Caring for an Aging America Act of 2008 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to: (1) establish a Geriatric and Gerontology Loan Repayment Program to enter into contracts with physicians, physician assistants, nurse practitioners, clinical nurse specialists, psychologists, and social workers trained in geriatrics or gerontology to pay educational loans in exchange for providing full-time clinical practice and service to older adults; and (2) establish the National Advisory Council on the Geriatric and Gerontology Loan Repayment Program.
Requires the Secretary to ensure that individuals eligible for the nurse loan repayment program include registered nurses who complete specialty training in geriatrics or gerontology and who elect to provide nursing services to older adults in home and long-term care settings.
Authorizes the Secretary to award nursing education grants and enter into contracts for programs that focus on specialty training in providing long-term care services for nursing personnel who provide services in home and long-term care settings.
Requires the Secretary to establish a Health and Long-Term Care Workforce Advisory Panel to conduct a research project to identify incentives for recruitment and retention of clinicians and providers who agree to serve vulnerable older adults in geriatric and long-term care settings.
[Congressional Bills 110th Congress]
[From the U.S. Government Printing Office]
[H.R. 6337 Introduced in House (IH)]
110th CONGRESS
2d Session
H. R. 6337
To amend the Public Health Service Act to attract and retain trained
health care professionals and direct care workers dedicated to
providing quality care to the growing population of older Americans.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 20, 2008
Ms. Kilpatrick (for herself, Mr. Cohen, and Mr. Baca) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to attract and retain trained
health care professionals and direct care workers dedicated to
providing quality care to the growing population of older Americans.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Caring for an Aging America Act of
2008''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The projected growth in the number and proportion of
older adults is unprecedented in United States history.
(2) By 2030, the population of the United States aged 65
and older will exceed 70,000,000, about twice the number of
such individuals in 2000.
(3) In the December 2007 final report titled ``From
Isolation to Integration: Recommendations to Improve Quality in
Long-Term Care'' the National Commission for Quality Long-Term
Care reported that there is abundant evidence that the health
and long-term care workforce is not equipped in skills or in
numbers to respond adequately to the aging of the United States
population.
(4) Inadequate training in geriatrics and gerontology often
results in misdiagnoses, medication errors, inappropriate
services, and a lack of care coordination, particularly in
transitions from one setting to another, that are harmful to
older patients and costly to our health and long-term care
system.
(5) Twenty-five percent of medical students report
inadequate amounts of time devoted to geriatric training, 30
percent feel unprepared to care for older adults in acute care
settings, and 42 percent say they are unprepared to care for
frail older people in nursing homes.
(6) Only 3 percent of psychologists view geriatrics as
their primary area of practice and only 28 percent of
psychologists have some graduate training in geriatrics or
gerontology.
(7) Less than 1 percent of nurses are certified
gerontological nurses and only 3 percent of advance practice
nurses specialize in aging.
(8) Only 5 percent of social workers are trained in aging
issues, yet 70 percent of licensed clinical social workers have
worked in some capacity with older adults and their families.
(9) By 2050, the United States will need three times as
many direct care workers in home, community-based, and
facility-based long-term care settings as are employed now to
meet the needs of the baby boom generation.
SEC. 3. GERIATRIC AND GERONTOLOGY LOAN REPAYMENT PROGRAM.
Part E of title VII of the Public Health Service Act (42 U.S.C. 295
et seq.) is amended by adding at the end the following:
``Subpart 3--Strengthening Recruitment and Retention for Geriatric Care
Practice
``SEC. 771. GERIATRIC AND GERONTOLOGY LOAN REPAYMENT PROGRAM.
``(a) Establishment.--The Secretary shall establish a Geriatric and
Gerontology Loan Repayment Program within the Health Resources and
Services Administration to ensure an adequate supply of physicians,
physician assistants, nurse practitioners, clinical nurse specialists,
psychologists, and social workers trained in geriatrics or gerontology
and to reduce critical workforce shortages in geriatric care practice.
``(b) Contracts.--Under the program established under subsection
(a), the Secretary shall enter into contracts with individuals
described in subsection (d) under which the individuals agree to
provide full-time clinical practice and service to older adults for a
minimum of 2 years.
``(c) Payment for Years of Service.--In consideration of the
Federal Government agreeing to pay, for each year of service under a
contract under this section, not more than $35,000 of the principal and
interest of the educational loans of the individual involved for each
of the first 2 years of service, the individual shall carry out
activities in accordance with subsection (d)(4). For subsequent years,
loan repayments of up to $40,000 per year for a third or fourth year of
service may be made available.
``(d) Eligible Individuals.--An individual described in this
subsection is an individual--
``(1) who--
``(A) is a physician, including an osteopathic
physician, who has completed specialty training in
geriatric medicine or geriatric psychiatry;
``(B) is a nurse practitioner or clinical nurse
specialist who has completed specialty training in
geriatrics or gerontology;
``(C) is a physician assistant who has completed
specialty training in geriatrics;
``(D) is a social worker who has completed
specialty training in gerontology;
``(E) is a psychologist who has completed specialty
training in gerontology; or
``(F) otherwise--
``(i) has a degree in medicine, osteopathic
medicine, clinical or counseling psychology
(doctoral degree program), social work
(master's or doctoral degree program), or who
is a certified nurse practitioner, certified
clinical nurse specialist, or physician
assistant; and
``(ii) is enrolled in, or has successfully
completed, an accredited program of specialty
training in geriatric medicine, geriatric
psychiatry, geropsychology, gerontological
social work, gerontological nursing, or
equivalent geriatric care practice (as
determined by the Secretary);
``(2) who has obtained an educational loan for costs
associated with graduate training in medicine, psychology, or
social work, or costs associated with becoming a nurse
practitioner, clinical nurse specialist, or physician
assistant;
``(3) who is appropriately licensed, without restriction
(as determined by the Secretary), in the State in which the
individual practices; and
``(4) who agrees to provide clinical services to older
adults for a period of not less than 2 years in a setting
determined appropriate by the Secretary.
``(e) Applicability of Certain Provisions.--With respect to the
National Health Service Corps Loan Repayment Program established in
subpart III of part D of title III of this Act, the provisions of such
subpart shall, except as inconsistent with this section, apply to the
program established in this section in the same manner and to the same
extent as such provisions apply to the National Health Service Corps
Loan Repayment Program.
``(f) National Advisory Council on the Geriatric and Gerontology
Loan Repayment Program.--
``(1) Establishment.--The Secretary shall establish a
National Advisory Council on the Geriatric and Gerontology Loan
Repayment Program (referred to in this section as the
`Council') that shall be composed of not to exceed 11 members
to be appointed by the Secretary.
``(2) Duties.--The Council shall consult with, advise, and
make recommendations to the Secretary with respect to the
Secretary's administration of the program established under
subsection (a).
``(3) Administrative provisions.--Members of the Council
shall be appointed for a term of 3 years and shall be
representative of the health professions, and professional
associations, that are eligible to enter into agreements under
this section.
``(g) Reports.--Not later than 2 years after the date of the
enactment of this section, and annually thereafter, the Secretary shall
prepare and submit to the appropriate committees of Congress a report
that describes--
``(1) the program established under this section (including
the number and amount of loan repayments, the number and
practice locations of the loan repayment recipients, the
demographics of the individuals participating in the program,
the default rate and actions required upon default, and to the
extent that it can be determined, the reasons for such
defaults);
``(2) how the program interacts with other Federal loan
repayment programs for primary health care professionals; and
``(3) the overall costs and benefits of the program.
``(h) Definition.--In this section:
``(1) Geriatrics.--The term `geriatrics' means the branch
of medicine that deals with the problems and diseases of older
adults and aging.
``(2) Gerontology.--The term `gerontology' means the
multidisciplinary study of the aging process and individuals as
they grow from middle age through later life. Such term
encompasses the social, psychological, biological, and economic
aspects of aging.
``(3) Specialty training.--The term `specialty training'
means coursework in geriatrics and gerontology and clinical
training, including internships or fellowships, in a geriatric
setting.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $4,000,000 for fiscal year
2009, $9,500,000 for fiscal year 2010, $16,000,000 for fiscal year
2011, $24,000,000 for fiscal year 2012, and $30,500,000 for fiscal year
2013.''.
SEC. 4. EXPANSION OF NURSING EDUCATION LOAN REPAYMENT PROGRAM.
Section 846 of the Public Health Service Act (42 U.S.C. 297n) is
amended--
(1) by redesignating subsection (i) as subsection (j); and
(2) by inserting after subsection (h), the following:
``(i) Geriatric Care Practice in Long-Term Care Settings.--
``(1) Loan repayments.--In providing for loan repayments
under this section, the Secretary shall ensure that eligible
individuals include registered nurses who complete specialty
training in geriatrics or gerontology and who elect to provide
nursing services to older adults in home and community-based or
facility-based long-term care settings, or any other program
determined appropriate by the Secretary.
``(2) Definition.--In this subsection, the term `specialty
training' means coursework in geriatrics and gerontology and
clinical training, including internships or fellowships, in a
geriatric setting.
``(3) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, $1,500,000 for
fiscal year 2009, $3,000,000 for fiscal year 2010, $5,000,000
for fiscal year 2011, $7,000,000 for fiscal year 2012, and
$8,500,000 for fiscal year 2013.''.
SEC. 5. EXPANSION OF CAREER LADDER PROGRAMS.
Section 831 of the Public Health Service Act (42 U.S.C. 296p) is
amended--
(1) in subsection (c)(1)(A)--
(A) by striking ``to promote career'' and inserting
the following: ``to--
``(i) promote career''; and
(B) by adding at the end the following:
``(ii) focus on specialty training in
providing long-term care services for nursing
personnel (including registered nurses,
licensed practical nurses, licensed vocational
nurses, certified nurse assistants, home health
aides, personal care attendants, or any other
related worker category designated by the
Secretary) who provide services in home and
community-based or facility-based long-term
care settings; and''; and
(2) in subsection (h), by adding at the end the following:
``There is authorized to be appropriated for grants under
subsection (c)(1)(A)(ii), $4,000,000 for fiscal year 2009,
$4,000,000 for each of fiscal years 2010 through 2012, and
$3,500,000 for fiscal year 2013.''.
SEC. 6. HEALTH AND LONG-TERM CARE WORKFORCE ADVISORY PANEL FOR AN AGING
AMERICA.
Subpart 3 of part E of title VII of the Public Health Service Act
(as added by section 2) is further amended by adding at the end the
following:
``SEC. 772. HEALTH AND LONG-TERM CARE WORKFORCE ADVISORY PANEL FOR AN
AGING AMERICA.
``(a) Establishment.--The Secretary, in consultation with the
Secretary of Labor, shall establish a Health and Long-Term Care
Workforce Advisory Panel (referred to in this section as the `Panel')
to--
``(1) examine workforce issues related to health and long-
term care for the aging population; and
``(2) provide advice to each such Secretary and to the
appropriate committees of Congress concerning workforce issues
related to health and long-term care for the aging population.
``(b) Membership.--The Panel shall be composed of not to exceed 20
individuals to be appointed by the Secretary.
``(c) Duties.--The Panel shall--
``(1) analyze the existing geriatric health and long-term
care workforce data infrastructure;
``(2) make recommendations for new or additional uniform
data elements across regions and States that is necessary to
track supply, demand, and workforce shortages related to health
and long-term care for the aging population;
``(3) conduct a research project to identify incentives for
recruitment and retention of new populations of clinicians and
providers who agree to serve vulnerable older adults in
geriatric and long-term care settings and make recommendations
for one or more demonstrations, including the design,
implementation, and evaluation of outcomes; and
``(4) carry out other activities determined appropriate by
the Secretary.
``(d) Focus of Research Project.--In carrying out the research
project under subsection (c)(3), the Secretary, in consultation with
the Panel, shall focus on individuals who are not otherwise eligible
for loan repayment incentives under this title or title VIII, such as
retired military clinicians or other retired health professionals,
health care professionals seeking a mid-career change, and direct care
workers in long-term care settings. To carry out such research project,
the Secretary may award grants or contracts. Eligible entities shall
include State or local government, health professions schools, academic
health centers, and other appropriate public or private non-profit
entities.
``(e) Administrative Provisions.--Members of the Panel shall be
appointed for a term of not to exceed 3 years (as determined by the
Secretary at the time of appointment), shall convene at least twice per
year, and shall be representative of diverse public and private sector
expertise and interests, including representation from the Department
of Health and Human Services (including the Health Resources and
Services Administration, the Agency for Healthcare Research and
Quality, and the Administration on Aging), the Department of Labor
(including the Bureau of Labor Statistics, the Employment and Training
Administration, and the Employment Standards Administration), other
Federal officials as the Secretary determines appropriate, academic
institutions, consumer organizations, national aging advocates, health
professional and paraprofessional associations, organized labor,
nationally-recognized researchers in the area of geriatric care and
long-term care workforce issues, health care and long-term care
associations (including those representing home and community-based and
facility-based settings), and private foundations that have sponsored
initiatives to expand health professionals to care for the aging
population.
``(f) Reports.--Not later than 2 years after the date of the
enactment of this section, and every 2 years thereafter, the Secretary,
based on the advice and recommendations of the Panel, shall submit to
the appropriate committees of Congress a report on the status of the
health professions and long-term care workforce for the aging
population.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $1,500,000 for fiscal year
2009, and such sums as may be necessary for each of the fiscal years
2010 through 2013.''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
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