,,ii  #aafth ,,congress  #ast ,session  
,s4 #bii  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,january #ca1       
#bjai,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
 education and training 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 and the
 ,geriatrics ,academic ,career ,award4  
#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       
professions schools 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 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 ,program requirements  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  7iii7
 shall give priority to applicants with 
programs or activities should           
substantially benefit rural1            
underserved1 or ,native ,american       
populations of older adults2 and  7iv7  
may give priority to any program that-- 
7,i7 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,,ii7 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,,iii7 emphasizes integration 

into existing service delivery locations
 and care across settings1 including    
primary care clinics1 medical homes1    
,federally qualified health centers1    
ambulatory care clinics1 age-friendly   
health systems1 critical access         
hospitals1 emergency care1 assisted     
living and nursing facilities1 and home-
 and community-based services1 including
 senior day care2  7,,iv7 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,v7 emphasizes education 
and engagement of family caregivers on  
disease self-management1 medication     
management1 and stress-reduction        
strategies for older adults2  7,,vi7    
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,,vii7     
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 #bjbj1 any amount        
appropriated for such fiscal year for   
purposes of carrying out this subsection
 that is in excess of the amount        
appropriated for the most recent        
previous fiscal year for which          
appropriations were made 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 subsection 7a77#a7 of this       
section 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  7,i7 ,annual report ,at the end
 of each year in which the ,secretary   

awards grants under this subsection1 the
 ,secretary shall submit to ,congress a 
report that provides a summary of the   
financial and programmatic performance  
of such 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
 adults4  7,,ii7 ,summary reports ,not  
later than #a year after the completion 
of each #e-year grant term under this   
subsection1 the ,secretary shall submit 
to ,congress a report--  7aa7 that      
provides a summary of the financial and 
programmatic performance of the funded  
grants and a summary of 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 adults2 and 
7bb7 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 and the number of       
faculty and practicing professionals who
 participated in continuing education   
program4  7ii7 ,public availability ,the
 ,secretary shall make each report      
submitted under clause 7i71 and         
supporting data1 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    
#bjbj through #bjbd4  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 an eligible 
entity1 on behalf of eligible           
individuals1 shall--  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#f72 and  7,c7 provide1 in   
such form and manner as the ,secretary  
may require1 documented commitment from 
such school or program to spend #ej     
percent of the individual's time that is
 supported by the award on teaching and 
developing skills in interprofessional  
education in geriatrics4  7#d7          
,equitable distribution ,in making      
awards under this subsection1 the       
,secretary shall ensure that awards are 
equitably distributed1 including among  
rural or underserved populations across 
the various geographical regions of the 
,united ,states4  7#e7 ,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#f7    
,service requirement ,an individual who 
receives an award under this subsection 
shall provide training in clinical      
geriatrics or gerontology1 including the
 training of interprofessional teams of 
health care professionals4 ,the         
provision of such training shall        
constitute at least #ej percent of the  
obligations of such individual under the
 award4  7#g7 ,authorization of         
appropriations ,there is authorized to  
be appropriated #f1jjj1jjj for each of  
fiscal years #bjbj through #bjbd for    
purposes of carrying out this           
subsection4  7c7 ,inapplicability       
,section #gia7;a7 shall not apply with  
respect to grants under subsection 7a7  

or awards under subsection 7b74  4