress-reduction 
strategies1 and social determinants of  
health in older adults2 or  7,,viii7    
proposes to conduct outreach to         
communities that have a shortage of     
geriatric workforce professionals4  7,b7
 ,special consideration ,in awarding    
grants under paragraph 7#a71            
particularly with respect to awarding1  
in fiscal year #bjai1 any amount        
appropriated for such fiscal year for   
purposes of carrying out this subsection
 that is in excess of the amount        
appropriated for fiscal year #bjah for  
such purposes1 the ,secretary shall give
 special consideration to entities that 
operate--  7i7 in communities that have 
a shortage of geriatric workforce       
professionals2 and  7ii7 in ,states in  
which no entity has previously received 
an award under such paragraph 7including
 under section #gec7;a77#a7 as in effect
 before the date of enactment of the    
,geriatrics ,workforce ,improvement     
,act74  7#f7 ,award amounts ,awards     

under paragraph 7#a7 shall be in an     
amount determined by the ,secretary4    
,entities that submit applications under
 this subsection that describe a plan   
for providing geriatric education and   
training for home health workers and    
family caregivers are eligible to       
receive #ajj1jjj per year more than     
entities that do not include a          
description of such a plan4  7#g7       
,reporting  7,a7 ,reports from entities 
,each entity awarded a grant under      
paragraph 7#a7 shall submit an annual   
report to the ,secretary on the         
financial and programmatic performance  
under such grant1 which may include     
factors such as the number of trainees1 
the number of professions and           
disciplines1 the number of partnerships 
with health care delivery sites1 the    
number of faculty and practicing        
professionals who participated in       
continuing education programs1 and other
 factors1 as the ,secretary may require4
  7,b7 ,reports to ,congress  7i7 ,in   

general ,not later than #e years after  
the date of enactment of the ,geriatrics
 ,workforce ,improvement ,act1 the      
,secretary shall submit to ,congress a  
report that provides a summary of the   
financial and programmatic performance  
of the funded grants1 which may include 
factors such as the number trainees1 the
 number of professions and disciplines1 
the number of partnerships with health  
care delivery sites1 the number of      
faculty and practicing professionals who
 participated in continuing education   
programs1 and other factors that assess 
the impact of the program under this    
subsection on the health status of older
 adults1 quality of care for older      
adults1 and the knowledge and skills of 
the ,nation's health care workforce to  
care for older adults4  7ii7 ,public    
availability ,the ,secretary shall make 
each report submitted under clause 7i71 
and supporting data publicly available  
in an accessible format on the internet 
website of the ,health ,resources and   

,services ,administration4  7#h7        
,authorization of appropriations ,for   
purposes of carrying out this           
subsection1 in addition to any other    
funding available for such purpose1     
there is authorized to be appropriated  
#de1jjj1jjj for each of fiscal years    
#bjai through #bjbc4  7b7 ,geriatric    
,academic ,career ,awards  7#a7         
,establishment of program ,the          
,secretary shall establish a program to 
provide geriatric academic career awards
 to eligible entities applying on behalf
 of eligible individuals to promote the 
career development of such individuals  
as academic geriatricians or other      
academic geriatrics health              
professionals4  7#b7 ,eligibility  7,a7 
,eligible entity ,for purposes of this  
subsection1 the term eligible entity    
means-- 7i7 an entity described in      
paragraph 7#a71 7#c71 or 7#d7 of section
 #gii;,b or section #hja7b72 or  7ii7   
another accredited health professions   
school or graduate program approved by  

the ,secretary4  7,b7 ,eligible         
individual ,for purposes of this        
subsection1 the term eligible individual
 means an individual who--  7i7 7,i7 is 
board certified or board eligible in    
internal medicine1 family practice1     
psychiatry1 or licensed dentistry1 or   
has completed required training in a    
discipline and is employed in an        
accredited health professions school or 
graduate program that is approved by the
 ,secretary2 or  7,,ii7 has completed an
 approved fellowship program in         
geriatrics or gerontology1 or has       
completed specialty training in         
geriatrics or gerontology as required by
 the discipline and any additional      
geriatrics or gerontology training as   
required by the ,secretary2 and  7ii7   
has a junior1 nontenured1 faculty       
appointment at an accredited health     
professions school or graduate program  
in geriatrics or a geriatrics health    
profession such as psychology1 pharmacy1
 nursing1 social work1 dentistry1 public

 health1 allied health1 health care     
administration1 or another health       
discipline1 as determined by the        
,secretary4  7#c7 ,application          
requirements ,in order to receive an    
award under paragraph 7#a71 the eligible
 entity shall1 on behalf of eligible    
individuals--  7,a7 submit to the       
,secretary or a designee an application1
 at such time1 in such manner1 and      
containing such information as the      
,secretary may require2  7,b7 provide1  
in such form and manner as the          
,secretary may require1 assurances that 
the eligible individual on whose behalf 
an application was submitted will meet  
the service requirement described in    
paragraph 7#g72 and  7,c7 provide1 in   
such form and manner as the ,secretary  
may require1 assurances that such       
eligible individual has a full-time     
faculty appointment in an accredited    
health professions school or graduate   
program and documented commitment from  
such school or program to spend #ej     

percent of the total time of such       
individual on teaching and developing   
skills in interdisciplinary education in
 geriatrics4  7#d7 ,requirements ,in    
awarding grants under this subsection1  
the ,secretary-- 7,a7 shall give        
priority to eligible entities who have  
not received an award under subsection  
7a77#a7 7including as such subsection   
was in effect prior to the date of      
enactment of the ,geriatrics ,workforce 
,improvement ,act7 and who establish a  
mentoring plan to support the           
integration of geriatrics education1    
training1 and best practices into       
academic program criteria2 and  7,b7    
shall ensure that grants are equitably  
distributed1 including among rural or   
underserved populations across the      
various geographical regions of the     
,united ,states4  7#e7 ,maintenance of  
effort ,an eligible entity receiving an 
award under paragraph 7#a7 on behalf of 
an eligible individual shall provide    
assurances to the ,secretary that funds 

provided to such individual under this  
subsection will be used only to         
supplement1 not to supplant1 the amount 
of ,federal1 ,state1 and local funds    
otherwise expended on behalf of the     
professional development1 with respect  
to geriatrics1 of such individual4  7#f7
 ,amount and duration  7,a7 ,amount ,the
 amount of an award under this          
subsection for an eligible individual   
for each fiscal year of such award shall
 be the lesser of--  7i7 #ej percent of 
the eligible individual's annual        
full-time salary for such fiscal year2  
or  7ii7 #ij1jjj4  7,b7 ,duration ,the  
,secretary shall make awards under      
paragraph 7#a7 for a period not to      
exceed #e years4  7,c7 ,payment to      
institution ,the ,secretary shall make  
payments to institutions which include  
schools of medicine1 osteopathic        
medicine1 nursing1 social work1         
psychology1 dentistry1 and pharmacy1 or 
other allied health discipline in an    
accredited health professions school or 

graduate program that is approved by the
 ,secretary4  7#g7 ,service requirement 
,at the end of an award period1 an      
eligible individual on whose behalf an  
application was submitted and approved  
under paragraph 7#c7 shall continue to  
teach geriatrics to geriatric health    
professionals in their faculty role1 or 
continue to provide training in clinical
 geriatrics or gerontology1 including   
the training of interdisciplinary teams 
of health care professionals1 for a     
period of time that is equivalent to the
 duration of the award4  7#h7           
,authorization of appropriations ,there 
is authorized to be appropriated        
#f1jjj1jjj for each of fiscal years     
#bjai through #bjbc for purposes of     
carrying out this subsection4  4